Thinking Ahead: Deciding Where to Live After Retirement
As we approach our senior years, deciding where to live is a major question. It's best to start thinking about it early. While we can't predict all the health and mobility challenges we might encounter as we enter our 70s, 80s and beyond, we can create a plan that allows for flexibility as our needs change.
The first step is to consider your own preferences and realities.
What is your financial situation? What kind of a retirement lifestyle do you envision? What is your current health status? Do you at present have any health conditions that are likely to reduce your mobility or vision or cognitive abilities? How much care and assistance do you think you'll need? (See the checklist at the bottom of this article to help you envision your future needs.)
The second step is to consider the many senior living options available today. These include …
Staying in your own home. This is the preference of a majority of people—more than 90 percent, according to the AARP. Staying in a long-time home offers many advantages, especially if your home is comfortable and housekeeping and maintenance are not a problem. At home, you have continued access to familiar services, friends and other established connections. Thinking ahead, would your home still be a good fit if you were to become ill or disabled? What home modifications and support services could adapt it to your needs?
Moving to a more appropriate home. Many seniors choose to "downsize" to a smaller house, condo or apartment. One-level living also is a popular choice, as climbing stairs may prove increasingly difficult for people with arthritis and other mobility challenges. Some retirees choose to move closer to children and grandchildren. Others look for a new neighborhood that offers improved access to shopping, medical services and public transportation. (See "Online Buzz: Elder-Friendly Communities Are Lacking" in this issue of Caring Right at Home to learn more about features that support active aging.)
Retirement living communities. These offer independent senior living in apartments, townhouses or detached homes. While their design emphasizes accessibility, they serve seniors who are generally in good health and are able to live without personal care or health assistance. Some offer housekeeping, dining, transportation and an activities program.
Continuing care retirement communities (CCRCs). These are essentially retirement communities with an important added element: They are structured to provide a full range of care—from independent living to assisted living to skilled nursing care—all in one complex or on one campus. CCRCs may require a long-term contract with a large initial payment when a resident moves in, and a monthly fee.
Assisted living. Assisted living communities are built with senior accessibility in mind. The arrangement combines some features offered by an independent living retirement community—privacy, independence, a home-like setting and certain support services—with some of the services that a nursing facility can offer, such as help with personal care needs and some healthcare services. Assisted living facilities are regulated on the state level, and services and features vary widely.
Sharing a home. Some elders choose to live with their adult children or other relatives, in their own home or in the home of the other person. Although this senior living arrangement became less common with the advent of Social Security and other senior support services, studies show that multigenerational living is on the increase these days. Indeed, a recent Caring Right at Home poll showed that almost half of the respondents were living in a home with two or three generations that included a senior. Non-family "home sharing" arrangements also are becoming more popular; your local senior services agency may offer a matching service if you would like to live with one or more other people.
Skilled nursing facilities and other supportive living. More nursing homes today focus on short-term rehabilitation with the goal of returning patients to their homes. But nursing homes also continue to provide extended care for frail or chronically ill people who require a higher level of skilled nursing care and supervision.
The Support of In-Home Care
You'll notice that in-home care isn't listed as an alternative to the above living options. This is because this type of assistance can take place almost anywhere! In-home care supports the well-being and independence of seniors who are living in their own home, or in a home they share with other family members, or in a retirement community or assisted living facility—wherever a senior calls home.
Skilled nursing care from nurses and other medical professionals can be provided in the home for patients who need hands-on medical treatment and supervision. At a far lower cost, nonmedical in-home support care helps seniors who need a little extra help staying safe and comfortable. Services are tailored to the person’s needs and might include:
- Assistance with hygiene and grooming, such as dressing, bathing, shaving, hair styling and oral care.
- Housekeeping, laundry and other household tasks.
- Meal preparation and planning.
- Medication reminders.
- Assistance with exercise and other prescribed activities.
- Companionship and mental stimulation.
- Safety supervision.
In-home care services can be provided on an hourly basis a few hours per week, or full-time.
The best retirement housing option depends on each senior's individual combination of needs and preferences. While there is a tendency to resist thinking about our own aging, considering this question ahead of time will make the choice seem less overwhelming. It’s time to make a plan!
Do you have the support you would need to live on your own? Have you overlooked needs that might arise as you plan for your senior years? Here is an easy-to-use worksheet for figuring out those areas in which you need—or may in the future need—some help.
The Eldercare Locator offers a free, online booklet to help seniors sort through the many housing options and make a decision about a particular senior living community.
For information on topics related to home care and healthcare, visit our Home Care and Healthcare Advocacy group on LinkedIn.