Senior Housing Options - #70
Take QuizOutlining the different options for senior living and which option is appropriate based on the older adult.
| Type of Facility | Description | Appropriate for: |
| Life-Lease Apartment/Condo | Age 55+, similar to owning a condo with a substantial monthly fee. Usually offer housekeeping and some offer onsite scheduled personal cares for an additional fee. Purchasing and selling rules vary by management/owner. |
Older adults who will likely be able to live independently for several years (4+). Not recommended for a person with dementia living alone. |
| Independent Senior Apartment | Age 55+, some may include a community meal & housekeeping for a fee,4 may pay a home care agency for assistance with personal cares, but the 2-hour minimum visits required by most agencies can make this cost prohibitive over time. | Older adults who are downsizing from a larger home2 and/or want increased social interaction, and are capable of seeking out these activities on their own. Not recommended for a person with dementia living alone. |
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Senior Apartment with Onsite Services **Some states offer optional certifications for these home care programs, providing additional rules and minimal oversight (e.g. Residential Care Apartment Complex in Wisconsin). |
Individual senior apartments that offer fee-for-service assistance with scheduled personal cares and medication reminders, and may offer 0-3 meals per day and housekeeping. Some settings offer pre-determined levels of care based on current care needs while others offer a-la-cart fee-for-services to be added as care needs increase. These may advertise as assisted living, but they do not provide a CBRF level of care. | Best for older adults with scheduled care needs. These settings sometimes bridge the gap when a resident cannot afford a CBRF and is on a waiting list for state funding. Not recommended for a person with dementia, living alone, or with unscheduled care needs (e.g. falls, dementia, medication management, incontinence, wandering). |
| Adult Family Home (AFH) | Private residence where 1-4 older adults reside with a non-family caregiver and receive care, treatment and services beyond the level of room and board. May include up to 7 hours per week of nursing care per person (rules vary by state). Nursing services can vary.4 | Older adults who prefer a home-like environment and have a few unscheduled personal care needs; often a good fit for individuals with persistent mental health challenges or frail elders.4 |
| Community Based Residential Facility (CBRF) | Provide room and board, 24/7 supervision, personal cares, meals, housekeeping, laundry and some nursing oversight (varies by facility). Commonly called Assisted Living Facility (ALF).4 |
Older adults with unscheduled personal care needs; often a good fit for those with dementia, as “memory care” units are common.4 |
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Skilled Nursing Facility (SNF) **Funded by Medicaid in most states, if the resident qualifies financially. |
Provides 24/7 skilled nursing care, personal cares and services 4 along with housekeeping, laundry, meals, social services, dietitians and access to onsite skilled PT, OT and ST. | Older adults needing skilled nursing care, often in addition to needing assistance with personal cares or managing dementia and/or having unscheduled care needs.4 |
| Continuing Care Retirement Community (CCRC) with: • Senior apartments • CBRF • SNF |
A multi-building complex with senior apartments, a community based residential facility (CBRF) and a skilled nursing facility on the same site. Most senior apartments offer additional services for a fee. | Partners/spouses who need differing levels of care2 now or in the future, or any older adult seeking a smooth transition between care levels. |
Older adults who may require, or are considering, relocating to a higher level of care.
Recommend appropriate and least restrictive level of care options for an older adult.
- In 2012, there were an estimated 15,700 nursing homes, and 22,200 residential care communities in the United States. 3
- 2 percent of people aged 50 and over, and 9 percent of people aged 50 and over who have one or more disabilities live in group settings, such as adult family homes, community based residential facilities and skilled nursing facilities.1
- At age 80, the percent of people who live in group settings increases to 8.3 percent.1
- By 2050, the number of older adults residing in nursing facilities, other types of senior housing or receiving home care services will likely increase from 15 million to 27 million.3
Science Principles
Describe the different types of senior housing options and associated levels of care/services they offer, and provide examples of when a higher level of care might be appropriate.
Geriatric Topics
ACGME Compentencies
Science Principles
- Baker K, Baldwin P, Donahue K, Flynn A, Herbert C, La Jeunesse E,Will A. Housing america's older adults - meeting the needs of an aging population. Available at: http://www.jchs.harvard.edu/sites/jchs.harvard.edu/files/jchs-housing_americas_older_adults_2014.pdf. Accessed 6/5/2017.
- Carrol J, Honn Quall S. Moving into senior housing: adapting the old, embracing the new. Generations, Journal of the American Society on Aging. Available at: http://www.asaging.org/blog/moving-senior-housing-adapting-old-embracing-new. Accessed 5/7/2017.
- Harris-Kojetin L, Sengupta M, Park-Lee E, Valverde R. Long-term care services in the United States: 2013 overview. National Center for Health Statistics. Vital Health Stat 3(37)2013.
- Senior Housing 101: Senior Care Types Explained. Retrieved May 05, 2017, available at: http://www.aplaceformom.com/senior-care-resources/articles/senior-housing-options. Accessed 5/5/2017.
- Toot S, Swinson T, Devine M, Challis D, Orrell M. Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis. Int Psychogeriatr . Available at: https://www.ncbi.nlm.nih.gov/pubmed/27806743