Look At Options

Home and Community Care
Subsidized Senior Housing (Non-Medical)
Assisted Living (Non-Medical Senior Housing)
Board and Care Homes
Summary of Options

In most communities, people who cannot live independently may choose from a variety of living arrangements that offer different levels of care. Before deciding on a care setting, talk to a doctor or maybe a social worker about your care needs. Most people want to stay in their home for as long as possible. However, if you are considering staying at home, make sure you know the amount of responsibility and work involved. If you cannot live independently, but don't want to live in a nursing home, you may want to consider some of the alternatives listed below.

Home and Community Care
A person who is ill or disabled may be able to get help from a variety of home services that might make moving into a nursing home unnecessary. Home services include Meals on Wheels programs, friendly visiting and shopper services, and adult day care. These programs are found in most communities.

If you are considering home care, discuss this option with family members to learn if they are able to help provide your care or help arrange for other care providers to come to your home. Some nursing homes may provide respite care and admit a person in need of care for a shot period of time to give the home care givers a break.

Depending on the case, Medicare, private insurance, and Medicaid may pay some home care costs that are related to medical care.

Subsidized Senior Housing (Non-Medical)
There are Federal and State programs that help pay for housing for older people with low to moderate incomes. Some of these subsidized facilities offer assistance to residents who need help with certain tasks, such as shopping and laundry. Residents generally live independently in an apartment within the senior housing complex.

Assisted Living (Non-Medical Senior Housing)
If you only need help with a small number of tasks, such as cooking and laundry, or reminders to take medications, assisted living facilities may be an option worth considering. "Assisted living" is a general term for living arrangements in which some services are available to residents who still live independently within the assisted living complex. In most cases, assisted living residents pay a regular monthly rent, and then pay additional fees for the services that they require.

Board and Care Homes
Board and Care homes are group living arrangements designed to meet the needs of people who cannot live independently, but do not require nursing home services. These homes offer a wider range of services than independent living options. Most provide help with some of the activities of daily living, including eating, walking, bathing, and toileting. In some cases, private long-term care insurance and medical assistance programs will help pay for this type of living arrangement. Keep in mind that many of these homes do not get payment from Medicare or Medicaid and are not strictly monitored.

Continuing Care Retirement Communities (CCRSs)
CCRCs are housing communities that provide different levels of care based on the residents' needs from independent living apartments to skilled nursing care in an affiliated nursing home. Residents move from one setting to another based on their needs, but continue to remain a part of their CCRC community. Be sure to check the record of the CCRC's nursing home. Your CCRC contract usually will require you to use it. Many CCRCs require a large payment prior to admission and also charge monthly fees. For this reason, many CCRCs may be too expensive for older people with modest incomes.

Summary of Options
The options discussed in this chapter may work for people who require less than skilled care, or who require skilled care for only brief periods of time. Many people with long-term skilled care needs require a level and amount of care that cannot be easily handled outside of a nursing home.

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