Senior-Specific Residences
As you approach your later years, you
might find that your once-comfortable home no longer affords you the convenience and security you require. You might have
concerns about your future financial and personal security or your physical or social well-being.
If you want to live independently but without all the worries of maintaining your residence, you could consider one of the
many senior-specific residences available for older adults.
The options in living arrangements available to you today are very attractive for those who are no longer wish to live
alone in the community or for those who no longer are able to manage on their own. If you anticipate that the time will
come when you no longer will be able to live in your own home safely and in good health, it is best to plan ahead.
Alone or with a family member or friend, you can visit a wide variety of alternatives, and you may well find a wonderful
option for you.
Apartment Communities Marketed to Older Adults
Some apartment developments are built and marketed specifically to appeal to
older adults who no longer care to live in a single-family home. These apartment developments often are built near
shopping and medical facilities to be more convenient for older adults. Most of these developments do not provide
assistive services, and you would have to make arrangements if you need to have services brought in. Independent Living Apartments
Like the apartments discussed above, independent living apartments are designed and marketed for older adults. But independent living
apartments offer additional services as part of their package. Many older adults who are unwilling or unable to keep up
with the demands of living on their own enjoy the security offered by independent living apartments. In these residences,
the older adult has his or her own apartment, complete with a kitchen, but also has access to services. Continuing Care Retirement Communities
A popular housing option among older adults is the continuing care retirement
community or CCRC. Religious organizations, fraternal groups and other nonprofit agencies sponsor most CCRCs. These communities provide
comprehensive residential and health care services. At the same time, they offer some distinct advantages: Most CCRCs require a one-time entrance fee and monthly payments thereafter. Fees vary from one community to another. They
depend on the type of housing and services each offers and the extent to which long-term care is covered. Other
communities operate on a rental basis, in which residents make monthly payments but do not pay an entry fee. In still
other communities, residents own instead of rent their units in arrangements similar to condominium or cooperative
ownership.
These services often include:
A 24-hour receptionist
These residences are marketed as condominiums or rentals with or without an entrance fee. Many provide federal subsidies
for older adults who meet financial need guidelines.
Security
The choice of at least one meal daily in the facility dining room
Maintenance services
A building administrator (often with a social work background) to oversee and assist
residents
Housekeeping services
A health office or clinic on site
Organized group activities, clubs and programs
Access to other assistive services including personal care.
physical and financial security
independence and access to health care
companionship of friends and neighbors of similar age
access to community facilities
privacy
As a CCRC resident, you can take advantage of a wide variety of activities and services conveniently offered within the
community. There are no restrictions on lifestyle. You can continue to travel, volunteer and enjoy life outside the
community as much as you like. The CCRC's emphasis on the individual, coupled with a supportive environment, allows
you to continue to pursue your lifelong interests.
What Services Are Included?
CCRCs provide a wide array of services tailored to each resident's needs, abilities and
preferences. Typical services and amenities include:
Nursing and other health-care services
What is a Continuing Care Contract?
Meals and special diets
Housekeeping
Scheduled transportation
Emergency help
Personal assistance
Assisted living
Recreational and educational activities
The CCRC contract is a legal agreement between you (the consumer) and a continuing care
retirement community. This agreement generally secures living accommodations and services, including health care
services, over the long term. Three common types of contracts are:
Extensive contract: This offers unlimited long-term nursing care for little or no
substantial increase in your usual monthly payments.
Modified contract: This includes a specified amount of long-term nursing care beyond
which you are responsible for payment.
Fee-for-service: You pay full daily rates for all long-term nursing care required.
When considering whether continuing care is affordable, review your present expenses, income
and assets, noting that many expenses no longer would be incurred, and compare these to what the cost would be in the
retirement communities that interest you. It is important to review health insurance coverage, especially if you are
enrolled in a Medicare managed care plan, to be sure the plan has a contract with the CCRC.
Here are some questions the CCAC suggests you ask when considering a retirement community:
Is there a waiting list? If so, how long is it?
Is a deposit required upon application? How large is the deposit? Is it refundable?
Does the community require an entrance fee and is any of it refundable?
What type of contract does it offer?
Extensive (unlimited long-term nursing care for little or no substantial increase
in your monthly payments);
What services and amenities are covered by the monthly fee?
Modified (specified amount of long-term nursing care beyond which you are
responsible for payment); or
Fee-for-service (you pay full daily rates for all long-term nursing care required).
Are the health care services and the fees charged for those services clearly
specified in the contract?
What government standards or regulations are CCRCs required to meet? Are they being
met?
How are residents kept informed of the community's financial status?
What is the community's mission? How does it fulfill it?
Is the retirement community CCAC- accredited?
What Should You Do
Before Selecting a CCRC? Assisted Living Residences
Sometimes, older persons need assistance with activities of daily living.
Activities of daily living (often referred to as ADLs), according to the federal Administration on Aging, include eating,
the ability to get around in your home, dressing, and bathing yourself. The assistance you need may not require the
round-the-clock, skilled health care a nursing home provides, yet your needs cannot be met living by yourself. Costs in assisted living residences range from less than $1,000 a month to $3,000 or more a
month, depending on the services and accommodations offered. The facility's charges will reflect the number of services to
which you have access. In addition to basic charges, there may be extra charges for some services. The cost may also vary
according to the size of the room or apartment. A Checklist of Important Questions to Help You Choose
Once you have chosen the types of facilities or services that best suit your needs and
lifestyle, narrow your search to those that meet your specific requirements. It is a good idea to visit several facilities
before making a choice. Visit more than once, and learn about the services offered. Talk with residents. Find out how much
input they have in their daily lives and the services or care they receive. Meet with the staff and volunteers, and observe
the way they interact with residents, visitors and each other.
Find out whether or not the CCRC is accredited
by CCAC. If it is not, do a thorough review of its services, operations and finances.
Consult an attorney or a financial advisor to determine if the CCRC contract is
appropriate for your lifestyle and financial situation.
Spend the night at the CCRC and fully participate in its activities for at least two
days.
Share the details of your CCRC contract with a younger person whom you love and
trust. In the event that your health declines, someone you trust should be aware of the details of your CCRC agreement.
Assisted living residences are designed to meet special personal-service and housing needs, and often health care needs as
well. Choices vary from single or double rooms to suites or apartments. Assisted living residences may be part of a
retirement community, nursing home, elderly housing, or they may stand alone. The goal of assisted living is to help you
continue living as independently as possible.
Assisted living in Wisconsin consists of three types: Residential Care Apartment Complexes, Community Based Residential
Facilities and Adult Family Homes.
Residential Care Apartment Complexes are defined
as "a place where five or more adults reside that consists of independent apartments, each of which has an individual
lockable entrance and exit, a kitchen, including a stove, and individual bathroom, sleeping, and living areas, and that
provides, to a person who resides in the place, not more than 28 hours per week of services that are supportive, personal
and nursing services."
Community-Based Residential Facilities (CBRF) is
another type of assisted living for older adults. A CBRF operates as a group home, in that each resident has his or her
own semi-private or private room, but residents receive their health services, meals, housekeeping, laundry, and
activities as part of an all-inclusive package. CBRFs are regulated by the State of Wisconsin.
These regulations are quite specific and are primarily focused on administrative management, resident rights, service
requirements and physical environment, and safety. The state permits residents to receive up to three hours per week of
nursing care in a CBRF. Residents in community-based residential facilities must be either ambulatory or self-mobile in a
wheel chair.
Adult Family Homes are the certified residences
in which care and maintenance above the level of room and board (including up to seven hours of nursing care) are provided for up to four individuals
by a person whose primary domicile is that residence.
Consumer Tips for Choosing an Assisted Living Residence
If you decide that an assisted living residence is the best option for you, visit a few
facilities. Talk to staff and residents, and keep in mind the following checklist of things to look for and questions to
ask as you make your decision.
Know what services the facility provides, and if these services are provided by the
facility's employees, or if arrangements are made with other agencies.
Financial Assistance for Assisted Living
Find out what kinds of activities and recreation are available, and how often they
are offered.
Know what the daily or monthly rate is, and what services are included in this fee.
There may be other services that are available for extra charges.
Ask about how much input you will have in your daily life and care, and how much
flexibility there is in the schedule.
Find out what choices of accommodations are offered there.
Ask if furniture and other personal items can be brought from home.
Consider the location of the facility, and if the location allows for frequent
visits from friends and family members.
Be sure you know what happens if you need additional assistance later on. Find out
if you have to move, or if the facility will be able to provide the care you need.
Check the facility for safety features, including well-lit stairs and halls,
handrails in the bathrooms, well-marked exits and a way to call for help if needed.
If applicable to you, find out if the facility accepts Medicare and Medicaid.
Find out if the state you are in requires the facility to be licensed. Ask to see
the most recent inspection report.
In most cases, the resident or family pays for the majority of assisted living services.
Here are some important points to consider when choosing a housing facility and/or community based services to best suit
your needs.
Does the housing, facility, or program (home health, etc.) offer the services you
need and want?
Is there a waiting list?
What is the payment policy?
What is included in the daily or monthly rate?
What services are available at an extra charge?
What happens if you need additional services?
What are the choices in housing or facility accommodations?
Are there activity rooms and lounge areas in the facility or housing complex for
residents to use?
If you are in a managed care plan, is the service provider part of your plan's
network?
Is the housing or facility location convenient for family and friends to visit?
Does the staff/management seem friendly, caring and accommodating to residents and
visitors?
Is the overall housing or facility well maintained, pleasing and cheerful?
Does the housing or facility have plans for expansion or renovation? If so, what
are they?
Are exits in the housing or facility clearly marked and not locked on the inside?
Do doors have alarm systems?
Does the housing or facility have an active residents' council? Does it have an
active family council?
Are special events held at the facility or housing complex?
Does the housing or facility plan special excursions for those interested in and
able to take advantage of them?
Go to Introduction
Go to Home and Community Based Services
Go to beginning of Senior-Specific Residences
Go to How to Access Services
Go to Stay Organized
Go to Making the Transition
Go to The Not-for-Profit Choice
Go to a listing of the not-for-profit facilities and services that are members of WAHSA.
Wisconsin Association of Homes and Services for the Aging
204 South Hamilton Street
Madison, WI 53703 USA
Telephone: (608)255-7060
FAX:(608)255-7064