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. 

These services often include:

• A 24-hour receptionist
  
• 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.
  

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:

• physical and financial security
  
• independence and access to health care
  
• companionship of friends and neighbors of similar age
  
• access to community facilities
  
• privacy

What Distinguishes Continuing Care from Other Housing Options?

Continuing care retirement communities offer an innovative and independent lifestyle for single and married older adults. This type of community is different from other housing and care options for older people because it offers a long-term contract that provides for housing, services and nursing care, usually all in one location. The CCRC continues to meet your needs in a familiar setting as you grow older.

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
  
• Meals and special diets
  
• Housekeeping
  
• Scheduled transportation
  
• Emergency help
  
• Personal assistance
  
• Assisted living
  
• Recreational and educational activities

• 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.

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.

Is Continuing Care Affordable?

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.

What Quality Standards Do Communities Meet?

Quality assurance in retirement communities is the primary purpose of the Continuing Care Accreditation Commission (CCAC) sponsored by the American Association of Homes and Services for the Aging. CCAC is the nation's only accreditation program for CCRCs. The commission accredits communities meeting strict criteria in the areas of finance, governance and administration, resident life and health care. When evaluating a retirement community, look for the CCAC seal of excellence or ask one important question: Is this CCRC accredited?

How Should You Choose a Retirement Community?

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);
  
• 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).
  
• What services and amenities are covered by the monthly fee?
  
• 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?

• 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

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.

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.
  
• 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.
  

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.

In most cases, the resident or family pays for the majority of assisted living services.

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.

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.