Thursday, August 11, 2016

Senior housing: How much will it cost?

"Aging is not lost youth but a new stage of opportunity and strength." --- Betty Friedan, American writer, feminist, activist. Author of "The Feminine Mystique." (1921-2006)

Senior housing definitions:
Independent Living: Communities for independent seniors that offer the conveniences of on-site recreation plus educational and social opportunities.

Assisted Living: Residential housing, assistance in daily activities, and some healthcare.

Continuing Care: Provide a continuum of care in one location from private units to assisted living and skilled nursing care
Skilled nursing care: Care in a hospital-like setting. Nursing, physical therapy, occupational therapy, and speech therapy are considered skilled care by Medicare.

Alzheimer’s Care or Memory Care: Fosters residents' individual skills and interests in an environment that helps to diminish confusion and agitation in a secure environment.

Adult day Care: Day-time care including meals in an organized setting with activities and services meant to promote well-being.

Adult family homes: Licensed residential homes with up to six residents. Services include room, board, laundry and necessary supervision along with help with daily living. 

As we age, most of us expect to remain in our homes and hope to be there until the end. The reality is that according to national surveys, 70 percent of us over age 65 will likely need some kind of long-term care and will die in a hospital.

At the start, those care services may be provided at home with drop-in help for bathing and meal preparation. As aging progresses, most of us will likely move to some sort of senior housing – independent living, assisted living, memory care or an adult family home.

Unless you are very low-income, you or your family will be paying for all or some of those services. Those costs can range up to more than $90,000 a year for skilled nursing services in a hospital-like setting following a stroke or other debilitating health challenge.

Finding senior services for a loved one and investigating housing options and costs can feel overwhelming for families.
The good news is that help is available, says Staci Levison,  a supervisor with a community services agency in my area of SW Washington state. Advisors there can help families get started with research and connect them with the best combination of local senior services. The service is free.

But there are challenges, in finding the right care at the right cost. In the Portland-Vancouver, Wash. area market (as in most other locations around the country) the demand for senior housing in certain categories is out-stripping supply. That means monthly rents and rates are increasing.

Low-income senior housing is in particular short supply.  “The reality is that the more income you have the better your chances are of finding senior housing,” Levison said. But with the help of community services specialists, families can get started on tailoring local support resources with the individual senior’s needs. These specialists know what questions families need to ask and what local services are available.

As with most housing searches, availability and cost are big factors for families.

What are those basic costs?

According to Washington Community Living Connections, the cost of one year of in-home senior assistance services can be as low as $20,000 a yea in the Portland, Ore. area. That is for three hours a day for bathing assistance, meal preparation and light housework.

On the other end of the scale, a year of skilled nursing care in a semi-private private room in Washington state will likely cost $93,000 a year, according Community Connections.

Such costs will drain away the assets of a senior, leaving them dependent on Medicaid and Social Security income.


Online, reports that there are 52 certified assisted living facilities in the Vancouver area with basic monthly rates starting at $1,993 a month. Monthly rates for the 19 Alzheimer’s care facilities in the Vancouver area range start at $1995 to $2995.

In all there are at least eight categories of adult care. Among those are adult family homes that are licensed residential units with up to six beds. Services in adult family homes include room, board, laundry and necessary supervision along with help with daily living. In the five-county Southwest Washington area there are 300 adult family homes, Levison said.

Monthly rates for these facilities can range from a low of about $2,500 a month for a private room with basic services to as much as $5,500 to $6,000 a month for hospice-level care, said Victoria Kovtun, owner of Harmony Senior  Homes in Vancouver, Wash.

“There is a lot of need in the community for low-income family home care, but unfortunately (for cost reasons) it is difficult for operators to accommodate more than two per facility,” she said. “Many homes won’t take low-income clients.”

Senior Housing outlook

Demand for senior housing is growing as baby boomers age into their 70s.
“Back in the 1970s, many seniors ended up in nursing homes in a hospital bed,” said Levison. “That’s changed. Now an array of services can be combined to allow people to age in place. In addition, there are more alternative housing options and more support for family care givers.”

As with all life’s challenges, she encourages families to plan ahead. Here are here recommended first steps:

-Take stock of the personal situation of your senior.
-Assess the needed level of care.
-Look at the current financial picture and what might change.
-Work with a senior living advisor in your area to find solutions to the challenges your family might face.

Those advisors also are available through private services such as A Place for Mom, Assisted Living Locators, Adult Living Solutions.

Along with costs and services, family may also be considering location of the care facility, said Monika Gartner, Portland-area owner of Care Service Options. “Location to and from work is very important for a family member who is employed and wants to check in with a loved one to or from work." she said.

In their book, "What You Really Need to Know for the Second Half of Your Life," the staff at Vancouver, (Wash.) law firm, Phelan Webber & Associates, points out that a socially active life style is beneficial at all stages of aging.

Depending on the personality and care needs of a loved one, families may be able to arrange in-home companionship through Meals on Wheels, drop-in care services and families visits.

When the time comes, even though an elderly person may resist a move to a care facility, a good transition to a group home or assisted living facility may lower stress levels for everyone and provided that needed socialization for the senior, the Phelan experts say.

At the point where such a move is necessary, an assessment is required from a nurse to determine the patient's level of care needs. The level of care will then dictate the needed level of services in a care facility. That translates into how much it will cost.

Eldercare locator: click here.
HUD information for senior citizens, click here.
Long-term care choices from Medicare, click here.

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