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Nicole McDermott | Apr 7, 2022
As we age, our living needs and other circumstances change. For many older adults, a supportive community and fewer responsibilities at home—be it yardwork, cleaning or any other necessary upkeep—can help improve safety, quality of life and peace of mind. That peace of mind extends to family members as well who can feel confident their loved one is receiving a safe balance of independence, care and assistance. But how do you know which option is right for you?
Read on to learn more about the different types of retirement communities and important factors to consider before packing any bags.
Before exploring the ins and outs of communities designed for older adults, let’s talk terminology. For starters, “retirement home” is no longer the term industry professionals use or prefer. “Most people use ‘retirement community’ now to get away from the stigma of the facilities of the past,” says Kelly O’Connor, a certified senior advisor, dementia practitioner and editor of the CSA Journal.
Another common term you’ll hear is “assisted living,” says Patrick Simasko, an elder law attorney and financial advisor at Simasko Law in Mount Clemens, Michigan. Simasko believes “independent living” is a more accurate descriptor in many cases since a good portion of the senior living options detailed below allow residents to live independently with some staff support, from shoveling snow and making meals to helping manage medication schedules and offering assistance with activities of daily living (ADLs) like getting dressed.
The idea is to reinforce the importance of autonomy in retirement communities. “It’s not a matter of giving up independence, but rather leaning on a professional community to help co-manage day-to-day living needs,” says Rebecca S. Boxer, M.D., a geriatrician at Kaiser Permanente in Colorado and medical director of clinical trials with Kaiser Permanente Institute for Health Research.
While there are several types of retirement communities, age restrictions—such as 55+ and 62+—separate senior housing options from other apartments and condominiums not designed specifically for older adults.
Types of Retirement Communities
One way to differentiate types of retirement communities, according to Simasko, is whether residents require memory care, a specialized type of care for older adults with memory loss due to dementia, Alzheimer’s disease or other cognitive impairments. “These facilities must have additional restrictions and licensing requirements for health, fire safety and more,” he says.
Meanwhile, other types of independent or assisted living communities don’t need the same amount of clinical oversight in order to keep residents safe. “They may monitor the door with cameras, or they may have a secretary or receptionist at the front door to see who comes and goes,” says Simasko. “But there are no restrictions on residents leaving.”
With that distinction in mind, let’s explore some of the most common community housing options for older adults.
55+ Communities
This type of housing typically offers the most independence. Often, residents who move into these communities live fairly active lifestyles and are looking to gain more convenience and amenities compared to living in a traditional single family home. “Apartment buildings and planned communities for 55+-year-old residents, often called active adult communities, don’t provide any type of care onsite,” says O’Connor. “Residents, however, can hire independent care agencies to provide care if they need a little extra support.”Independent Living Communities
In this type of housing—typically offered in one large building or facility—independent residents enjoy full amenities, including a meal plan or on-site restaurant, says O’Connor. This option is best for people who don’t need frequent medical care but are looking to downsize—perhaps to cut costs and scale back on upkeep—and take advantage of planned social events and dining options.Continuing Care Retirement Communities
Continuing care retirement communities (CCRCs) offer a range of care, from independent living to skilled nursing, either in one building or spread out on a campus, says O’Connor. She explains that despite being a relatively costly option, CCRCs that offer a Life Plan contract—or upfront fees that cover future medical costs—provide additional long-term reassurance. “The benefit of CCRCs is the security residents have in knowing they have a home for life no matter where their care needs take them.”Memory Care
This type of secured housing is for older adults with significant cognitive impairment. This option may be best for those who are navigating the mid-to-late stages of Alzheimer’s disease or dementia, with staff available 24/7 to aid residents with transportation, housekeeping, laundry and other important ADLs.“Memory care can physically keep residents from leaving, which makes them safer,” says Simasko. In fact, research suggests residents in memory care assisted living have a lower risk of hospitalization and skilled nursing facility admission compared to those in general assisted living facilities[1]. Memory care communities usually have specialized training for staff and services specifically designed for individuals with dementia and other cognitive impairments.
Depending on the extent of a resident’s health care needs, O’Connor says memory support services can be provided in two secured settings: assisted living and skilled nursing.
Assisted Living Communities
This option is for older adults who need physical care, medication administration support, transportation to and from doctor appointments and/or additional forms of support. “While independent living has meals, transportation, housekeeping and life enrichment activities, it doesn’t offer medication assistance or personal care services,” says O’Connor. “An assisted living community has a nurse on staff to oversee the care staff and work with a resident’s private physician to coordinate their care needs.”Many states have another type of assisted living community in residential homes, which serve a small number of residents (often in the range of six to 12). These communities are typically regulated like their larger assisted living counterparts.
Skilled Nursing Facilities
Skilled nursing facilities (SNFs) offer care to older adults with significant medical needs who require professional medical care to treat, manage or observe certain conditions. “It’s the only type of senior living that is licensed as a true medical facility,” says O’Connor. “Residents at other places can receive medical care in their apartments or suites, but it’s delivered by an outside resource.”What to Look for in a Retirement Community
Ultimately, your decision should come down to the factors that allow you or a loved one to live as independently as possible while maintaining health and safety.The level of urgency may also play a part in your immediate decision, but remember that you can take your time to find the right fit down the line. “If there are immediate care or safety needs that have to be met, then immediate placement in a facility is appropriate,” says Dr. Boxer. “It is always possible to find a new facility and switch later if need be.”
When vetting retirement communities, consider the following factors before making a final decision:
Location. Your ideal location may come down to cost, safety, conveniences, preferences and proximity to the people who matter most to you. “Living in a facility near friends and family makes it easier to visit, stay connected to your surroundings and otherwise interact with your community,” says Dr. Boxer. By staying local, loved ones can stop by more easily—a benefit that she says is important for continued mental health and well-being.
Cost. “A main topic of discussion is always cost, especially as aging adults tend to have a strict budget,” says Dr. Boxer. For families with more limited resources, it may be best to find a community that accepts Medicaid or other financial assistance. “Family members should also look into an extra veterans benefit if their loved one was a wartime veteran,” says Simasko. “World War II-, Korea-, and Vietnam-era veterans—or their surviving spouses—are entitled to a VA benefit to help pay for care in certain circumstances.”
Staff. Introduce yourself to staff members to gauge friendliness, and then observe how they interact with and treat current residents. “There are many big companies that have good reputations overall, but when it comes down to it, the skill and the tenure of local staff is the most important factor,” says O’Connor.
Accommodations. After checking out what the rooms look like, find out whether residents need to share a room or a suite with a roommate—an option some people prefer when it comes to companionship and reduced cost. Additionally, many retirement communities allow pets. “If there is a loved pet that will make the transition successful, it is important to inquire,” says Dr. Boxer.
You’ll also want to closely examine each facility’s dining options, activities and socialization opportunities.
Level of care needs for other residents. Before signing on the dotted line, check with the community’s administrators to determine whether you or your loved one have a similar scope of needs as the other residents in the community—and what level of support the community can provide if needs increase over time. “If you go to an assisted living facility and the majority of residents are much more physically and/or cognitively impaired than you are, it won’t be a good fit,” says Dr. Boxer.
How to Decide if a Retirement Community Is Right for You
Before deciding if a retirement community is a good fit for you or a family member, O’Connor says to:Ask plenty of questions.
Visit the community at different times of the day to observe the activities available and meet other residents.
Eat a meal there to get a feel for the quality of the food.
Read online consumer reviews and state regulator reports.
In addition to meeting with one of the community’s salespeople, meet with the executive director and the life enrichment director to get to know them.
“It can be difficult to know if a facility is the right choice until having lived there for a while,” says Dr. Boxer. Remember: If a retirement community is not the best fit, it’s OK to keep looking.