Written by Pamela Leland, PhD, Executive Director
With large numbers of people moving into the “senior citizen” category, services related to where, how, and with whom we will age, have spawned a huge and growing industry.
Trying to sort out your living options can be confusing and overwhelming: Do you stay in your own home or move into a senior community? If you choose a senior living community, what type? Do you buy into a “life plan community” or choose a rental living option? And do you stay in your current neighborhood or move somewhere else, maybe even another state?
How to decide?
Despite the myriad of options, there are 3 over-arching questions that will guide (or dictate) your choices: What do I want? What do I need? What can I afford?
Identifying the questions is the easy part; answering the questions can be unexpectedly hard. And if you are part of a couple, final decisions will likely include negotiation and compromise.
A complicating factor in this decision process is the interactivity of these 3 questions. For example, I may want to move into a life plan community, but I can’t afford it. Or I may need the supportive services provided in a community living environment, but I want to stay in my own home. The first hurdle in answering these questions is acknowledging your unique situation and any existing constraints.
When talking with people about what they want as they age, I often suggest they start with the financial component. How does your financial situation expand – or limit – your options?
If money is no object, then you can focus on your wants and needs. While accepting what you need and knowing what you want may not be easily (or quickly) answered, the good news is that you have choices.
Most of us, however, will age with some financial constraints. I recently heard a statistic that if you reach age 60 without any significant health condition (e.g., heart disease, diabetes, high blood pressure, etc.) you should plan to live to be 100. This means that someone aged 60 today, needs to have the financial resources to live another 40 years. This has consequences for not only how, where and with whom we will age, but how much longer we might need to work and save money.
Housing options for seniors vary widely, from “Life Plan Communities” to federally-subsidized rental housing. And there is, of course, always the option to stay where you are or move in with a family member.
Life Plan Communities, formerly known as Continuing Care Retirement Communities (“CCRCs”), require an initial and significant capital investment – typically $300,000 to $500,000 in this area – in addition to substantial monthly fees. In exchange, you are guaranteed care through the end of your life. As with any insurance product, there are different types of contracts (monitored by state insurance commissioners) and different degrees of risk. Depending on the specific contract, your estate may or may not get any of your capital investment back upon your death.
At the other end of the affordability spectrum is federally-subsidized senior housing. These fall into two types – HUD 202 or Senior Tax-Credit projects. With both options, there are eligibility requirements and long waiting lists. If you think you might be eligible for one of these housing options, do your homework now and be prepared to wait 5 years for an available apartment.
To meet the growing demand for housing from middle-income seniors is an increasing number of independent senior apartment communities (e.g., 55+ communities). These communities vary widely, providing little to no amenities to extensive amenities, such as planned activities, athletic facilities, and meal plans. Rental fees vary by size of unit, location and the amenities that are included. Supportive services are not provided in these independent living apartment communities. Sponsoring companies, however, typically partner with home care and/or home health care agencies so that these types of services are available on-site if and when they become needed.
If it is time to begin thinking about where, how, and with whom you will age, here are some questions to explore:
- What are the benefits of living with/among other older adults in a senior community environment? Is this idea attractive to you? If not, why not?
- Would you consider alternative models of housing, e.g., living with 1 or more roommates, co-housing, communal housing?
- How do your financial resources shape your options? [Note you may need assistance from a financial advisor to answer this question.]
- Who will be your support system as you need more help and assistance? How much help could be provided by friends and/or family?
- How important is it that you remain in your current neighborhood, town, or county? If important, why?
- Do you have any health issues that will predictably require care and assistance from another person or persons in the future? How will you access care and support if and as your health declines?
- How do transportation needs impact your choices of where to live? What happens when you are no longer able to drive?
- If you would prefer to remain in your current home environment, what do you need to do to make it safe for you as you age? Do you need to make any physical modifications to your home? How will you handle all the tasks that go into maintaining your own home?
The issues and questions outlined above apply to older adults who are currently independent and able to continue to live successfully on their own. For older adults who are no longer independent, i.e., who need some assistance with the activities of daily living, there are Personal Care Homes (PCH). Personal Care Homes in Pennsylvania are all private pay, i.e., there are no public funds to subsidize the monthly rental or care fees. Some long-term care insurance products may help with PCH fees, but benefits and restrictions vary widely. And as with senior apartment communities, there are many kinds of Personal Care Homes, from the small home of 4-6 residents to the larger communities of more than 100 people.
Assisted Living and Skilled Nursing facilities are available to those who need significant medical support or assistance. Assisted Living in PA is also private pay. Skilled Nursing facilities may be private pay or subsidized, if you meet the federal eligibility requirements.
Aging has become big business; the sheer numbers of people moving into the “senior citizen” category demand this. At its core, however, aging is a very personal journey of continuing to find joy and purpose. There are no more relevant questions to this than those related to where, how, and with whom we will age.
Printed in the Daily Local News on Wednesday, August 28, 2019.