Senior Living: What Are Your Options?

Whether you are looking for an assisted care facility, a skilled nursing home, or an active adult community, here is some valuable information and advice.

The graying of America is evident here in Tucson, where many seniors come to escape the colder climes. Our city has myriad choices available for those looking for active adult communities, assisted living facilities or full-on nursing homes. We offer an overview of these senior living options.

Active Adult Communities

It was estimated that by this year, a full 25 percent of the residents of Arizona would be over 60 years of age, according to the U.S. census. In addition to migration from other states, our local population is aging, as well. Many baby boomers finally are reaching retirement age, referred to by some as a “Silver Tsunami.”

Those seniors who live an athletic lifestyle and want to continue in that vein might choose one of the many active retirement communities. These are akin to miniature cities, replete with resort-style amenities, fine dining, and sports options ranging from golf to bocce ball, pickleball courts, tennis, swimming, and fitness classes designed to accommodate all ranges of mobility. Other pluses can include nearby shopping, and transportation to events and medical appointments.

Housing options in these communities vary in cost, depending on the size the residence. For those looking to downsize, smaller active retirement apartments or mobile home parks are available, but one thing many have in common is age restrictions, so no worries of children and teens in residence.

There also are communities where you have a residence, but also have the ability to transition to assisted living, memory care, rehabilitation, and Medicare-certified skilled nursing.

Assisted Living Residences

These accommodations, also called residential care facilities, are not an alternative to skilled nursing care, but provide an intermediate level of long-term care and safety.

Two of the top reasons seniors may choose an assisted living facility is because they need some help with the activities of daily living, such as getting in and out of a bath or shower, or that they fear falling. The Centers for Disease Control and Prevention cites falling as the leading cause of fatal and non-fatal injuries in those over age 65. Assisted living facilities can help reduce that risk by encouraging their residents to exercise and improve their balance. Being physically active, staying connected to friends — or making new ones — and developing new interests all contribute to successful aging.

Many residents liken Assisted Living to having their own apartment, with their own furniture and as much independence as they choose, with help available if and when they need it. Most have a monthly fee that includes their apartment with a private bathroom, a kitchenette, housekeeping, laundry facilities, a communal dining room, planned activities, exercise classes, and a shuttle to doctor or specialist appointments. Three meals a day are served in the dining room, or residents can have their meals delivered to their rooms. Assistance with bathing and getting dressed, as well as help with prescription medications, can be arranged for an additional cost.

Some facilities are authorized or certified to participate in Medicaid, and those will have an employee who can help figure out the financial portion. (If people choose to apply for Medicaid assistance, they will have to use up all of their own money first before they can start benefiting from the program. There are stringent rules in place that prevent people from “gaming the system,” so be sure to get advice from your certified financial planner or accountant before going that route.)

Many Assisted Living facilities also have a “memory care” wing, or option, where those who are able-bodied but suffering from dementia or Alzheimer’s can have supervision 24 hours a day.

Nursing Homes

Nursing homes, also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus on medical care more than most assisted living facilities. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, also are available.

Some people stay at a nursing home for a short time after being in the hospital. After they recover, they go home. However, most nursing home residents live there permanently because they have ongoing physical or mental conditions that require constant care and supervision. offers a service called Nursing Home Compare, which allows you to find and compare nursing homes certified by Medicare and Medicaid. The service covers more than 15,000 nursing homes around the country.

The National Institute on Aging ( offers the following advice when beginning your search for a nursing home.

Consider what you want. What is important to you — nursing care, meals, physical therapy, a religious connection, hospice care, or special care units for dementia patients? Do you want a place close to family and friends so they can easily visit?

Talk to friends and family. Talk with friends, relatives, social workers, and religious groups to find out what places they suggest. Check with healthcare providers about which nursing homes they feel provide good care.

Call different nursing homes. Get in touch with each place on your list. Ask questions about how many people live there and what it costs. Find out about waiting lists.

Visit the facility. Make plans to meet with the director and the nursing director. The Medicare Nursing Home Checklist has some good ideas to consider when visiting. For example, look for:

• Medicare and Medicaid certification

• Handicap access

• Residents who look well cared for

• Warm interaction between staff and residents

Ask questions during your visit. Don’t be afraid to ask questions. For example, ask the staff to explain any strong odors. Bad smells might indicate a problem; good ones might hide a problem. You might want to find out how long the director and heads of nursing, food, and social services departments have worked at the nursing home. If key members of the staff change often, that could mean there’s something wrong.

Visit the facility again. Make a second visit without calling ahead. Try another day of the week or time of day so you will meet other staff members and see different activities. Stop by at mealtime. Is the dining room attractive and clean? Does the food look tempting?

Carefully read your contract. Once you select a nursing home, carefully read the contract. Question the director or assistant director about anything you don’t understand. Ask a good friend or family member to read over the contract before you sign it.

The Centers for Medicare and Medicaid Services requires each State to inspect any nursing home that gets money from the government. Homes that don’t pass inspection are not certified. Ask to see the current inspection report and certification of any nursing home you are considering.

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Home is Where the Art Is

By Romi Carrell Wittman / Photography by Alexandra Yarborough

This modern home is the perfect fit for the Eltze family of five, and also serves as a showroom/studio for the homeowner’s art.

On the northwest side, one residence also functions as a showroom for the homeowners.

Artist Tanja Eltze’s stunning modern home can be found surrounded by nature on the northern edge of Oro Valley. She and her husband Jens chose this 1.25-acre lot for its beautiful rock outcroppings, and easy access to hiking and biking trails that the family uses frequently.

Originally from Germany, the couple and their three daughters lived in the Dallas area for many years before relocating to Tucson in 2012. Tanja saw this as an opportunity to create a home that better reflected the family’s personal tastes and lifestyle.

Those tastes were first shaped in the southwest area of Stuttgart. As a result of being quite a bit younger than her siblings, Tanja was taken by her parents to art museums early and frequently. “They were done with the kid stuff,” she jokes. But she credits their frequent visits to the Staatsgallery or the Design Center Stuttgart with her lifelong appreciation of art, architecture and design.

It later turned out that Stuttgart also would be the place of her first exhibition, a photography show in collaboration with her former employer Hugo Boss.

Moving to Tucson and into the Sonoran Desert that they already knew and loved from prior trips, Tanja and her husband sought a home that featured clean modern lines and was full of light, with sweeping views that blurred the distinction between indoor and outdoor spaces. At the same time, it was imperative the home be multifunctional, accommodating not only their family of five, but also Tanja’s art practice. The couple turned to local architect Kevin B. Howard to help them realize their vision.

Desert living requires a certain mindset. Not only does one have to contend with the intense heat of the summer months, but a respect for native vegetation and wildlife is essential. This is something Howard, an Arizona native, has demonstrated in his work, which can be found in several Arizona communities, as well as Park City, Utah, and San Diego, California, among other places.

The end result is a gorgeous, 3,000-square-foot, five-bedroom home with large windows just about everywhere. Thanks to the orientation of the windows, they allow a lot of light into the home, while limiting summer heat gain.

“We wanted a house large enough for our family as well as occasional guests, but we didn’t want something that required too much land or energy usage,” Eltze notes. This is in keeping with her past work educating elementary schoolchildren in the Frisco, Texas, school district about the environment, and the importance of living in more eco-friendly ways.

Polished concrete floors with exposed aggregate, a Venetian plaster wall, and stark white spaces accentuate pieces of abstract art, all by Eltze, creating a dramatic, yet accessible space.

Her dining room doubles as a showroom for her many clients. “I meet here with art collectors and interior designers to show them my work in a living environment,” she says. She adds that it gives people an opportunity to see how large-scale art can look in a home. There is another benefit, as well. “I love the fact that I get to live in a home where art changes over time,” she says. “As pieces leave for exhibition or are sold, new pieces are created.”

Her work is focused mainly on large-scale abstract paintings on canvas, but she also works on paper or wood, specifically for a series that incorporates natural elements of the Sonoran Desert. She says she finds inspiration not only in modern architecture and design, but also in the many patterns of nature. She admits, though, that she wondered how she would ever get work done in her studio. “The view is so beautiful,” Eltze enthuses. “I worried that I wouldn’t be able to focus on my work!”

That didn’t prove to be the case, and her business is thriving. Her process is a little different than other artists because she involves the client at every stage. “I talk with them to learn about their need, interior design style and other preferences,” she says. “Next is ‘art speed-dating.’”

This phase, she says, involves showing the client several of her 100-plus technique samples to get a sense of what strikes a chord with them, and to find middle ground when partners who live together have different views on art. “With so many samples to look at, there are always some that both of the partners are drawn to,” Eltze adds. Next comes a proposal for the commissioned piece, or pieces, which takes not only the technique into account, but also the ideal dimensions and colors for the space. “I try to get a feel for the space and also determine what I think the space needs,” Eltze explains. This could be a splash of color to enliven a space, sophisticated neutrals or real gold leaf when an upscale, elegant room is the goal. Once the goal is agreed upon the piece is created. Finally, the client meets with Eltze in her showroom for feedback. “This step is essential,” she says, “because the artistic process of creating, evaluating and adjusting doesn’t allow you to predict 100 percent how the piece will look in the end.” To mitigate that risk for her clients, she offers to work with them until they love the piece without reservation.

Eltze works with interior designers and design professionals, business owners, and private art collectors or homeowners. Her creations — and a look inside her extraordinary studio/home — can be found at

Source: Kevin B. Howard Architects,

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