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.

Medicare.gov 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 (www.nia.nih.gov) 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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