13 Sep After reading chapter?6,?in no less than 275 words, reflect?upon?what trends you think are likely to affect assisted living in the future? You can also complete this in point form. P

CHAPTER SEVEN: SENIOR HOUSING

CHAPTER HIGHLIGHTS

Why the growing need for senior housing?

· Growing number of elderly

· Growing need for alternative housing options

What is “Senior Housing”?

A variety of options:

· Age-restricted housing – home ownership or rental opportunities for adults 55 years of age and older, or sometimes 62 years and older.

· Reverse mortgage – a means of borrowing money from the amount the home is worth beyond any mortgage debt.

· Age-restricted retirement communities – senior communities like any other neighborhoods or communities except restricted to people usually 55 or over or 62 and over. It often involves purchase of property or condominiums.

· Senior Apartments – is multiunit rental housing for older adults who are able to care for themselves.

· Cohousing – a type of collaborative housing in which residents participate in the design and operation of their own neighborhoods.

· Independent Living – residential living setting that may or may not provide hospitality or supportive services. In this living arrangement, the senior requires minimal or no extra assistance, and leads an independent lifestyle filled with recreational, educational and social activities amongst other seniors

· Congregate Housing – a form of independent living that usually provides convenience or supportive services like meals, housekeeping, and transportation in addition to rental housing.

· Continuing Care Retirement Community (CCRC) – a community which provides a continuum of care, offering several levels of assistance, usually including independent living, assisted living and nursing home care commonly all on one campus or site.

· Life Care Community – a form of CCRC that offers an insurance type contract and provides all levels of care. It often includes payment for acute care and physician's visits.

Philosophy of Care

The various forms of senior housing are designed to give seniors the services and assistance they need, while seeking to optimize their independence.

Services Provided

· Age-Restricted Communities:

· Provide the least amount of services of the various options.

· Some may also provide different kinds of services to the people who live there including meals, transportation, social activities and other programs.

· Independent Living – offer a variety of living arrangements, including:

· studio apartments,

· one-, two-, or three-bedroom apartments,

· cottages,

· townhouses,

· duplexes,

· cluster homes,

· single-family homes

· Congregate Housing – usually provides the same basic services as most senior retirement apartment complexes:

· Shared meals

· Fulltime staff on duty 24 hours a day to assist residents

· Housekeeping

· Areas within the building for socializing with other residents

· Secure building

· Planned recreational and social activities

Beyond these basic services, congregate housing may have the following options, often for an extra fee:

· Laundry service

· Transportation for shopping and doctors' appointments

· Health monitoring

· Help with taking medications

· Continuing Care Retirement Communities – offer a broad range of service and housing packages that allow access to independent living, assisted living, and skilled nursing facilities.

Ownership

· Age-Restricted Communities – a mix of for-profit ownership and publicly-owned.

· Independent Living – market rate, for-profit independent living communities comprise the vast majority of the independent living sector.

· CCRCs – While many CCRCs are for-profit, nonprofit organizations sponsor many of them.

Consumers Served

· Age-Restricted Retirement Communities – are apt to be younger than in some of the other options, in part because 55+ communities define “senior” a bit younger than others.

· Senior Apartments – are likely to have moved to those units to preserve their assets by selling their homes that they may no longer need and cannot care for.

· Independent Living – largely widowed, white females in their mid-80s. Most have annual household incomes ranging from $25,000 to $75,000 and a total net worth ranging from $100,000 to $500,000.

· CCRCs – seniors who enter into a CCRC contract while they are healthy and active, knowing they will be able to stay in the same community and receive nursing care should this become necessary.

Accreditation

· Most senior housing is not accredited as are some other forms of long-term care. The exception is continuing care retirement communities (CCRCs). They are accredited by the Continuing Care Accreditation Commission (CCAC).

Financing

· Age-Restricted Housing – varies from expensive high-end communities to government-subsidized senior villages.

· Independent Living – mostly private pay with rents depending on services provided.

· Congregate Housing – most facilities have a rental contract or agreement but many do not require a long-term financial commitment.

· Continuing Care Retirement Communities – the most expensive long-term-care solution available to seniors. CCRC residents sign a binding, lifelong contract at the beginning of their residency.

Staffing

· Staffed somewhat similar to non-senior housing options, they are much like the hospitality industry (hotels, apartment complexes, etc.).

Management

· Managers of senior housing range from for-profit owner/operators to hired administrators. There is no requirement that they be licensed or otherwise credentialed (again with the exception of nursing facility and assisted living components of CCRCs).

Significant Trends and Their Impact

· Desire for More Options – today’s seniors seek (and demand) housing options that meet their needs and also are attractive, desirable places to live.

· Quality of Life – seniors also want the quality of their life to not only decline when they move into senior housing, but to improve.

· High Occupancy Rates – demand for senior housing is at a record high with occupancy levels running at over 90 percent throughout most of the country.

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• CHAPTER SIX: ASSISTED LIVING
• CHAPTER HIGHLIGHTS
• What is assisted living?
• How Assisted Living Developed
• Philosophy of Care
• Maximizing dignity, autonomy, independence, privacy, and choice
• Providing a homelike environment
• Accommodating residents' changing care needs and preferences
• Minimizing the need to move when a resident's care needs increase
• Involving families and the community
• Ownership of Assisted Living Facilities
• Services Provided
• 24-hour supervision;
• Three meals a day plus snacks
• Personal Care Services
• Health Care Services
• Social Services
• Supervision of Persons with Cognitive Disabilities
• Social and Religious Activities
• Exercise and Educational Activities
• Arrangements for Transportation
• Laundry and Linen Service
• Housekeeping and Maintenance
• Consumers Served
• Where they come from:
• Where they go:
• Market Forces
• Seeking Care Alternatives – potential residents looking for alternatives to nursing facilities
• Impact on Children – loss of nuclear family impacting care of elderly family members
• Cost-Cutting Efforts – payers are looking for less costly alternatives.
• Regulations
• Regulations affecting residents – there is concern about following the nursing facility model too closely.
• Other regulations – similar to nursing facility regulations.
• Accreditation
• Financing Assisted Living
• Costs/Charges – vary widely depending on services provided:
• Reimbursement:
• Private pay – use of an individual's own funds – remains the largest source of reimbursement for assisted living.
• Medicare does not cover it, although in some cases, there is some coverage under Social Security Supplemental Income (SSI).
• Staffing/Human Resource Issues
• Nature of the Workforce:
• Fewer nurses and other clinical staff
• Customer Service Focus
• Staffing Regulations:
• Training:
• Legal/Ethical Issues
• Autonomy and Decision-Making – need to balance the residents’ desire to be independent with the facility's responsibility to protect them from harm.
• Aging in Place – problem with providing all of the services needed or desired.
• Management of Assisted Living
• Where ALF administrators come from:
• Management Qualifications:
• Management Challenges & Opportunities:
• Developing an Organizational Identity – not nursing care.
• Interacting with Residents – ALF administrators are much more personally involved with the residents than they would be in other types of long-term care.
• Significant Trends and Their Impact on Assisted Living
• Movement Toward Agreement – , the field of assisted living has begun to take on more coherence and stability.
• Increased Regulation – regulation is growing, but still inconsistent and not uniform.
• Growth in Coverage by Managed Care and Government – public payers are seeing assisted living as a lower cost alternative to nursing facility care.
• Integration with Other Providers – most providers will find that they can provide better services and prosper financially by joining with other types and levels of long-term care providers in integrated systems.

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