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Your Ultimate Guide to Senior Living Communities

What's independent living? Is a CCRC right for me? How do I know if I need skilled nursing care? Our guide answers all of your questions surrounding Senior Living Communities.

The right senior living community can provide a sense of purpose and belonging to those who choose to live there. But how can you ensure that you are making the right decision? 

The decision process starts with a full and complete understanding of the types of senior living communities that are available to you. Our guide will help you with that, and more!

Table of Contents

Chapters

Read the full guide below! Or you can also fill out the form for a downloadable PDF version of the guide you can reference later.

Your-Ultimate-Guide-to-Senior-Living-Communities

Chapter

What is a Senior Living Community?

Beginning to consider a move to a senior living community may seem daunting considering all of the different options available in the industry. When you take away all of the jargon surrounding senior living communities, it is easy to categorize the different types of senior living. For the most part, there are four types of senior living communities:

Independent Living

Independent living is exactly like it sounds. There is a common misconception that a senior living community is a place only for adults nearing the end of their lives, but this is simply not the case. Most independent living accommodations are just like living in a regular neighborhood, but only with people around your age. Most independent living communities have a minimum age restriction you must meet, which can range from 55-62. This ensures that you won’t end up living next door to a 25-year-old bachelor who loves to throw parties. Instead, you will be surrounded by others in the same stage of their lives as you. Independent living usually offers a host of maintenance-free options that fit a wide variety of preferences and budgets.

Although each community is different, they often include the opportunity to choose from dining plans, monthly service plans, fitness plans and more.

Independent living in senior living communities can come in a wide range of styles.

Apartments

Most senior living communities offer maintenance-free apartment living. You are able to choose a floor plan and apartment building with all of the amenities you desire. Apartments range in size, so you don’t have to give up your guest room if you don’t want to. Many senior living apartments include separate storage areas to accommodate holiday decorations or other items that are not frequently accessed.

One benefit of apartment living is the opportunity to engage with the community through a wide variety of resident-directed clubs and social and cultural opportunities in shared spaces throughout the apartment building.

Cottages 

Most of the time, cottages are stand-alone buildings set up as a duplex. In this senior living community set up, you still get the feeling of living in a house without all of the maintenance that comes with being a homeowner. Cottages are a great option for those looking to downsize, as they are typically a smaller space than a traditional home. Many times, cottages will include an attached garage, personal off-street parking, and a small yard.

Some cottage-style communities do not have communal spaces, while others may have a community building which offers space for a wide variety of activities. The only difference is instead of going down the hall like you can in an apartment building, you have to go outside to access any shared space the community may offer. 

Individual Homes

Many senior living communities offer the option of an individual home. In this situation, you may either rent or own an entire house, usually with 1-3 bedrooms. Typically, senior living communities that offer individual homes are designed with the needs of aging residents in mind, allowing them to age in place. This is an appealing option for those looking to keep their independence and privacy while living in a community without children or young adults, or those who want to ensure they have options for their needs to be met in the event of declining health.

Independent senior living communities often have a larger variety of amenities and services than your average neighborhood and tend to be located a reasonable distance from shopping centers, restaurants, churches, recreational areas, and medical centers.

Affordable Senior Housing

Many senior living communities offer affordable senior housing options. These housing options are based on an individual’s income and have minimum and maximum income limits established by the government. These income guidelines are established based on Area Median Income (AMI). For example, a senior living community may serve seniors who fall below 50 to 80 percent of the AMI. From there, the cost of rent is determined based on a predetermined percentage of the person’s gross income.

Generally, affordable senior housing options are in the form of apartments. While the apartment styles vary, you can typically expect an affordable senior housing unit to be in some sort of complex. Although affordable senior housing is often limited to apartment style living, you can still expect a wide variety of amenities to be available to you. Designed to support your desires and decisions, affordable senior housing communities provide freedom, privacy and security for people ages 55+ or 62 and older.

Personal Care and Assisted Living

As a resident’s care needs increase from what is available in independent living, personal care and assisted living represent the next level in care and services. Both personal care and assisted living are designed to support residents and their individual needs. The services provided by personal care and assisted living vary from person to person, as plans are customized based on the needs of the resident. In personal care and assisted living, you can expect that you or your loved one’s needs will be met as those needs change.

Personal care and assisted living settings range from rooms to studios to one and two bedroom apartments with kitchens. These private residences usually have secured surroundings and staff on hand. A new type of personal care and assisted living communities that are being seen more and more is the small house concept. The goal of the small house concept is to provide the perfect balance with ample opportunities for privacy, social activities and support. In this type of assisted living, a group of residents live together with shared common spaces. Each individual has a private living suite along with the option of joining the other house members in the living room, dining room, etc.

Continuing Care Retirement Communities (CCRCs)

CCRCs, also referred to as Life Plan Communities, are senior living communities that usually encompass all of the aforementioned senior living styles, and more. CCRCs are designed to help you age in place, allowing those who live in a CCRC to have peace of mind knowing they will not have to move far due to potential future health problems.

Most CCRCs are built on a campus and may include independent living, affordable senior housing, personal care or assisted living, skilled nursing and rehabilitation, memory support, adult day services, respite care, at-home services, and end of life and comfort care. By offering all of these services in one community, residents are able to stay at one place as their needs may grow. There are many other benefits to moving to a CCRC, too, like opportunities to engage in life-enriching activities, and a rewarding environment for seniors who strive to keep their minds and bodies in shape. CCRCs are able to go from supporting your vibrant, independent life to caring for you on your last days, when the time comes.

Chapter

What are the Types of Care/Services Provided by Senior Living Communities?

Personal Care and Assisted Living

According to the Pennsylvania Department of Human Services, Personal Care Homes are “residences that provide shelter, meals, supervision and assistance with personal care tasks, typically for older people… who are unable to care for themselves but do not need nursing home or medical care.” You can expect a senior living community that has personal care to provide you or your senior loved one help with daily tasks like taking medications, bathing, dressing and helping them to eat well. On top of daily necessities, personal care communities help residents stay engaged and involved in activities around the campus and with their peers. Staff at personal care communities are also able to assist residents with things like scheduling and attending doctor’s appointments, including physical, occupational and speech therapy.

Many people become confused as to what the difference is between personal care and assisted living. The main difference in Pennsylvania between personal care and assisted living today lies in legislation that was introduced a number of years ago that separated the two terms and gave each one their own defined parameters and licensing.

Assisted living still provides similar care to what someone would receive with personal care, but it also can care for people who require more intensive medical attention for a longer duration.

Personal care can not provide long-term acute medical care, where a person receives active treatment for a severe injury or illness or a chronic medical condition. Because of this, assisted living was created to bridge the services gap. Because the legislation is still relatively new, you will likely find far more personal care than assisted living communities, although this may vary from state to state.

Skilled Nursing and Rehabilitation

Skilled nursing and rehabilitation care can be a smooth experience from planned surgeries to accidents requiring surgery and professional care.

Skilled nursing provides patients with the most comprehensive care you can attain outside of a hospital. Patients in a skilled nursing community may receive short- and long-term care for various types of rehabilitation, whether it be recovering from an injury or specialized care for ongoing health concerns.

Skilled Nursing and Rehabilitation communities provide a full range of rehabilitation services, respite services, recuperative care, hospice and end-of-life care, secure memory support care, as well as short and long term care. The goal is to help patients retain their quality of life and dignity at all times by working to make the most of every day in a warm and caring environment.

The staff at a skilled nursing community provide round-the-clock care to ensure that the needs of the patient are met at any time, day or night. You can expect the staff at a skilled nursing community to offer additional assistance with daily activities to help keep patients as active and engaged as possible. As with all levels in the continuum of care, licensed nursing staff works closely with residents and their families, as well as the rest of their team, to ensure each individual’s needs are met and that services are adjusted as those needs change.

Most skilled nursing communities feature specialized spaces for individuals who may have Alzheimer's or dementia, Parkinson's disease, or respiratory diseases, among others.

Some skilled nursing and rehabilitation services you could expect to see at a skilled nursing senior living community include:

  • Private or Semi-Private Rooms
  • Long-Term Skilled Nursing Care
  • Point of Care Resident Information System
  • Social Work
  • Hospice and End-of-Life Care
  • Respite Care
  • Recuperative Care
  • Inpatient and Outpatient Rehabilitation
  • Physical Therapy to restore function for individuals who have experienced neuromuscular or skeletal dysfunction
  • Occupational Therapy to assist individuals with adaptation to their social and physical environment
  • Speech Therapy to address communication and swallowing dysfunction
  • Activities and Social Events (organized by an activities director or staff member)
  • Chaplain Services (for all residents and families)
  • Chapel or Meditation Room

In addition, senior living communities are embracing technology to further enhance the lives of the people they serve. The Point of Care resident information system, a real-time computer information system, enables licensed nursing staff as well as nursing assistants to access resident care needs and assignment information. These systems are being utilized more and more frequently in senior living communities. This enables staff to complete documentation at the time the observation and care occur. Nursing assistants are now charting as they care for residents, instead of waiting until the end of their shift and trying to remember what happened throughout the day.

Memory Support

Most memory support services at senior living communities provide skilled nursing, personal care, and therapy to those with Alzheimer’s Disease and other forms of memory impairment.

The goal of memory care is to allow residents, staff and family to thrive in an environment that is supportive, calm and secure. Memory support services positively approach Alzheimer’s and dementia care and create customized plans that provide the necessary level of care in a structured and nurturing environment. A good memory support center in a senior living community will place the utmost importance on the physical, mental and emotional well-being of the residents they serve. In a specialized memory support unit in a senior living community, staff are trained and educated in all aspects of dementia care. You can expect the program to provide daily, specialized programs and activities, personalized care focused on the individual and spacious rooms for entertainment, activities and crafts.

Adult Day Services

Adult Day Services can be great resources for caregivers, but many people aren’t aware of the benefits they can provide. For many caregivers, balancing your personal responsibilities and caring for your loved one can be incredibly stressful, and you may need a break every once in a while. That’s where adult day services come in.

How Adult Day Services Can Help

Usually, Adult Day Services are planned programs for older adults in a community-based group setting that lasts for all or part of the day. Like assisted living, Adult Day Services can have a comprehensive range of services to meet the needs of older adults. Instead of having the senior live in the community, Adult Day Services start and end at a specific time each day, and it is up to the caregiver to resume care for their loved one in between. This can be very beneficial for caregivers who still have to go to work each day, or who need a short break from the demanding responsibilities of caregiving.

You may feel guilty about leaving your loved one at an adult day center, but in reality, it could be the best move for both of you. Adult Day Services can give you the peace of mind that comes with knowing your loved one is safe and secure, while seniors enjoy the social interaction and attention from staff. There are plenty of services provided at most adult day centers that your loved one may benefit from.

Services may include:

  • Nursing care
  • Individual treatment plans
  • Caregiver support groups
  • Educational seminars
  • Transportation
  • Assistance with eating, taking medicines, using the bathroom, bathing and walking
  • Counseling
  • Exercise programs
  • Preparation of meals and snacks
  • Social activities (crafts, field trips, games, etc.)
  • Therapy (occupational, physical, speech, etc.)

There are currently around 5,700 Adult Day Centers in the U.S. Each state provides different regulations, so it’s important to research your options and choose an Adult Day Service provider you can trust. According to the National Adult Day Services Association (NADSA), there are generally three main types of adult day centers:

  1. Social: These types of adult day centers focus on providing seniors with social interaction and activities and offer some health-related services.
  2. Medical: These centers still provide social activities, but also offer more intensive health and therapeutic services.
  3. Specialized: Specialized centers provide services only for specific care recipients, such as those with dementia or developmental disabilities.

Who Benefits from Adult Day Services?

Adult Day Services may be the right choice for you if:

  • You’re a caregiver in need of a short break.
  • You work during the day and can’t provide your loved one with daily supervision.
  • Your loved one has Alzheimer’s or another form of memory impairment.
  • Your loved one is making the transition from hospital to home and is in need of follow-up care.

Improving the quality of life for both caregivers and seniors is the core of all Adult Day Service programs. They strive to provide older adults with supportive care in order to help them remain independent and in their homes.

If a senior’s health deteriorates, and the stress of caring for a loved one increases, Adult Day Services can supplement a caregiver’s normal routine to provide a needed break. Whether you’re in need of a few hours, or a whole day, Adult Day Services can help you balance work and other personal obligations with caregiving duties.

Caregivers may also enjoy the peace of mind that comes with knowing their loved one is cared for in a supervised and safe environment, amongst caring and supportive staff.

Respite Care

Simply said, respite care is a solution that provides short-term relief for caregivers. This service gives caregivers peace of mind knowing that their senior loved one is in safe hands while they have the chance to recharge to continue providing the best care for their loved one. These arrangements can range from a few hours to several days or weeks. Respite care environments vary from each senior living community, but for the most part, they can be provided at home, on a senior living community campus, or at an adult day center.

For the most part, respite services are charged by the number of days services are provided with additional charges for any medications administered. Typically, insurance does not cover the costs of respite care, which is something to consider before choosing to take advantage of the service. Medicare will cover most of the cost of up to 5 consecutive days of respite care in a skilled nursing facility for someone receiving hospice care. Medicaid also may offer assistance.

At-Home Services

At-home services are just as they sound. These services allow seniors to remain in their home even when they may start needing help with day to day tasks. At-home services are provided in their current home, whether they live on a senior living community’s campus or not. It is common to see at-home services assist in activities such as:

  • morning or evening routines
  • holiday and birthday event planning
  • shopping
  • caregiver support services
  • homemaker services that are non-medical
  • companion care
  • transportation to appointments
  • medication
  • routine pet care and pet appointments
  • concierge services
  • personal errands
  • supportive care
  • airport drop off and pick up
  • personal laundry and ironing

The at-home services at each senior living community vary, so it is important to find out what specific services they offer to ensure that you or your senior loved one will receive the adequate assistance they need.

End-of-Life and Comfort Care

When your loved one reaches the end of their life, it is a hard time for family and friends alike. Senior living communities know this and provide end-of-life and comfort care for that reason. Sometimes referred to as hospice care, the goal of this type of care is to comfort terminally ill patients both physically and emotionally and provide any kind of spiritual support services they need. End-of-life and comfort care is also there to support the families of patients. The goal of most senior living communities who offer end-of-life and comfort care is to prevent people from feeling alone when they are approaching the end of their lives.

You can expect the staff and volunteers to provide emotional support and peaceful surroundings while providing end-of-life comfort to residents and their family and friends. Staff receives ongoing training in pain management and in ways to help people cope with the emotions surrounding the end of life.

Chapter

Floor Plans and Amenities

Studio

Description: A studio apartment is the smallest offering that one will find when looking at a senior living community. Studios do not have a separate bedroom and are just one large space. They usually range from 300 to 600 square feet. Studios usually feature a kitchenette which would allow one to prepare small meals. Most studios will have common household appliances such as a refrigerator, stove, microwave and dishwasher. Where studio offerings differ from other apartment offerings is in the laundry situation. Some studios will come with a washer and dryer, usually only in the stackable option, although that is not typical. For studio apartments that do not have an in-unit washer and dryer, there are usually laundry services on the same floor. Most of these services are free of charge, and you can still do it yourself or utilize a housekeeping service if it is available.

Who is this for?: Given that this is the smallest apartment offering you can find, this is ideal for a single person occupancy. This is the entry-level option, meaning the price is the most affordable choice. Studio apartments are much more popular and common in city and urban environments. If you desire that type of setting or come from a similar background, a studio may be a great fit for you. In contrast, this may not be the ideal choice for someone who comes from a rural setting and has a lot of personal belongings to bring with them.

One Bedroom Apartments

Description: A one bedroom apartment is just like it sounds: an apartment with only one designated bedroom. Many people may think of a one bedroom apartment as small, however, many one bedroom options also come with designated dens which can provide for extra workspace, leisure space, or storage space. One bedroom apartments usually range anywhere from 500 to 900 square feet, but you may find some locations over 1,000 square feet. One bedroom apartments come with full kitchens and, like the studio, may or may not have laundry options in the apartment. Also, like the studio, if there is not an in-unit washer and dryer set, there are usually laundry facilities available on the same floor.

Who is this for?: Though single occupants usually occupy one-bedroom apartments, this is the first size that appeals to couples who are interested in downsizing and don’t feel they need a ton of space. Many senior living communities do not have studio apartment options, so a one bedroom apartment may be their smallest and most affordable option. One bedroom apartments are many times the most popular choice in senior living communities given the affordability if the resident is not in need of a lot of space. One bedroom apartments are also the most utilized when someone may want to transfer from a larger unit on the campus, so demand is usually very high for these options.

Two Bedroom Apartments

Description: The two bedroom apartment option is typically the largest apartment option one will find when searching for apartments in a senior living community. They vary from approximately 700 to 1,400 square feet. Generally, two bedroom apartments will have either a bath and a half or two bathrooms. Also, some units may come with additional room space such as a den or study, although it is not common. You should expect a full kitchen and laundry within the unit. Though rare, some two bedroom apartments will not have a washer and dryer set in the unit.

Who is this for?: Two bedroom apartments in a senior living community are great for both singles and couples. The allure of apartment-style living rather than a cottage or villa is the ease of convenience of on-site campus offerings such as dining, fitness centers, activity rooms, etc. These amenities are often attached to the apartment building, which makes it especially nice during inclement weather, so there is no need to face the elements to take advantage of the services that are provided to you. Of all apartment-style living options, a two bedroom apartment requires the least amount of downsizing.

Miscellaneous: Apartments usually have additional locked storage areas that are available for residents to use. Depending on the senior living community, this may be a free amenity or may be available for an additional fee. These extra storage spaces are great for storing seasonal decorations, gardening and outdoor supplies, and anything else you don't use on a frequent basis. Some of the newer senior living apartment complexes have reserved underground parking to keep your vehicle safe and dry. For the adult child looking for their loved one, apartments are very desirable given that the apartment lifestyle often offers everything under one roof. You can also have peace of mind knowing your loved one is residing in a secure building with on-site call systems in case of any kind of emergency.

Summary of Apartment-Style Living

Pros: affordability, convenience, location

Cons: size, storage space (no personal garage)

Cottages/Villas

Description: In recent years, the trend in senior living accommodations has been predominantly apartments and high rise condos. Although this is a very popular option, there is still a vibrant market for those looking for more space. Cottage or villa retirement living is the perfect happy medium for those who still want space and privacy, while having all of the amenities of a senior living community. You are likely to see a broad range in square footage in these types of floor plans. Cottages and villas can usually range anywhere from 800 square feet to 3,000 square feet. It is common for cottages and villas to come with a garage, either attached or detached. Garages are usually big enough to house a single car, and many come climate controlled and may even have enough extra space for a golf cart. Cottages and villas generally have a den, 2 or 3 bedrooms and 1 to 2 bathrooms. Every senior living community varies, but cottage and villa style homes will either be standalone or set up as a duplex. An open floor plan with a kitchen island is becoming more popular versus the traditional floor plan that hosts a separate dining room. Cottages and villas usually provide outdoor space for more hobbies than an apartment would allow. In most senior living communities, residents of cottages and villas are able to plant their own garden and have a personal section of lawn. Cottages are usually more customizable than apartments as well, given the additional space. Some residents will even take the additional space provided by the garage and convert it into a spare den, a personal workshop or even a gym.

Who is this for?: Cottage and villa style homes typically attract couples over singles. This option is also very appealing for someone coming from a larger home looking to downsize without losing all sense of space and privacy. Sometimes people feel that apartment-style living can be "too maintenance free." Cottage and villa style homes give the ability to maintain independence regarding home personalization and maintenance. While most senior living communities offer services for any maintenance you might need, including lawn care, cottage and villa style living may provide the option to do these things yourself, if you prefer. When someone lives in a cottage or villa, there is said to be an associated feeling of youth, as their position on a senior living community's campus might require them to walk further to get to community activities. Many say they prefer having this extra distance because it allows them to get more exercise than they would if they lived in an apartment building. In addition to all the previously mentioned, cottages and villas can be more accommodating for guests to stay while visiting and capable of hosting social functions. The primary allure of cottage and villa style living is the feeling like you are still living on your own, but with the peace of mind knowing that additional care is available, if needed.

Terrace Homes/Lodges, etc.

Description: Terrace homes and lodges are the luxury line of floor plans in the senior living community market. These homes are not typical to see in many senior living communities, but they are out there. Terrace homes and lodges are the largest floor plans available, ranging from 1,000 to 5,000 square feet. The main difference between terrace homes and lodges is in the amount of space. Typically, lodges are stand-alone homes with individual lots, driveways and garages, while terrace homes will have a shared entryway and one or more shared walls. Additionally, terrace homes may have an underground parking garage, rather than a private parking area. Terrace homes are a perfect blend of cottage and apartment living. Both of these styles of senior living typically encompass fine detail throughout the architecture and interior design, sometimes with signature designs, such as Frank Lloyd Wright styles. Terrace homes and lodges usually feature gourmet kitchens, wireless technology, gas heat, and two-car garages. It is also common to see this style of home built on the concept of going green, which can include solar panels that allow the homes to be 100% naturally powered.

Who is this for?: The typical persona of this style of senior living is a younger (55-64) couple who is still very active, although they are available for anyone. Terrace homes and lodges are typically for those who want all the perks of living a lavish life while also possessing the security of lifetime care and a zero-maintenance environment. For the most part, terrace homes and lodges allow individuals to live the same style of life they were before their move, while adding all of the perks that come with living at a senior living community. In many cases, lodges are reserved by future residents before they are built, enabling them to fully be a part of customization and finishes from the start of construction, which makes this a very attractive option to some. Terrace homes and lodges are great for someone who would like the ability to fully customize their home to their own personal tastes.

Amenities

When you make the decision to move yourself or your loved one into a senior living community, odds are there will be a plethora of amenities available to you. This is absolutely something to keep in mind when making the decision to move. Find out all that the senior living community offers, and if they do not provide an activity that you enjoy, find out if you can bring it to the campus. Often times, senior living communities encourage residents to start new clubs or activities that allow them to be social with others while doing something they love. It is important to know that the senior living community you are interested in fosters a sense of community and promotes a blend of unique talents and interests. Senior living communities could be nestled among beaches, cities or wide-open country, and with each of those come exclusive opportunities.

Every senior living community is different, but some of the common amenities you can expect to find include:

  1. Transportation Services
  2. Aquatic and Fitness Centers
  3. Guest Accommodations
  4. Computer Lab/Internet Access
  5. Fine Arts Studios
  6. Beauty and Barber Salons
  7. Chapel & Chaplain
  8. Fishing
  9. Gardening
  10. Library
  11. Pet-Friendly
  12. Model Train
  13. Woodworking Shop
  14. Community Specific Events

Chapter

Expectations in Working or Communicating with the Staff

When you make the decision to place your loved one under the care of a senior living community, there are often many worries and questions that will come up during the process. One of the biggest aspects of moving your loved one into a senior living community is the change in responsibility of you as a caregiver to the community providing care. If you have any questions you feel are left unanswered, reach out to the senior living community, and don’t be afraid to ask very specific questions.

When your senior loved one resides in a senior living community, you have the ability to contact them as much as you would like. In many communities, residents are able to have a landline in their room and may have their own personal cell phone. Additionally, it is common to see a phone available in common areas for those who are not interested in having their own device. You also might find communities that have the capability to set up virtual visits for residents and their families. This is especially ideal for those who have family far away and still want the ability to see their relatives in real time. Visiting hours at senior living communities are usually 24/7.

A resident’s responsible person may contact staff at any time to discuss questions or concerns. In a personal care or assisted living community, each resident has an assessment completed at least annually, or more often if their condition changes significantly.

When your senior loved one resides in a senior living community, they will interact with staff daily. The type of staff they will encounter varies depending on the level of care they are receiving. In all levels of care, residents may come in contact with all types of staff during their stay. From servers during meals to housekeepers who regularly clean apartments and common areas, staff are encouraged to chat and help residents when needed. As the level of care increases, so does the amount of staff they interact with.

Here are a few examples of staff they may encounter in a skilled nursing community:

  1. Nursing Home Administrator (NHA): oversees and is responsible for the operations of the skilled nursing community. They will interact with all patients and their families on a regular basis. They are available to address any concerns from patients or families.
  2. Director of Nursing (DON): leads the nursing staff.
  3. Registered Nurse (RN): provides daily assessment of individuals and directs care.
  4. Practical Nurse (LPN): administers medications.
  5. Certified Nursing Assistant (CNA): provides personal care to all individuals if needed and provides encouragement for individuals to do as much as possible for themselves.
  6. Dietary Staff: provides meals tailored to the person’s needs and likes/dislikes.
  7. Social Worker: provides emotional support and coordinates any discharge planning needs. They also assess all individuals at admission and meet them on a regular basis throughout their stay.
  8. Community Life Staff: provides individuals with group and individual activities.
  9. Admissions Staff: assists individuals and their families with admission to the community.
  10. Therapy Staff: assesses all individuals at admission and provides services as warranted.
  11. Chaplain: available for those seeking spiritual support.
  12. Business Office: handles all billing, payment and insurance matters.

Chapter

Pricing for Senior Living Communities

It’s one of the main concerns when choosing a senior living community: cost. Unfortunately, providing an exact dollar amount for the cost of senior living in isn’t possible, or even practical, because of the wide variety of services and companies available. However, examining the factors that affect the cost of a senior living community, and the financial benefits the state has for retirees, shows just how advantageous senior living can be.

To give a brief overview of why an exact dollar amount isn’t practical, let’s take a look at Assisted Living. The average cost of Assisted Living in Pennsylvania is $3,555 a month. That seems easy enough, until it’s broken down. The median cost by city can range anywhere from $2,665 a month in Erie to $4,756 in Philadelphia. But that's just one level of care. Other communities will cost more or less depending on the services needed. But there is good news; Pennsylvania is a great place to retire, and there are ways to lower some costs when choosing a senior living community.

Pennsylvania has been named one of the most generous states in the nation when it comes to income tax exclusions for retirees. Social security benefits are not taxed, and the state doesn’t tax 401(k)s, IRAs, or other retirement accounts either. While these tax breaks may not directly affect the cost of a senior living community, they will make it easier to live in one over multiple years.

Another area of senior living community finances that is often confusing is all of the costs involved in Continuing Care Retirement Communities (CCRCs). CCRCs are the most comprehensive senior living communities, which means they can also be the most expensive.

A big part of that expense will be the upfront costs, but there are also monthly charges and fees for other services. Whether you choose a non-profit or a for-profit community can also affect how much you’ll be paying, and what will happen if you outlive your resources.

Upfront Costs

For most CCRCs, incoming residents pay an upfront entrance fee to the community. The entrance fee is only paid once, and is usually the largest fee associated with the move in. The amount owed for the entrance fee will depend on the community, the accommodations selected and the level of service required for the resident. The entrance fee generally covers a resident’s health care costs and provides the resident with the ability to move to a higher level of care, if needed.

At some newer CCRCs, a buy-in, or ownership fee, is included. This fee can be substantial, as it involves the purchase of real estate. However, this means you would own your unit. These buy-ins are typically more expensive than the usual entrance fee, but since you own your unit, you are able to sell, will, or deed it like any other type of property, according to the CCRC’s rules.

Monthly and Additional Fees

Once you move into a CCRC, there will be monthly fees to cover continuing costs like housing, maintenance, and occasionally health-care. The community sets the monthly fees, but you should expect an increase every so often to keep up with inflation.

Some CCRCs offer an option to pay monthly fees only, like a rental unit. This option can be attractive for those who can’t or don’t want to pay the entrance fee, but costs can stack up quickly since these pay-as-you-go options usually don’t cover medical expenses.

Regardless of the community you eventually choose, there are some things you should keep in mind, and one of those is the possibility of additional fees. Ask about the services that aren’t included in your contract to get a good idea of what is available to you and how much it will cost for other services. These additional fees can include pet deposits, parking permits, phone lines, TV and Internet, and more. A late charge may apply if you do not pay your monthly fees by the set due date.

Insurance

Insurance will be a major factor in how much a senior living community will cost you. For those who qualify, Medicare and Medicaid may lower the cost for some skilled nursing care, as well as the medical costs for residents at certified facilities. Some communities will require you to enroll in Medicare Part A and Part B, or obtain long-term care insurance. These policies are in place to make sure you still receive care if your funds run out.

Pennsylvania’s Department of Aging offers a free health insurance counseling program to assist seniors with Medicare. The program APPRISE can help you understand your coverage options, and your Medicare Prescription Drug (Part D) benefits. The counselors can also give you more information on financial assistance programs that may be available to help pay for your Medicare premiums, deductible and co-pays.

Non-Profit vs. For-Profit

Whether you pick a non-profit or a for-profit community may also affect how much you pay, or what happens if you can’t. Both non-profit and for-profit senior living communities can provide excellent care, however, many non-profits, like Presbyterian Senior Living, have benevolent care funds for residents who outlive their resources. That means the resident won’t be asked to leave if they run out of money.

Research by independent companies has shown that for-profit communities can have lower levels of staffing and higher rates of hospitalization when compared to their non-profit counterparts. Depending on the services needed, a hospital visit could increase your costs considerably.

Another less expensive option is a senior living community that is based on rentals. With rental properties, there are no upfront costs or entrance fees that will tie you down or sacrifice your savings. These lease terms can go year to year or month to month which allows flexibility if you or your loved one may ever need to relocate. Additionally, the financial qualifications to get into a rental senior living community is not as high as a CCRC, so there is more opportunity for those with low to moderate asset levels. One downside to consider when choosing a senior living community based on apartment rentals is that you may need to relocate to a different community or location should you or your loved one’s needs change. Increased care can be very costly to obtain outside of the traditional CCRC model.

While it’s impossible to give an exact dollar amount for the cost of senior living in Pennsylvania, it should be reassuring to know that the state has programs in place to help those who need it. Non-profits like Presbyterian Senior Living also have funds available to those who outlive their resources to help them stay in a caring place. If you would like more information on the differences between non-profit and for-profit senior communities, download our free e-Book.

Preparing for Retirement Costs

Planning for retirement can’t begin soon enough. In fact, any good professional financial advisor will strongly recommend having enough social security, pension and investment income to remain financially afloat for at least 20 years following retirement.

In addition, a health crisis could strike any one of us at any time in our lives, even if we have been given a clean bill of health by our physician. With medical costs at an all-time high, soon-to-be retirees cannot afford to neglect pursuing retirement planning strategies that provide reliable and ample returns on investments. Even with insurance and Medicare helping to pay medical bills, one week in a hospital could possibly wipe out everything a senior has worked for all their lives.

Estate plans and wills are also vital components of a solid retirement plan. A misconception exists that wills are simple documents stating who gets what after someone dies. In actuality, developing a will that can withstand objections brought up in probate court is complex and time-consuming. Family estate attorneys recommend everyone begin building a will as soon as they begin accumulating valuable items, such as real estate, savings accounts, IRAs or other liquid assets.

Chapter

Choosing a Senior Living Community

How do I know when it’s time to start looking for a senior living community?

There are many different reasons you or your loved one might be interested in moving to a senior living community. Sometimes it may be hard to tell when it is the "right" time to make the move. Some signs it might be the right time for you to consider moving to a senior living community include:

  • Feelings of isolation or loneliness
  • Trouble getting around your current floorplan because of mobility issues
  • Not being able to travel without assistance
  • Home maintenance becoming too much to handle
  • Feeling like you have too much space or too much stuff
  • Not being able to keep track of your bills

Far too often, people make the move to a senior living community and wish they would have made the decision much sooner. It is easier to make the choice to move while you still have a sense of independence and are able to make your own decisions about downsizing and lifestyle choices. In addition to senior living communities having a wide variety of opportunities to get involved and meet new people, living at a comprehensive community will allow you to age in place and lessen the burden of care on your family.

If you are an adult child or friend of a senior loved one that may have growing needs, there are a variety of tell-tale signs to keep an eye out for. Here are just a few of the signs that your aging loved one might be ready to move to a personal care or assisted living community:

  • Decrease in care of personal hygiene
  • Careless driving
  • Stale, expired, or too much food in the house
  • Excessive clutter or an unkempt home
  • Weight loss
  • Change in social relationships
  • Unattended plants and household pets
  • More easily agitated than usual
  • Increased confusion
  • Increase of recent accidents or close calls
  • Worsening health conditions

There are a lot of companies that offer senior living communities; how do I know how to pick the right one?

Today's senior living communities come in all shapes and sizes — offering a multitude of options and life-enriching opportunities. The senior living community market is a large one, so trying to find the perfect fit for you may feel daunting. When you start your hunt for a senior living community, test the waters before committing. The only way to be certain you are in love with your choice is to try it out. Did you know senior living communities often welcome visitors to attend on-campus events? This allows you to meet other residents, engage with staff, and learn about services, features and amenities available. It's also a great way to test the waters without feeling like you have to commit. By doing this, you'll be able to get a greater sense of if you want to call a senior living community home.

How do I know what’s most important for me/my loved one?

Take a moment to think about what is important to you or your loved one in everyday life. Is it vital to have a yard, a pet, or a spare bedroom? Make a list of all of the things that you want versus the things that you need. Do the needs outweigh the wants? Can you find a senior living community where your needs do not have to exceed your wants? These types of questions will help you come to the root of the things that are important to you or your loved one and help you create a personal checklist when searching for a senior living community.

How do I know a senior living community will provide the same level of quality care that I give my loved one?

Being a caregiver for an aging loved one can take a serious toll on you. If you get to a point where you are considering moving your loved one into a senior living community, there are sure to be concerns that arise. In a senior living setting where your loved one requires care from the staff, residents will have daily contact with experienced caregivers who are able to give them any extra attention they may need. If a nurse sees a change in a resident's condition, they can immediately assess them to determine what is causing the change and take the necessary steps to address it. A family caregiver who does not have any official medical training may not be able to address an issue as quickly as a senior living community, as they would most likely have to transport their senior loved one to a doctor or call a service to come into their home. In addition, senior living communities welcome loved ones to be an active part of care and communicate any changes or concerns very frequently. Often, loved ones find that being removed from the primary caregiver role gives them the freedom to enjoy their loved one's company without the stress of being the caregiver. Senior living communities can also offer companionship and socialization. Residents become a part of a community, which can greatly enhance their lives.

When beginning your search for a senior living community, there is a lot to take into account. From expense to amenities and everything in between, the decisions may feel endless. The most important thing to remember is to take your time to ensure that you or your loved one will be getting the best care possible. When starting this process, make a list for yourself and take into account all of the aforementioned subjects. This will help you get a clearer vision of what you want out of a senior living community, and help you make the right choice at the end of the day.

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