WHEN IT'S TIME TO MOVE: FINDING SUITABLE HOUSING FOR AGING FAMILY MEMBERS

An excerpt from: Because We Care: A Guide for People Who Care -(U.S. Administration on Aging)

There are many times when it is not possible for a caregiver and care receiver to live together. The level of care that your spouse, relative or friend needs may require highly skilled health care personnel on a regular basis. In this case, an extended care facility, such as assisted living or a nursing home, may be a better care alternative. Your relative or friend may live in another town and does not want to move. There may not be room in your home, or family members, including your relative, may not want to live together.

Whatever the reasons, living in different housing does not mean that you cannot be a good caregiver. You and your relative will, however, need to make arrangements for additional help and/or services as needed--either in his or her present home or in a new housing arrangement.

Points to Consider When Choosing Housing and Living Arrangements When providing services to older persons who have limitations in their mobility and multiple needs, the type of housing and living arrangements you choose become critical keys in assuring that they get the care they need. Housing and care in this instance go hand in hand. There are many types of housing arrangements available for older persons, and they often overlap in the types of care and services they provide. Before making a housing choice, you and your older relative should assess present needs and envision, as best as possible, how these needs may change in the future. What options will be open to you if the need for more supportive housing and living arrangements arises? Will your family member need to move to another care arrangement? Are these facilities available in the community, and how much will they cost? How are you going to pay for housing and services now and in the future? If you enter into housing that requires a substantial deposit at the time of admission, will some of the money be returned if your relative decides to leave? What guarantees do you have that the facility is financially secure?

You and your older relative will want to ask these questions before making a decision about moving into a new housing arrangement. If this arrangement involves a large entrance fee or deposit or the signing of a contract, you also will want to consult an elder law attorney (www.naela.org) before making the commitment.

Guidelines for Choosing Housing Options Regardless of what the facility is called, check it out thoroughly before making a decision. The types of facilities range from informal home-share arrangements to commercial enterprises, government-sponsored facilities, and housing options administered by nonprofit organizations. Some are licensed or accredited, others are not. Accreditation is an evaluation of a facility's operation against a set of standards. The Continuing Care Accreditation Commission--a membership organization of continuing care communities--is one such organization. Licensing is an evaluation of a facility's operation in accordance with government regulations. About half of the states currently regulate assisted living facilities. Many skilled and intermediate care nursing facilities are accredited to accept patients under the Medicare and/or Medicaid programs, which means that they must meet certain standards and provide certain services. Regardless of these considerations, you are responsible, in large part, for ensuring that the facility is the right one for your spouse, relative or friend. Even if you are not thinking about housing options in the foreseeable future, it is wise to have several in mind in case an emergency arises and you need temporary care for your relative.

Home care agencies often do not have staff available to fill in on short notice, and you may need the services of a long-term care facility. You can start your preliminary search by phone, but this can be a time consuming process if you are not already familiar with various housing options. You can save time, reduce stress, and make a more informed decision by contacting a geriatric care manager in the community where the housing is wanted. These elder care professionals are experienced and knowledgeable about a wide range of housing options, their costs, and the reputation of many facilities in the area they serve. You can find a geriatric care manager in your geographic area on line at the web site of the National Association of Geriatric Care Managers (www.caremanager.org)

Visit those facilities that have the services your care receiver wants and needs. If possible, take your older relative to see the facility. Better yet, visit several (or hire a care manager to do this with you, or if you are far away to do this research for you), and let your relative make the final choice, if at all possible. If your relative is able to make sound decisions, and does not like any of the housing options or does not want to move into a facility after visiting several, keep looking or further explore the possibility of home care in her home or yours.

Use a check list. We currently have a limited supply of two housing publications that will be useful for you.; "Assisted Living: What To Look For."; and "Choosing a Long Term Care Facility." To receive a free copy of these booklets, which contain consumer checklists simply send an E-mail with your postal address to kathym@elderlifeplanning.com.

You may also want to visit several other web sites that contain useful housing information for older people. National Resource and Policy Center on Housing and Long-Term Care (http://www.aoa.dhhs.gov/housing). This web site offers information on home modification, and government-supported housing programs for older persons as well as links to other useful sites. The web site, produced by the Family Caregiver Alliance (www.caregiver.org) includes a reading list and articles in the Fact Sheet section that discuss Out of Home Care Options and Assisted Living, as well as many other topics of interest to caregivers.

For additional information on various types of housing options go to the web site of The American Association of Homes and Services for the Aging (www.AAHSA.org) web site. It describes the types of residences available, what to look for, and offers a search device for member facilities by community. The Assisted Living Federation of America (www.alfa.org) is a national nonprofit trade association dedicated to enhancing the quality of life in assisted living residences and representing the interests of the assisted living industry. Finally, the American Health Care Association (www.ahca.org) is a professional organization that represents the interests of licensed nursing homes, assisted living, and sub-acute care facilities. This web site offers information on the types of facilities and how to choose one.