Living Long, Living Well

Not long ago — maybe 20 years — there were few options for older people who didn’t want to, or couldn’t, stay in their homes. Maybe they needed help getting dressed, taking their medication or cooking a meal. Maybe they just didn’t feel like doing household chores, like cleaning the house, anymore.

Where could they go? Back then, most stayed put, depending more and more on their families as the years went by and, perhaps, finally ending up in a nursing home.

What a difference 20 years makes. Now seniors of all ages and physical conditions have many choices of facilities that are tailored to their needs. For people who need some (or a lot) of help, there are ALFs, or assisted living facilities. For those who are healthy but ready to be relieved of the burdens of owning a home, there are ILUs, or independent living units.

“Maybe they’re tired of taking care of a big old house, tired of cooking, cleaning and worrying about the yard,” says Victoria Chapman of Hillcrest Terrace Retirement Community in Manchester. “Maybe they’ve given up driving and want someone to provide transportation so they won’t have to ask their daughter to take them to the supermarket.”

Independent living facilities by law can’t provide medical care other than emergency response. (If the ILU is affiliated with an assisted living facilities, there could be access to the nursing staff there.)

Residents can purchase home health care services from outside providers, just as they could if they were still in their home.
An added benefit — a feeling of safety with people around. “If someone was living alone and, God forbid, took a spill, they might not be found for a day or two,” says Denise Cadorette, executive director of the Inn at Spruce Woods in Durham. “Here, if someone is sick, we peek in and see how they’re doing.”

Most ILUs — which can be apartments, condos or detached housing — have kitchens, but residents can also get dinner at a central dining room. “It’s like going to a restaurant every night,” says Cadorette.
At assisted living facilities, where residents are in need of more help, three meals a day are served. Generally, full kitchens aren’t provided, just a refrigerator and sink. The apartments themselves tend to be small — one-bedroom or a studio. Other services offered with assisted living: help with the activities of daily life like bathing, dressing, laundry, housekeeping and taking medication. A nursing staff generally is on 24-hour call in the building.

“With assisted living, it’s more that they can’t do things, rather than they don’t want to,” says Victoria Chapman. “They may live in a two-story house and can’t do stairs anymore. They may be taking a lot of medications and get confused. They can’t do it themselves.”

Both assisted living and independent living facilities provide another important benefit: a social life. Frank S. Crane, president/CEO of Riverwoods at Exeter, says, as people get older, their friends pass away and they become “the sole survivor. Their social network pretty much disappears. When you come into a place like [Riverwoods], you’ve got a whole social network where you can make new friends.”

Plus, he says, the people are “socially, economically and culturally birds of a feather, so they’re likely to have similar interests.” They may even have enough of an interest in each other to get married. Crane says romance still flourishes; there have been some weddings at Riverwoods.

Riverwoods is an example of a CCRC, or continuing care retirement community (sometimes called life care community), which provides on one campus a full continuum of care as seniors progress through the aging process. They move in when they still functioning independently, then move into assisted living, and eventually into the skilled nursing facility, which can provide for people who need nursing care on a regular basis, but do not need to be hospitalized.

The cost of retirement communities varies widely; CCRCs are the most expensive. With a life care contract, according to Crane, a resident pays a large one-time entrance fee ranging from $200,000 to $400,000 (which is usually 90 percent refundable if a resident dies or leaves the community), along with a monthly service fee, typically ranging from $1,000 to $3,000. Assisted and independent living facilities may or may not have an upfront fee, but all have a monthly fee, usually based on the services provided.

Today’s housing options for seniors are not inexpensive, but, as Crane says, the residents feel safe and their families feel good about that.