Your Aging Parents: Living Arrangements

Housing is another important, and potentially difficult area in which your parents might require your assistance. Ideally, Mom and Dad will be able to live safely and comfortably in their own house for their entire lives. Some people are fortunate enough to have that happen.

Chances are, however, that one or both parent may someday need to move.

This could occur for many reasons. Perhaps the family home your folks have lived in for the past 40 years is simply too large and requires too much upkeep. Or one parent might die and the other moves in order to be closer to a son or daughter. Maybe Dad is tired of cleaning and cooking for himself and decides to move to an apartment building designed for elderly folks that includes meals and a cleaning service. Or Mom may need to go into assisted living because she can no longer take care of her own needs.

If your parent or parents are thinking about moving, you can assist them by letting them know what options are available. Older people have many more housing options these days than they used to, and some of them are really interesting. Let's take a quick look at some of what's available.

ECHO Housing

ECHO homes (it stands for Elder Cottage Housing Opportunity) are fairly new, but they're gaining in popularity. They're modular homes that you move onto your property for as long as necessary, and remove them when they're no longer needed. Usually about the size of a large garage, a typical ECHO home includes a living room, kitchen, eating area, bathroom, and one or two bedrooms. Because they're designed especially for older people, they are wheelchair accessible, energy efficient, and all on one level. They typically cost about $25,000. Be sure to check with the municipality in which you live to make sure this type of housing is permitted. You can find out more about ECHO housing on the Senior Resource's Web site at www.seniorresouce.com/hecho.htm.

Adult or Retirement Communities

These vary greatly in scope, and offer different services and amenities. Typically, retirement communities are clusters of homes on small lots. Outside maintenance usually is provided, and there normally are common areas for residents to share. Some communities include a lake or pond for fishing, a golf course, tennis courts, shuffleboard courts, horseshoe pits, and so forth. There often are planned activities, such as bingo or card games, day or overnight trips, entertainment, and educational programs. Your parent would either buy or rent the house, and would pay a monthly or quarterly fee for services such as grass cutting, snow removal, and outside painting. If your parents are considering moving to a retirement community, be sure they shop around before committing themselves. There are huge differences from community to community, and, while many are very nice, others are less desirable. The cost of retirement communities varies greatly depending on location, the type of homes, services provided, and whether your parent would buy or rent. Some retirement communities offer lots for sale, and allow you to build a house of your choice.

Continuing Care Communities

Continuing care communities are those that offer independent living, assisted living, and skilled care, all on the same campus. They're usually large, often upscale complexes, sometimes sprawling over miles of land. The basic concept of a continuing care retirement community is as follows. Mom and Dad pay an entrance fee that gets them a house or an apartment.

Mom and Dad live on their own until something happens that means one of them can't live independently anymore. Let's say that Mom has a stroke. When she returns from the hospital, she and Dad find that she can't take care of herself, and it's too much for Dad to handle. At that point, Mom gets moved to the assisted living section of the community, while Dad remains in the apartment. Dad can go visit Mom every day, and has peace of mind knowing that she's getting the care she needs. If Mom gets well enough to take care of herself again, she moves back in with Dad. If she continues to need assistance, she stays where she is. And, if she encounters another health problem that makes her unable to do anything for herself, she'll be moved to the skilled care section of the facility, which is really a nursing home.

Continuing care communities are expensive places to live. Entrance fees can range from $30,000 to $300,000 or more, depending on the type of dwellings offered. And, monthly fees can vary from $500 to $3,500, depending on services.

Senior Apartments

Senior apartments can be built and run privately, although many are constructed and maintained by the Department of Housing and Urban Development (HUD). HUD housing is intended for low-income seniors, and is subsidized by the government. The eligibility for this type of housing varies from state to state, so you'll need to inquire with your local housing authority if you want to see if your parent qualifies. Because this type of housing is built exclusively for seniors and uses federal money, it must be fully handicap-accessible. Most senior apartments have dining rooms where residents may eat, although many include individual kitchens. Some community agencies offer services on-site at senior apartments, and many senior apartments have their own bus or van to transport residents to the doctor, grocery store, or so forth.

Assisted Living

Assisted living is a level of care that's somewhere between independent living and nursing home care. It varies greatly because every person in an assisted living facility may have different levels of need. Geriatric specialists say that people in assisted living generally need help with activities of daily living, such as dressing, bathing, eating, and using the bathroom. Assisted living also provides, or provides help with, tasks such as using a telephone, taking medicine, cooking, managing finances, using transportation, and so forth. Most provide three meals a day, with residents eating together in a dining room. Many offer transportation to doctor appointments, shopping, and other locations; activities and recreation; and housekeeping and laundry services. Assisted living facilities are not nursing homes. While some facilities accept high-need residents, most do not take people who suffer from dementia or who are incontinent.

Nursing Homes

No one likes to think about sending a parent to a nursing home, but there sometimes is just no choice. If Mom has Alzheimer's disease or anther type of dementia, is incontinent, can't move, or is just too sick for you to care for and no longer qualifies for assisted living, she may need the skilled care of a nursing home staff. Most nursing homes provide 24-hour nursing care, on-call physicians, personal care, meals and nutritional monitoring, laundry, activities, therapy, rehabilitation services, and counseling. Patients with different needs normally are placed in different sections of the building. Alzheimer's patients, for instance, may live in a separate wing. People who are in the nursing home temporarily for rehabilitation services after a stroke or illness may be housed in a certain area. All nursing homes have to be licensed, and they're inspected by state and federal agencies. There are a lot of issues—financial, practical, and emotional—involved with placing a loved one in a nursing home.

Senior citizens are coming up with some innovative housing solutions on their own. Some are taking on a roommate, or arranging for house sharing situations. Allow your parents to be creative when assessing their living arrangements.

Excerpted from The Complete Idiot's Guide to Personal Finance in Your 40s and 50s © 2002 by Sarah Young Fisher and Susan Shelly. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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