Senior Housing Guide: A Guide to Aging in Place and Deciding When to Transition to Assisted Living Transitioning into assisted living is a major milestone for most, and it often entails a difficult decision. It requires evaluating whether or not you have the finances for this next phase in life, what care you require, and what responsibilities you’re physically capable of handling. Although giving up a lifetime of independence can be a daunting prospect, there are a variety of living options for seniors looking to maintain their independence. Let’s discuss the benefits of aging in place, the alternative living arrangements for seniors, and when you and your loved one should decide to make other living arrangements such as assisted living. Understanding Your Housing Options There are several housing options a senior might have. Ultimately, it will come down to your specific needs, budget, and even what you’re comfortable with. When choosing your housing options, consider the following: Aging in Place Aging in Place is the practice of staying in one’s own home and receiving care and assistance there, rather than transferring to an assisted living community, nursing home, or other care facilities. Many seniors choose this option because of their desire to remain as independent as possible for as long as possible. Who is best suited for this option?  This option is best for anyone with one spouse or life partner who can prepare meals and do light housekeeping. It's also helpful if there are at least two people in the household for safety reasons. What are the cost estimates?  Those who can maintain their home can live for a year or two on the estimated income from Social Security and personal savings. It’s also possible to set aside money from earnings and other resources for those who have an earlier onset of disease or disabilities. What level of support is required? Depending on your overall health and your ability to move freely, the level of support required may vary. What other special considerations should be accounted for? The cost of both purchasing or renting a home and having it modified for special needs can be a challenge. But in some cases, the modifications are less expensive than the cost of moving to an apartment or a nursing home. Co-Housing Co-Housing is a type of living arrangement that involves six or more adults sharing the responsibility for their homes. Each adult has their own private living space and shares cooking, cleaning, and childcare responsibilities.  The community designs its layout to be inclusive of people with differences in age, physical ability, social needs, and interests. The residents of co-housing are also involved in designing a community that best meets their needs for friendship, support, and privacy. Co-housing communities for seniors are one of many alternatives to assisted living rising in popularity. Co-housing communities consist of small clusters of homes with common spaces such as a laundry room, garden, and play area and are designed to provide more freedom and privacy. Residents have their own units but share common amenities. Multigenerational Housing Multigenerational housing refers to the concept that more than one generation can live in one household. For example, if a grandparent lives with their child and grandchildren, this would be considered three generations living in the same house. Multigenerational housing reached record popularity during the rise of the COVID-19 pandemic due to its affordability and ability to comfortably house more family members. New York, Houston, Phoenix, and Raleigh communities feature multigenerational housing options, and according to Generation United, about 25 of Americans live in a multigenerational household.  Independent Living Communities Independent living communities are ideal for active seniors looking to downsize from their current home and live among others in the same age group. According to Pew Research Center, 27 of adults aged 60 and older live alone. People who live in independent living communities have more opportunities for fun and exercise and a chance to socialize.  Assisted Living Communities Assisted living is the right choice for many people in the later stages of life. Whether you're battling a chronic illness like Alzheimer's or just need some help with day-to-day tasks, assisted living offers an effective way to give seniors more independence while receiving medical support when and if they need it. The benefits of assisted living include improved quality of life and peace of mind for both seniors and their families. Aging in Place Best Practices There are many reasons why a senior might want to continue living in the home they've known for years, and no one should be forced to move simply because they are growing older. Luckily, seniors can live safely in their own homes with their independence and dignity intact with the help of architectural design principles, home modifications, and caregivers. Universal Design Universal Design is the practice of creating buildings and public spaces that are accessible to people of all ages. It is a design philosophy that works toward balancing the needs of people with disabilities and those who can move about freely in their space. It also emphasizes respectful, thoughtful design choices that allow for age-appropriate access. Integrating Universal Design into your home can help you age in place better, so you won’t be forced to seek out other assisted living options due to lack of accessibility. Home Modifications for Accessibility The home environment can play a significant role in the quality of life for seniors. Seniors who feel like they have control over their living situation and who face fewer barriers to independent living are more likely to live longer, healthier lives. That's why it's important to take steps now to modify your home so that it meets the needs of seniors as they age. Here are a couple of modifications you can install in your home that will make it easier for a senior loved one to remain mobile. Wheelchair Lifts  A wheelchair lift is an excellent option for seniors who can no longer navigate the stairs. Most wheelchairs can be raised with ease, so it may be possible for you to install one at the very top of your staircase or in your basement or attic. There are many options for flooring that are easy to clean and maintain. Threshold Ramps Threshold ramps are a good option for those who prefer to stay in their own homes but remain mobile. Some styles may be installed under your home's flooring, which will keep your floors protected. These can be in various heights so that your family member will have the ability to get around in the kitchen or bathroom without needing to use a chair or lift. Walk-In Tubs Walk-in tubs are also a good option for seniors who enjoy staying in their own homes but have trouble getting around. These are great options if you have a shower or bathtub in your home because your senior loved one can use the walk-in tub as an extra room to get ready or relax. You'll need to discuss bathroom conversion options with your contractor and installer if you're interested in this idea. In-Home Assistance & Hiring a Caregiver Suppose you're looking for a home caregiver to assist your senior loved one with cooking, cleaning, bathing, or light housekeeping throughout the week. In that case, there are many things to consider before hiring someone. You'll want to find someone reliable and trustworthy and who has experience providing in-home care. You'll also want to check the caregiver's résumé to see if the home care agency has screened them before hiring them and ensure they've had appropriate training. Here are some helpful tips for finding the right caregiver for your loved one. Make sure you're looking for an hourly or live-in caregiver. Hourly caregivers are in your home full-time, whereas a live-in caregiver is there for a set number of hours, such as 7:00 am to 6:00 pm, every day or shift. Think about what kind of caregiver you need. Do you need someone to help you with light housekeeping, cooking, or caring for a loved one? Or would a full-time caretaker be better for your needs? Look at the caregiver's resume or employment history and contact their references. When you interview potential caregivers, ask them about their work history and if they've ever been charged with any crimes. Get recommendations from your doctor, health care organizations, and the local agencies that provide services to people with disabilities on how to best find a quality caregiver. Make sure the caregiver is bonded and insured and licensed by the state if required. Ask how recent their policy is and how much it covers in case of an accident or lawsuit. Have the caregiver meet family members and other people who will be regularly involved in the care of your loved one. Remember that caregivers should be treated fairly, respectfully, and kept up-to-date on their loved one's care to prevent confusion among needed treatments. Ask the caregiver if they have any medical conditions or disabilities that may affect their ability to work. If so, find out how they will be able to manage the care of your loved one because of those conditions. Types of In-Home Assistance A great caregiver will address their patient’s needs as best as possible. They will also need to be skilled in the following areas to provide a patient with as much assistance as possible: Mobility Some seniors require help with getting dressed, bathed, and in and out of the bathtub. If the patient is in a wheelchair, the caregiver also needs to be knowledgeable on the best practices for transferring the patient from their wheelchair to their bed, bathtub, chair, etc. Medical The patient receives help with things like administrating their medication, listening to what the patient’s doctor says during appointments, and maintaining knowledge of the most up-to-date emergency first aid procedures (CPR, AED, Heimlich Maneuver, RICE, etc.) Food Prep & Other Light Housework  This includes cooking and food prep for the patient. Caregivers should be able to do everything from taking out the trash to cleaning the dishes. This is helpful for seniors with limited mobility or those unable to cook their own meals.  Transportation As some seniors may be able to drive, they may need a caregiver to drive them around to their necessary doctor's appointments, the grocery store, or even visits with their friends and family. Not only is this necessary for their mental and physical well-being, but it helps seniors to maintain their independence.  How Do You Know When It's Time to Downsize? Ultimately, downsizing may be an inevitable option for most seniors moving on to this next stage of life — no matter what kind of assisted living option they opt for. Although this may be a difficult decision, it can be a great way to start a new chapter in life, especially if a change of lifestyle or family situation has occurred. You're ready to downsize and sell your home if you answered “yes” to any of the points below: You want to find a new home that’s smaller and better designed; You want to pay less for utilities and price per square footage; You are looking for a more convenient space to upkeep, such as a condo, where you’re not responsible for all maintenance and repair jobs. Downsizing typically requires further research to gauge what home fits your needs for a good price. For example, if you live in, or are planning to purchase property in Raleigh, check the local listings for a smaller house that satisfies your requirements. How to Downsize with Minimal Stress Selling your home, downsizing, or buying a new one can be stressful if you don’t know where to start. However, the following tips will help you during this stressful period: Look for clutter in the basement, attic, and garage The first place to check should be the storage areas, which are usually filled with items from years past that will never be used again. When you pack these areas up, you’ll have much less to take with you when you move to a smaller home. Sort your clothes You shouldn’t hang on to your entire wardrobe on the off-chance you might wear things again. If the clothes are still in good shape, donate them to a thrift store. You can also have a yard sale to sell the clothes you no longer want or need. Do away with any items you have do not need Make a list of items that you've got too much of, then sell or give away the extras. If you're unable to use them, and no one else wants them, just toss them in the trash. Signs that Assisted Living Is Needed Although there may be moments when you question if assisted living may be necessary, it may not become apparent until you start witnessing several signs in your loved one, especially if their quality of life is declining. There are many benefits to assisted living, but some potential signs indicate that a senior may require more involved services.  A Decline in Memory and/or Cognition The loss of memory is a common aspect of aging. However, some seniors may be unaware that their cognitive decline has progressed to the point where they need additional help with daily tasks. For example, seniors who have memory impairment may have trouble driving to their appointments or running errands. They may need assistance with bank transactions and credit checks. The inability to remember one’s children, loved ones, and important life events can signify a significant decline in the senior’s health. Inability to Self-Care Seniors who can no longer care for themselves may need live-in assistance with basic needs. For example, someone who requires assistance with bathing, finances, shopping, and cooking should not be living independently.  Personality and Mood Changes In some cases, an individual may be aware that there has been a change in their personality or moods. However, seniors may not even be aware of these changes, or they may choose to ignore them because of embarrassment or shame. It may also be that the individual with memory loss is unaware that they are now more susceptible to anxiety and depression. Behavioral Changes The behavior of an individual who has memory impairment will usually change as they age. However, if there is a significant decline in the senior’s cognitive abilities, behavioral changes could be a sign that an assisted living facility may be needed, especially if further medical care is needed. Seniors may exhibit changes in their sleeping habits, restlessness, or inappropriate behavior such as taking medications without a doctor’s instruction. It is important to talk to someone about the possible changes in behavioral patterns. Unable to Complete Basic Tasks Seniors who are unable to carry out basic tasks at home may develop aches, pains, and other health problems that can be corrected by being cared for at an assisted living facility. Seniors may have difficulty following complex instructions or remembering where they hid their keys. It’s common for seniors to become forgetful and rely on others more than they had before. However, if a senior is not able to follow basic instructions or perform simple self-care tasks, it’s time to consider assisted living. How to Make the Transition to Assisted Living Deciding to make the transition to senior living can be stressful, so here are some tips for any senior on how to do it successfully: Assess your needs Your wants and desires are just as important as your needs. However, make sure that the things you want from your assisted living facility (such as a private room) correspond to their services. Be honest about your health, the medications you take, and any health conditions (varying from pain to mental illness) that you currently have. Get your affairs in order  Be sure to have all your personal information, essential documents, and financial records organized and inventory any possessions that may be of value or have sentimental value. Get to know your neighbors Having other people to share experiences with will make your transition to assisted living much easier. When you first arrive at the facility, be sure to introduce yourself to as many people as possible. Keep a daily to-do list Keeping a list of things to do each day helps to establish a new routine for you in your new home. Aside from increasing productivity, this will also help you keep a sense of purpose.  Spend time with your family and friends Having your family and friends out to visit is also a great way to help you bridge the gap between your old life and your new one. Maintaining those connections will allow a more seamless transition and reduce any anxiety you might have. Get involved in the community Be sure to check out that activities board every chance you get, because going out and being social enables you to build more relationships with people that share your interests, and helps you to feel more at home. Alzheimer's Self-Evaluation & Evaluating a Loved One Alzheimer's disease is a progressive, irreversible brain disorder that slowly destroys memory and the ability to think, learn, communicate, and reason. If you think you or a loved one may have this degenerative condition, it’s up to you to evaluate yourself or your loved one and determine if Raleigh’s special housing accommodations are necessary.  Ask your local real estate agent about housing accommodations available for Alzheimer's or Dementia patients. Resources and Further Reading Senior citizens, family, and caregivers should always strive to learn more about aging in place, assisted and independent living, and anything that will help them and their family/patients happy and comfortable. Resources are aplenty, but you can start with some of the agencies below: Aging in Place: Aging in Place connects seniors with the resources and tools they need to remain independent for as long as possible. They feature articles for caregivers, product reviews, and more.  Caregiver.org: While this organization provides information mostly for caregivers, older adults can also find information on how caregivers should care for others, themselves, and their health conditions. USC Leonard Davis School of Gerontology: The University of Southern California’s Gerontology program is among the world’s leading authorities on aging. A Place for Mom: A Place for Mom offers many informative articles for seniors and caregivers. Find information on assisted and independent living, memory care, and even veteran resources. Caring.Com: Caring.com offers information resources on assisted living, memory care, senior living, home care, and more for older adults and caregivers alike.