Housing and care options as you age: Discussion now may save stress later


Have you considered your future living arrangements? Where do you see yourself living in 10 years? In 20 years? As we age, we may picture ourselves living with our adult children or extended families. Perhaps we envision moving to an assisted living facility. According to the AARP, 71 percent of adults aged 50 to 64 want to stay in their current home and community as they age. At age 65+ that number jumps to 87 percent.

Despite these desires, unplanned illnesses and injuries may prevent us from living independently for as long as we may like. While there is not necessarily a right time to start thinking about our future housing options, we know the earlier these conversations take place, the more prepared we are when the unexpected occurs.  In fact, preplanning can greatly reduce stress, allowing us to feel more in control of our future and more comfortable with potential changes.

Here are some options to keep in mind as you think about the possibilities for future housing and health care needs:

Option 1: At-home services
• If you are relatively healthy and live at home, but have trouble with mobility and/or no longer drive, local organizations provide a wide range of services that may cater to your unique needs. Services could include: personal care, homemaking care, meal care, transportation, geriatric care managers to help with your finances, and home health aides to administer medications.
• Speak with your primary care provider (PCP) to ask if they provide specialty at-home care or if they can refer you to a home health aide/registered nurse (RN) specifically for seniors.
• You can also call our or email the BCBSRI Case Management team to speak with an advocate who can assist in identifying the services that are right for you.
• The National Association of Area Agencies on Aging is also a good resource.

Option 2: Short-term care
• Unexpected illness or injury may result in the temporary inability to safely care for ourselves. When this occurs, short-term care may be an option.
• Depending on your unique needs, a professional caregiver may be assigned to visit you at home and temporarily provide assistance with daily living activities, administering medications, and changing any wound dressings.
     - If a skilled nurse is required to provide at-home care, then Medicare Part B can cover the cost. There is a monthly premium for Part B based on income. The purchase of Part B is optional and there may be a late enrollment penalty if you do not sign up when you are first eligible for Medicare.
• If the situation calls for a hospital stay and rehab, then there are senior living communities with experienced professionals (doctors, nurses and therapists) that can provide medical short-term care to residents and help you transition safely and smoothly back into your daily routine.
    - Medicare A covers inpatient care in hospitals, skilled nursing facility care, hospice care and home healthcare. Most people do not need to pay a Part A monthly premium because they contributed into Social Security while working.

Option 3: Assisted living
• Similar to at-home services, assisted living communities provide a wide range of needs to seniors who may not be able to live safely on their own, but maintain their independence under the supervision of medical professionals.
• According to American Senior Communities, nearly one million Americans live in some type of senior living community, and that number is expected to double by the year 2030.
• Assisted living communities provide housekeeping, meals, transportation, exercise programs, organized activities and events, and may be pet friendly too. Some of the communities even have on-site amenities such as beauty salons and pharmacies.

Option 4: Nursing home
• Nursing homes are an option for seniors who require long-term, 24-hour supervision and a high level of medical care and assistance.
• Some individuals benefit from this type of care because they require consistent supervision to remain safe, for example avoiding recurrent falls and threat of injury.
• It may be difficult to put your trust in a stranger, let alone a strange and unfamiliar place. This is why to find the best nursing home you must make sure to visit and verbally indicate what your preferences are. Things that may be important to you (home cooked meals, nice outdoor space, extracurricular activities, friendly staff) can make the transition easier and more comfortable.

Life is unpredictable, but planning ahead through discussions with your family, doctor, and health plan can help you be better prepared for the unexpected. Take the time to learn about senior housing options and keep in mind location, quality of care that may be needed, medical and rehab services, and finances (what does your health insurance cover and what do you need to pay for?). Talk with your health care provider about what option may be the best one for you.

Kathleen Simon, LICSW is the manager of care management at BCBSRI.

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