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Unit 3: Week 3 - Chapter 7 Outline

CHAPTER SEVEN: SENIOR HOUSING

LEARNING OBJECTIVES

After completing this chapter, the reader will be able to

1.   Understand how senior housing developed and where it fits in the continuum of care.

2.   Identify and define the components of senior housing.

3.   Identify and describe regulations affecting senior housing providers.

4.   Understand the financial, ethical, and managerial issues facing senior housing providers.

5.   Identify and discuss trends in senior housing and its management.

 

CHAPTER HIGHLIGHTS

Why the growing need for senior housing?

·         Growing number of elderly

·         Growing need for alternative housing options

What is “Senior Housing”?

A variety of options:

·         Age-restricted housing - home ownership or rental opportunities for adults 55 years of age and older, or sometimes 62 years and older.

·         Reverse mortgage - a means of borrowing money from the amount the home is worth beyond any mortgage debt.

·         Age-restricted retirement communities - senior communities like any other neighborhoods or communities except restricted to people usually 55 or over or 62 and over. It often involves purchase of property or condominiums.

·         Senior Apartments - is multiunit rental housing for older adults who are able to care for themselves.

·         Cohousing - a type of collaborative housing in which residents participate in the design and operation of their own neighborhoods.

·         Independent Living - residential living setting that may or may not provide hospitality or supportive services. In this living arrangement, the senior requires minimal or no extra assistance, and leads an independent lifestyle filled with recreational, educational and social activities amongst other seniors

·         Congregate Housing - a form of independent living that usually provides convenience or supportive services like meals, housekeeping, and transportation in addition to rental housing.

·         Continuing Care Retirement Community (CCRC) - a community which provides a continuum of care, offering several levels of assistance, usually including independent living, assisted living and nursing home care commonly all on one campus or site.

·         Life Care Community - a form of CCRC that offers an insurance type contract and provides all levels of care. It often includes payment for acute care and physician's visits.

Philosophy of Care

The various forms of senior housing are designed to give seniors the services and assistance they need, while seeking to optimize their independence.

Services Provided

·         Age-Restricted Communities:

·         Provide the least amount of services of the various options.

·         Some may also provide different kinds of services to the people who live there including meals, transportation, social activities and other programs.

·         Independent Living - offer a variety of living arrangements, including:

·         studio apartments,

·         one-, two-, or three-bedroom apartments,

·         cottages,

·         townhouses,

·         duplexes,

·         cluster homes,

·         single-family homes

·         Congregate Housing - usually provides the same basic services as most senior retirement apartment complexes:

·         Shared meals

·         Fulltime staff on duty 24 hours a day to assist residents

·         Housekeeping

·         Areas within the building for socializing with other residents

·         Secure building

·         Planned recreational and social activities

Beyond these basic services, congregate housing may have the following options, often for an extra fee:

·         Laundry service

·         Transportation for shopping and doctors' appointments

·         Health monitoring

·         Help with taking medications

·         Continuing Care Retirement Communities - offer a broad range of service and housing packages that allow access to independent living, assisted living, and skilled nursing facilities.

Ownership

·         Age-Restricted Communities – a mix of for-profit ownership and publicly-owned.

·         Independent Living - market rate, for-profit independent living communities comprise the vast majority of the independent living sector.

·         CCRCs - While many CCRCs are for-profit, nonprofit organizations sponsor many of them.

Consumers Served

·         Age-Restricted Retirement Communities - are apt to be younger than in some of the other options, in part because 55+ communities define “senior” a bit younger than others.

·         Senior Apartments - are likely to have moved to those units to preserve their assets by selling their homes that they may no longer need and cannot care for.

·         Independent Living – largely widowed, white females in their mid-80s. Most have annual household incomes ranging from $25,000 to $75,000 and a total net worth ranging from $100,000 to $500,000.

·         CCRCs - seniors who enter into a CCRC contract while they are healthy and active, knowing they will be able to stay in the same community and receive nursing care should this become necessary.

Accreditation

·         Most senior housing is not accredited as are some other forms of long-term care. The exception is continuing care retirement communities (CCRCs). They are accredited by the Continuing Care Accreditation Commission (CCAC).  

Financing

·         Age-Restricted Housing - varies from expensive high-end communities to government-subsidized senior villages.

·         Independent Living – mostly private pay with rents depending on services provided.

·         Congregate Housing - most facilities have a rental contract or agreement but many do not require a long-term financial commitment.

·         Continuing Care Retirement Communities - the most expensive long-term-care solution available to seniors. CCRC residents sign a binding, lifelong contract at the beginning of their residency.

Staffing

·         Staffed somewhat similar to non-senior housing options, they are much like the hospitality industry (hotels, apartment complexes, etc.).

Management

·         Managers of senior housing range from for-profit owner/operators to hired administrators. There is no requirement that they be licensed or otherwise credentialed (again with the exception of nursing facility and assisted living components of CCRCs).

Significant Trends and Their Impact

·         Desire for More Options - today’s seniors seek (and demand) housing options that meet their needs and also are attractive, desirable places to live.

·         Quality of Life - seniors also want the quality of their life to not only decline when they move into senior housing, but to improve.

·         High Occupancy Rates - demand for senior housing is at a record high with occupancy levels running at over 90 percent throughout most of the country.

 

LECTURE OUTLINE

A.  Identify learning objectives for the session

B.  Introduce the lecture topic

C.  Discuss why senior housing is needed.

D.  Discuss what senior housing is, defining and explaining the options and terms involved, including:

·         Age-Restricted Housing

·         Reverse Mortgage

·         Age-Restricted Retirement Communities

·         Senior Apartments

·         Cohousing

·         Independent Living

·         Congregate Housing

·         Continuing Care Retirement Communities

·         Life Care Communities

 

E.   Philosophy of Care. Discuss the philosophy of care of senior housing and how it differs in the various types of housing.

F.   Services Provided. Identify and discuss the types of services provided by the various housing options.

G.  Ownership. Identify differences in ownership of senior housing options.

H.  Consumers Served. Identify those served in:

·         Age-Restricted Retirement Communities

·         Senior Apartments

·         Independent Living

·         CCRCs

I.    Accreditation. Discuss how senior housing services are accredited.

J.    Financing. Discuss how senior housing services are financed, and by whom.

K.  Staffing. Identify and discuss staffing of senior housing services.

L.   Management. Discuss management of senior housing services.

M.  Significant Trends. Identify and discuss significant trends impacting senior housing, including:

1.   A Desire for more options

2.   Quality of life

3.   High occupancy rates

L.   Summarize the discussion, recapping the key points of the lecture.

 

VOCABULARY TERMS

Affinity groups - groups such as religious organizations, fraternal orders, and ethnic groups with whom nonprofit continuing care retirement communities may cater. 

Age-restricted communities – senior housing complexes that are restricted to people of a certain age (e.g., “55 plus” communities).

Aging in place - The concept of allowing a person to progress through different levels of long-term care services without having to move to another facility. Services are brought to the consumer instead of taking the consumer to the services.

Cohousing - a type of collaborative housing in which residents participate in the design and operation of their own neighborhoods.

Congregate housing - a form of housing that provides convenience or supportive services like meals, housekeeping, and transportation in addition to rental housing.

Continuing Care Accreditation Commission (CCAC) - an organization that accredits continuing care retirement communities (CCRCs).

Continuing Care Retirement Communities (CCRC) - housing communities that offer several levels of assistance, including independent living, assisted living, and nursing home care.

Fee-for-service contract - a form of Continuing Care Retirement Community contract that requires where residents pay separately for all health and medical services and for long-term care.

Independent lifestyle - lifestyle filled with recreational, educational and social activities amongst other seniors that is found in independent living settings.

Independent living - a living arrangement in which the senior requires minimal or no extra assistance.

Life care community - a form of Continuing Care Retirement Community that offers an insurance type contract and provides all levels of care.

Life care/extensive contract  - provides unlimited long-term nursing care at little or no additional cost for as long as the nursing services are necessary

Lifetime contract - a contract that provides for housing, services and nursing care, usually all in one location, enabling seniors to remain in a familiar setting as they grow older.

Modified continuing care contract – a CCRC contract that permits seniors to purchase services on an as needed basis.

Section 202 subsidized housing - the federal Supportive Housing for the Elderly program that subsidizes housing for some low income seniors.

Senior apartments - age-restricted multiunit rental housing for older adults who are able to care for themselves.

Senior housing – housing options designed to meet the needs of the elderly, providing a variety of housing and long-term care services.

Service amenities – services designed to improve the quality of life for seniors in different housing options.

Supportive Housing for the Elderly program - a federal program (also known as section 202) that subsidizes housing for low income seniors.