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For a Less Expensive, More Homelike Atmosphere in Senior Housing, Consider an Adult Foster Home

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The housing choices for aging seniors have traditionally fallen into one of two categories: either living at home (including with a family member) or living in some sort of retirement home. Increasingly, however, seniors and their families are turning to a third “in-between” option. They’re choosing what many refer to as adult foster homes.

A Viable Housing Option

This article just published on the NextAvenue website does a good job explaining what this relatively new living option is all about, and what are some of the good and the not-so-good points. “Call them adult foster homes, board and care homes, residential homes, group or adult care homes,” says the article, written by health journalist Liz Seegert. “Regardless of the moniker, these small-setting, family-like environments blend neatly into local communities, and are a viable housing option for older adults who may need help with daily living basics, but not the clinical care or amenities of traditional assisted living facilities and nursing homes.”

Seegert explains in the NextAvenue article how many seniors and their families don’t consider residential home care until faced with some form of housing emergency. “[Adult foster care] is a choice that may not be on a family’s radar until a health crisis leads to the realization that their loved one can no longer live alone,” she writes. “Families then often face a sudden dilemma: they cannot move the person in with them, but institutional care is not necessary. Traditional, multi-unit assisted living can be too impersonal and prohibitively expensive. But there’s another, less well-known option. Adult foster homes can be an ideal alternative for some.” In 2014 there were 168,000 men and women living in about 30,000 licensed adult foster homes in the U.S. The facilities range in size from four to twenty-five residents. Some even smaller facilities are also out there but due to their diminutive size – one to three residents – some states don’t require them to report any care statistics.

A Neighborhood Setting

Because these facilities are in private homes in ordinary neighborhoods, many locals may not even recognize their presence. “It’s often a hospital social worker or discharge planner who may first suggest this alternative for an older adult who struggles to live independently,” says NextAvenue. “Adult homes are an especially welcome option in rural areas, where limited populations can’t support larger multi-unit housing. They also work well in suburban and urban areas, thanks to their smaller, less overwhelming, footprint, which fits into a neighborhood.”

Adult family homes make sense for many seniors whose health care needs are not particularly acute. “Older people are not as sick as they are frail,” said senior health care advocate Keren Wilson in the NextAvenue article. “And what they really need for long-term care is not medical care, so much as personal care.” But that poses a problem, Wilson adds, because federal health care officials “don’t want to pay for personal care. They don’t want to pay for the kinds of things that help people stay independent longer.” For that reason most adult foster homes or adult family homes are paid for through a blend of private pay and Medicaid under what’s called a home and community care waiver. Costs vary widely by location, but, says Genworth Insurance, the national median cost is presently estimated at $3,750 per month.

National Guidelines Lacking

The big question mark, warns NextAvenue’s Seegert, is the quality of care.  “There are no national guidelines for this type of adult residential housing,” she cautions. “Certification and licensing vary by state, as do training, services and oversight.”  This puts a special fact-finding burden on families as they seek to evaluate the right place for mom or dad. “Professionalism can be inconsistent from home to home, and staffing is sometimes a problem, especially when residents require nursing care or other assistance beyond what an owner/operator provides,” the article states. Additionally, abuse or neglect may be more difficult to pinpoint, so it’s important to speak with other residents and to check with the state ombudsman to see whether a specific home has any complaints or violations. Frequent unannounced visits by family members may provide a good means of making certain a loved one’s needs and expectations are being met.

“Finding the appropriate environment for each individual is so critical to successful aging,” Seegert writes. “With the right supports in place, we can lessen our reliance on institutional care.” That seems to us to be a good goal, and for that reason we think the NextAvenue article will be helpful to families by giving them more care options to consider. Making the right housing choices, as we’ve said many times here at AgingOptions, is a vital component to aging well, whether you elect to age in place, live with family, choose a group home or move to a retirement community.   The important thing with thinking ahead about your future housing needs is not to be complacent and assume everything will turn out fine.  The missing link when it comes to housing, just as it is with retirement, is planning.

No One-Size-Fits-All Plan

Here at AgingOptions we recommend a uniquely comprehensive approach to retirement planning in which housing is just one of many components. We call this LifePlanning, because this approach really does cause all the key aspects of life as you age to mesh together: housing, medical, financial, legal and family. With a LifePlan in place, you’ll be able to experience a secure and fruitful retirement in which your assets will be protected, you’ll be able to avoid becoming a burden to your loved ones, and you won’t be forced against your will into institutional care. Why not invest just a few hours and find out more? You’ll be very glad you did! The best way to explore the power of an AgingOptions LifePlan is by accepting Rajiv’s invitation to join him at an upcoming LifePlanning Seminar. We offer these popular free informational events several times each month, in locations throughout the area. Please visit our Live Events page for a complete calendar of currently-scheduled seminars, then register online or by phone for the date of your choice.

Just as no one type of housing is the right choice for every senior, there’s no “cookie-cutter” plan that’s right for every retiree. Your personalized LifePlan will literally become the passport to the retirement of your dreams. Age on!

(originally reported at


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