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Age-Segregated Housing - Types Of Age-segregated Housing

nursing care elders settings options

One way of exploring the advantages and disadvantages of age-segregated housing is to ask who moves to such settings and why. A brief overview of the array of housing options for older adults will make it clear that the age structure of a setting is probably not the only consideration elders take into account when they choose among the many options available on the housing market. Resources and preferences (health, functional abilities, economic resources, informal support, embeddedness in community) and housing characteristics (availability, location, cost, amenities) are as important as age. One could even argue that for some older adults' age segregation is the accidental result of having opted for a number of amenities—most often the assurance of nursing care in the future—that happen to attract other older adults.

The continuum of housing options for older adults is most often described in terms of levels of independence, ranging from independent households at one end to nursing homes at the other end of the continuum, with each offering different levels of supportive services (Atchley, 1999). This difference in supportive services is reflected in the definition of three categories of retirement housing: age-segregated communities for active retirees with minimal or no services; congregate housing with a service package that most typically includes meals and socialization; and life care communities offering extensive long-term care (Stockman and Fletcher). Settings vary also in their willingness to accommodate residents' increasing frailty and thus allow them to age in place (Tilson).

Another important distinction is that between publicly and privately sponsored settings. Recent developments in the market for senior housing have largely been limited to the private sector while already inadequate public housing programs have experienced even greater losses, much to the detriment of poor elders who have few real choices amid the proliferating array of new options in senior housing (Golant, 1992). Among the five major types of affordable housing identified by Golant, low-rent apartment projects, either with or without some congregate services, are low-income elders' only age-segregated housing option. The demand for such housing vastly exceeds the supply and has resulted in long waiting lists of eligible elders who have few other options. Finally, there is the distinction between planned and naturally occurring (Hunt and Ross) or de facto age-segregated settings (Golant). While the former are quite visible and receive most of the publicity, the latter are evolving slowly and often imperceptibly in many places throughout the United States, shaped by demographic forces such as out-migration of the young, elders choosing to age in place or moving into apartment complexes where many older adults already reside (Sykes), and by other push and pull factors such as proximity to friends, physical features of the building, and increasing dissatisfaction with previous housing (Hunt and Ross).

Settings designed for active and independent retirees include continuing care retirement communities (CCRCs), retirement villages, and retirement towns of varying sizes, with a selection of housing type and cost. Settings designed for frail elders include a number of types of congregate housing variously described as board and care homes, group homes, personal care homes, or adult care facilities, many of which provide adult care services in a home-like setting at relatively low cost. The recently developed concept of assisted living facilities is rapidly gaining in popularity. Designed for elders of varying levels of frailty, such facilities provide the level of care that meets individual needs short of continuous nursing care.

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