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Architect's Rendering of Avalon Homes

Not too long ago, it was an omen for the elderly: when it was time to leave home, the next stop was an old folk's home.

Today's aging population, including the burgeoning group of baby boomers, has brighter alternatives than simply "being put out to pasture."



Assisted Living

A flurry of construction activity has centered on the assisted living market, with choices now ranging from private rooms to apartments, with residences ranging from high-rise complexes to single-level dwellings.

These facilities are ideal for elderly people who do not yet require nursing home care, but might need assistance with daily activities such as cooking and housework. Some people choose to go into assisted living facilities upon the death of a spouse to avoid loneliness, and these homes generally provide a lot of socialization, as well as services like transportation, laundry service and meal preparation.



Home Healthcare

To qualify for home healthcare, a growing market for the elderly, seniors must meet certain requirements. They must be homebound and require part-time or intermittent skilled nursing care, according to their physician.

The most common conditions home healthcare providers treat include diabetes, hypertension, congestive heart failure, skin integrity issues requiring wound care and osteoarthritis. Besides skilled nursing, common services include physical therapy, occupational therapy, speech therapy, counseling and dietetic consultation. Key elements of the orthopedic program include physician-specific protocol applications and outcomes measurements for physicians.

Besides short-term healthcare, some agencies now provide more long-term, maintenance types of services in the home.



Co-housing

Co-housing represents one of the most innovative trends for seniors. Based on a Danish concept, co-housing members own individual homes and have access to common areas. While some of these communities are not limited by age, others are specifically geared towards elders. Residents are able to maintain their privacy while sharing meals and activities. With this concept, more groups are writing their own destiny by deciding beforehand their co-housing mates and even designing and planning their community, rather than leaving it to a developer's imagination.

Dr. Bill Thomas, a Harvard-trained geriatrician, developed Eldershire to transform the culture of aging. The community co-housing project designed specifically to reduce loneliness, boredom and helplessness among seniors is often referred to as an "intentional community." Private homes are grouped in an arrangement promoting face-to-face interaction. Residents share facilities such as gardens, trails and play spaces. The complex features a common house used for shared meals, meetings, workshops and activities.

The first Eldershire demonstration project, Avalon, was developed on a hilltop in Sherburne, New York. The community consists of 30 custom log homes with shared courtyards, garden areas and outdoor activity spaces. Nearby facilities available to residents include a conference and retreat center with dining facilities, walking trails, a horse stable, a wildlife refuge and a labyrinth walking trail.

The Green Houses at Traceway in Lee County is based on Thomas' concept. Mississippi Methodist Senior Services, owner of The Green House project, plans to build additional projects throughout the state.

Even though some insurance providers cover short-term care, special policies might be required for more extensive treatment. Many adults are purchasing long-term policies to cover these costs.



Covering The Costs

When coverage for healthcare or housing is not available through private means, seniors might seek help from the government. Medicaid does not cover assisted living expenses, and for nursing home care, applicants must meet certain income requirements.

Certain waivers are available for home care. The elderly and disabled adult (EDA) waiver is available for seniors over age 65 or for people under 65 who are disabled and cannot live alone. Under this plan, qualified applicants may receive a personal care attendant. The waiver also provides respite services for caregivers living with the elderly. The drawback: often years-long waiting lists.

Medicaid's adult day health care (ADHC) program works like traditional child daycare, allowing a live-in caregiver to drop off a senior at an adult care facility during the day. The typical waiting period for this program is months, not years.

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