In my elder law practice, I see many clients who worry about how growing older will impact their living situation. One truth is universal -- that it is better to begin thinking about this while healthy and able, rather than waiting until there is a crisis. Advance planning means it is more likely that the elder will control his or her housing choice rather than have it decided by someone else.   Here are five housing options to consider.  

1. Remain in your current home.  Staying put is often people's first choice in housing and this is a viable option for many. I advise my clients who want to remain in their homes that they need to remain flexible and open to the possibility that some changes to their living space may be necessary. For example, staying at home may require physical modifications to the home such as moving the bedroom to the first floor, widening doorways to allow for a walker or wheelchair, replacing flooring to minimize the chance of falls, and renovating the bathroom.   Planning to remain at home must also include a willingness to accept help from home health aides or others, as needed. Figuring out how to pay for needed modifications and for help at home is an important part of the equation. Some options include a reverse mortgage, community Medicaid, long-term care insurance or savings.

2. Live with family members.   For some folks, moving in with family or having family members move in with them is a great solution. This can be mutually beneficial to everyone, especially when the older person is still fairly independent. Grandma can help with the grandchildren, even if that means simply sitting with them while they do homework. Living in the same home and interacting on a daily basis can foster a strong bond between grandparents and grandchildren. Of course, it is important to establish boundaries at the outset and set expectations to avoid misunderstandings and hurt feelings. Since everyone needs their own space, these arrangements often work best when a separate in-law apartment is added to the home.

3. Independent Living. Independent living is often the next step for seniors who want to be free of the expense and stress of maintaining a house. Independent living can refer to many types of living arrangements, from a rental apartment in a senior housing complex to the purchase of an independent living unit in communities such as Fox Hill Village in Westwood or NewBridge on the Charles in Dedham. Independent living is right for individuals who are able to live on their own but want the convenience of easily accessible transportation, the opportunity for socialization, and the comfort of knowing support is nearby if needed.

4. Assisted Living. Assisted living combines housing with personal service. Assisted living is for people who need support with day-to-day activities such as meals, bathing, and dressing.   Some assisted living facilities require residents to purchase an interest in the facility, most of which is returned to the family upon the resident's death. Some assisted living facilities charge rent for the apartment. All assisted living facilities charge a monthly fee for the services provided. Paying for assisted living can be a challenge for some. There are limited public benefit programs that will pay for assisted living, so this option is most readily available to those who have savings or long-term care insurance from which they can pay for this type of housing. Currently, veterans or surviving spouses of veterans may qualify for veteran's benefits to help pay for assisted living.

5. Continuing Care Retirement Community (CCRC). A Continuing Care Retirement Community (CCRC) provides multiple levels of living options from independent living to nursing home care. The purpose of a CCRC is to allow residents to "age in place."   Many CCRCs offer amenities such as private clubhouses, restaurants, a fitness center, and entertainment. Medial staff and security are often on duty 24 hours a day. For those who need a higher level of care and attention, assisted living services such as assistance with housekeeping, laundry and shopping are available. Most CCRCs also have a skilled nursing facility for individuals who need 24/7 care.   CCRCs can be especially appropriate where one member of a couple may require more care or assistance than the other.

Considering the possibility that there may come a time when you are not able to live alone in your home is not easy. Exploring options and planning in advance will make the transition easier - an elder law attorney can help.

This article is not intended to provide legal advice or create or imply an attorney-client relationship. No information contained herein is a substitute for a personal consultation with an attorney.

By Attorney Maria C. Baler