For many, emotions and memories are tied to their homes, and that’s what makes it difficult to consider leaving their home. Even when there might be good reason.
But it is a scenario many older adults and their adult children face, wondering what is the best situation for themselves or an aging loved one.
There are many options out there. How to choose?
According to the 2020 Census, nearly 56 million people age 65 or older live in the United States, about 16% of the population. A study done by the Pew Research Center found that 27% of American seniors live alone and 46% share a home with a spouse or partner.
Elderly in this country are basically left on their own compared to many countries where multiple generations live together in one home. While living alone might be fine for the older person who is physically and mentally fit, good health doesn’t last forever.
Everyone ages differently, but most eventually move from independence to interdependence, then dependence to crisis management — ultimately to end of life. It is recognizing that within each different stage there will be new issues to address. Understanding this can assist in making decisions with where to live.
People can find help in determining what living situation is best for them or for their parent from a couple government websites:
Senior Linkage Line (mn.gov/senior-linkage-line) is a free Minnesota statewide service of the Minnesota Board of Aging in partnership with Minnesota’s area agencies on aging. It offers information, resources and guidance to help with understanding aging, caregiving and Medicare. People can call to talk with someone to ask questions (800-333-2433) as well.
Minnesota Board on Aging (mn.gov/board-on-aging) also has its own website. The 25-member, governor-appointed board advises on and coordinates government plans around aging to ensure that Older Americans Act requirements are met. It allocates state and federal funds and creates public awareness. The website is a comprehensive platform that provides information on caregiving, Medicare and housing. It offers a phone number for people to call to talk to someone in person to answer questions, too (651-431-2500).
“I recommend people start with these,” said Donna Birk, McLeod County Social Services supervisor. “They have a lot of information people can read through on their own. If they have questions, they can call these places, and someone will try to help or direct them to an agency that will.”
County social services agencies can also assist in determining the needs of an older adult through MnChoices, a web-based tool used for assessment and support planning for Minnesotans who need long-term services and supports. Responses to questions posed within the tool determine eligibility for a number of public programs, including home and community-based waivers and personal care assistance.
“A person has to qualify to apply for many of these services,” Birk said. “It can be complicated and is handled through case management to coordinate the proper services.”
Other resources include the Minnesota Nursing Home Report Card (nhreportcard.dhs.mn.gov) and Minnesota Assisted Living Report card (alreportcard.dhs.mn.gov). Both websites allow a person to type in the name of the facility they’re considering and the town/city they are located to find how facilities rank within the state.
The assisted living report card is new this year, and has only 20% of the assisted living facilities listed, focusing on the largest ones. It will expand early next year, adding more facilities and ratings based on the Minnesota Department of Health’s licensing surveys and suggestions. The nursing home report card is older and more established and should have all area facilities listed.
After the research comes choosing the type of facility.
INDEPENDENT LIVING
Independent living facilities offer housing options that are friendlier to older adults with easier accessibility and no maintenance, snow removal or yardwork to worry about. A resident can still have their own vehicle with these facilities, which provide a garage to accommodate them. The resident, who needs little assistance with daily living, comes and goes on their own.
Independent living facilities offer many amenities to their residents, including activities and clubs that help residents connect over arts and crafts, continuing education classes, movie night, card or board games, yoga or exercise programs and book clubs. The facilities also offer services like beauty salons, daily meals and basic housekeeping and laundry.
Most don’t offer medical care or nursing staff, but residents can find their own in-home care services, at their expense, if they desire.
Hutchinson offers a variety of independent living facilities. At Village Cooperative, residents purchase a share and pay a monthly fee. Prince of Peace and Woodstone offer apartments with monthly rent. Residents purchase units at Greencastle and Lakewood. Park Towers and Evergreen are both income-based, rented apartments.
In Litchfield, Ecumen of Litchfield offers Gloria Dei independent living apartments. It has studio and one-bedroom apartments for 62 years and older. It also offer six HUD subsidized units.
Many of the facilities put a focus on residents’ socialization.
“Friendship is so important to our health and longevity,” said Jill Springer, executive director at Woodstone, which has one- and two-bedroom units for rent. “We want to foster that.”
“We believe we help people stay in their home longer because of the socialization,” Destiny Doring, executive director at Prince of Peace, said. “We have a ‘buddy system’ where we pair new residents with someone who has been here longer to help them get adjusted. We also have the best staff, who are willing to listen and will help find answers to questions.
“One thing we’d like the area to know is that most of our activities and meals are available to the public,” Doring added. “We welcome friends and family members. You can just add your name to our newsletter and you will receive the same notices and information that residents do. All we ask is that they give us a day notice that they’re coming, especially for the meal.”
Most independent living facilities are private pay, so the question for many is what happens when the money runs out?
“Sadly, that does happen,” Doring said. “We are a private pay facility only, but we will do what we can to help the person find new housing options if they can no longer afford to live here. We care and want to offer whatever support we can.”
“We are able to consider other sources if the resident can no longer pay the rent themselves,” Springer said. “It would be on a case-by-case basis.”
Overall, residents are happy living in this type of senior living option.
“Most of our residents tell us they wish they would have moved here sooner,” Doring said. “We are the independence you want, we have the activities you need and the freedom to come and go as you desire.”
ASSISTED LIVING AND MEMORY CARE
Assisted living facilities provide housing for people who cannot live independently anymore. They may need help getting dressed, bathing, taking medications.
Facilities still encourage independence and offer activities to encourage peer interaction, as well as physical and mental stimulation. Assisted living facilities have lower level of care than nursing homes, but still might have a registered nurse and medical staff present during the day.
Assisted living facilities can be private pay but also have other options for affordability, including medical assistance, long-term care insurance and veterans administration contracts. Billing is mainly by the month. Along with “rent,” residents pay for care provided during that time.
“Unlike most assisted living communities, we have one price that includes all levels of care,” Woodstone’s Springer said. “We may be a little more expensive upfront, but that’s going to be the bill no matter what. You will be able to depend on what your expenses are consistently.”
“We try to be fiscally responsible,” Luke Krueger, campus administrator at Harmony River, said. “We know what we spend affects our residents. We do try to keep that in mind. We want to be good stewards.”
Other assisted living facilities in the area include The Oaks and Pines, Prairie Senior Cottages, and River Oaks at Shady Ridge in Hutchinson, and Ecumen in Litchfield. Both Woodstone and Harmony River have architecture features to aid memory care residents.
“We have suites of rooms that go around the central dining and lounge area, Springer explains. “They share common spaces. They are called neighborhoods. This setup allows our memory care patients to be able to just walk around in the circular hallway. They will eventually be brought back to their room with ease.”
“Our builders were smart when they configured our neighborhoods,” Krueger said of Harmony River. “Our memory care patients just follow the walls so they can’t get lost in their neighborhoods. It’s a natural flow.”
While Woodstone isn’t classified as a nursing home, residents can look to stay for most of their stages of aging.
“We are half the price of a nursing home,” Springer said. “We do have 24-hour wellness care.”
Viona Schroeder has been a resident at Harmony River for 11 years, and she said it’s been a good experience.
“The staff are so friendly and nice,” she said. “They go out of their way to take care of you.”
Charles Markert, also a Harmony River resident, agreed: “I love it here! I’ve been here for over three years. It’s like being in a five-star hotel.”
Markert, previous owner of Sky High Art, which paints hot air balloons, is a veteran who served in Germany and Beirut, Lebanon, in the 1950s.
“My family wanted me to stay in my apartment, but I said I need more care,” he said. “ I came here and have been so happy. The staff are excellent. They’re here to help you. I feel so safe.
“It’s also a good learning environment,” he added. “I can’t paint hot air balloons anymore, but I can do art on the iPad that I learned to do here.”
NURSING HOMES/SKILLED NURSING FACILITIES
A nursing home is for older adults in need of short- and long-term care that can no longer be provided at home or in an assisted living facility. Skilled nursing facilities have qualified medical staff on site to provide medical care. They help residents with personal care, medications and activities of daily living. This can be the care facility for the final stages of life.
Nursing homes in the area include Harmony River in Hutchinson and Meeker Manor Rehabilitation Center in Litchfield.
Nursing homes charge by the day, and the rate is set by the state of Minnesota. The pay sources are the same as assisted living with the exception of Medicare Part A for short-term stays. Medicare covers 100 days of assisted living expenses after three days of prior hospitalization and covers 100% for the first 20 days. This may be all that is needed for a family member who has fallen and sustained an injury that requires aid to heal and physical therapy.
“People should be aware that you’re not guaranteed a full hundred-day stay if you don’t need it,” Harmony River’s Krueger said. “A lot of times a patient expects to be in our facility for that period of time only to be surprised when it’s not necessary.”
Krueger also cautioned that people should be aware of stipulations with long-term care insurance.
“It’s important for people to understand that with long-term health insurance, it doesn’t cover the first three months of stay,” he said. “There’s an elimination period before the insurance payments kick in. It’s important that people understand to call the insurance company as soon as the person is admitted. The 90-day period starts on the date of the call.”
“Long-term health insurance is great when you have it, but it’s a lot of money to invest in,” Krueger added. “Some people never get to use it. Others use it for a long time.”
He encourages veterans and their spouses to take advantage of resources available to them.
“Harmony River is a Veteran Administration-contracted facility,” Krueger said. “Connect with veteran agencies to find out what advantages there are. Sometimes they aren’t used because veterans and their spouses aren’t aware.”
ADVICE
The consensus among senior facility administrators is that research and planning are critical during the aging process.
“Learn what’s out there,” Woodstone’s Springer said. “People who think ahead and know what’s available can communicate with their family what their wishes are.
“Second, know what you can afford,” she added. “There are all kinds of resources out there. Also, know what you’re paying for.”
Making realistic assessments of needs and sharing that in conversations with family is important, Springer said.
“With that, ask what happens when my needs change when you look into facilities,” Springer advises. “Have a care plan and get everything in order.”
Krueger has suggestions, too.
“Do the research,” he said. “ There are multiple places to go like Senior Linkage and Minnesota Board of Aging. Tour facilities. You want the place to feel like it’s the right fit for you. Pay attention to the vibe you get when you walk in.”
Getting finances in order is especially important, he said. No matter what facility is chosen, it’s going to be expensive.
“It’s hard to figure things out when you’re in crisis management mode,” Krueger said. “Make health care directives, get your power of attorney in order and have the tough conversations with what your wishes are.”
With planning and a little luck, the process can be a positive experience.
As Markert, who is having fun at this stage of his life, said, “Tell them not to be scared.”
