It’s a safe bet that pretty much everyone wants to live at home as long as possible. All too often, however, reality intervenes and wreaks havoc with plans for “aging in place.”  Regardless of whether moving from home is by choice or necessity, sorting out senior living options is a daunting task.  There are many types of housing available and multiple factors need consideration when assessing the options.  What level of care is needed?  How is the housing and/or care going to be paid for?  How close is the housing to family and other support networks?  In the following paragraphs we will try to answer at least a few of the most common questions about the different types of senior housing.

Independent Living

There is great variety among independent living communities. The physical buildings range from apartments to condos to stand alone houses.  The unifying factor, however, is maintenance of the living unit and any surrounding grounds is typically available for the residents.  As there is great variety in the types of independent living communities, there is also great variation in cost.  Obviously an apartment is going to cost less than an independent home on a golf course.  Although some government programs can assist with apartment rental costs for low income elders, independent living often requires residents to pay fully from their own funds.

Assisted Living

Assisted living facilities offer care for residents who can live independently as well as those that need some help from trained caregivers (who have oversight from nurses or doctors) with the “activities of daily living” such as cooking, cleaning, dressing, and medication dosing. The level of care provided varies greatly on the level of care needed.  Meal service is typically available in a dining hall or in a resident’s room.  Some assisted living facilities even have independent “cottages” on the grounds that allow residents greater privacy.  Assisted living facilities in the northern Puget Sound typically require a period of private pay before they will accept payment through Medicaid (they receive a reduced rate when a resident is receiving Medicaid), if they will take Medicaid at all.  Some long term care insurance may also cover assisted living costs.


Adult Family Homes

Adult Family Homes are private residences that are operated by licensed care providers who are present at all times. Many home operators have a nursing background and staffing ratios are always at least six residents to one caregiver. Homes can accommodate anywhere from 2 to

6 people and offer an environment that can feel more intimate and “home like” than a larger facility. Some adult family homes will accept payment through Medicaid, or long term care insurance.

Skilled Nursing Facilities and Rehabilitation Centers

These facilities, commonly referred to as “nursing homes,” have the staff and capacity to provide round-the-clock skilled nursing care and rehabilitation services such as physical or occupational therapy. Residents in these facilities have meals prepared for them and live in rooms located in a common facility.  Nursing homes are required to accept Medicaid payment without a waiting period.  In northern Puget Sound, the private pay rate at nursing homes is in the $7000 to $9000 range.  Nursing home care is almost always included within long term care insurance coverage.

Memory Care Communities

Memory Care Communities are care facilities designed around the specific needs of elders with dementia. Memory care may be provided in stand-alone facilities or it may be incorporated into larger assisted living or skilled nursing units.  Stand-alone memory care facilities are often secured so that residents cannot leave without proper accompaniment.  Trained caregivers are on staff and always present at these facilities.  Although stand-alone memory care may provide similar services to a nursing home, they are not always licensed as such.  If they are not licensed as nursing homes, they are not required to accept Medicaid payment.  However, some memory care facilities have a limited number of beds set aside for Medicaid.  Coverage by long term care insurance plans is dependent on plan details.

Continuing Care Communities

Part independent living, part assisted living and part skilled nursing home, Continuing Care Communities offer a tiered approach to the aging process, accommodating residents’ changing needs.   Healthy adults can choose to live in single-family homes, apartments or condominiums. When assistance with everyday activities becomes necessary, they can move within the facility into assisted living or nursing care facilities. These communities give older adults the option to live in one location for the duration of their life, with much of their future care already figured out. Payment options vary depending on the type of living arrangement and the policies of the community.

As you can see, the options are numerous and it can be a bit of challenge to figure out what is right for you or your loved one. Kaaran Anderson, our in-house Geriatric Care Manager, specializes in helping clients navigate through housing options and planning. Additionally, if a plan includes applying for Medicaid, we have extensive experience and expertise in preparing for and making these applications. If you are thinking about your current or future housing needs, we encourage you to schedule a consultation to ensure that you are making a fully informed and considered decision.


What Is A Geriatric Care Manager?

A Geriatric Care Manager is a professional, such as a social worker, nurse, or gerontologist, specializing in assisting older people and their families to attain the highest quality of life, given their circumstances.

The Geriatric Care Manager serves as an experienced guide and resource for families caring for adults directs and family members with dementia (Alzheimer’s or other types), Parkinson’s and other chronic health conditions.

For more information about Geriatric Care Managers please visit the website of the National Association of Professional Geriatric Care Managers @


Barry M. Meyers

David M. Neubeck 

Elder Law Offices of

Barry M. Meyers

DISCLAIMER: The content of this newsletter is: for information purposes only, subject to change by government agencies, should not be relied upon as current, and, does not constitute legal advice. Reading this newsletter does not establish an attorney-client relationship.