If you've been thinking about making a move into retirement housing, now is a great time to get serious about the decision. Whether you want to live independently in a retirement community, need an assisted living facility, or want more extensive support in a nursing home, it's a buyer's market today. The recession has forced even high-end communities to offer wide-ranging discounts and inducements to attract residents. At the same time, this softness won't last forever. And when conditions improve, the pent-up consumer demand will reveal serious shortages of high-quality senior housing.
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The development of new housing units for older residents has pretty much been stopped in its tracks during this downturn. Potential residents have been squeezed by declines in their retirement investments and their biggest nest eggs -- their homes -- have either been cracked or broken by the collapse of the housing market in many parts of the country. On the development side, this weak demand has deterred new construction but so has the disappearance of credit to finance new building.
Meanwhile, of course, the supply of older persons continues to grow. Maybe our healthcare system is financially bloated and does not deliver the best care for the money. But that hasn't stopped older people from living longer and longer. Although there has been a surge in efforts to assist people to stay in their homes as they age, soaring numbers of aging Americans will eventually need institutionalized care. And the living units will be increasingly in short supply. Now may just be the best time to make the move.
Having said that, it can be hard to find the best facility for you or a family member. Nursing homes are regulated and licensed by individual states. However, Medicaid pays for many people in nursing homes, and the Centers for Medicare and Medicaid Services provides a comparative tool to assess the quality of nursing homes around the country. This tool has been enhanced by U.S. News for its America's Best Nursing Homes rankings.
There is no such comparative tool for assisted living, continuing care retirement communities, and other facilities. There isn't even a set of national definitions for the types of services that are offered in these various facilities. State and local rules differ. Some communities are operated by non-profits while others are looking to make attractive profits for their owners.
There is a big range of costs and services, so the best approach is to have a very clear idea of exactly what you want, and then search for the communities that meet those specific needs. Several sites have online directors of senior living communities, including Gilbert Guide, Seniors for Living, and SeniorOutlook.com. Sites may be paid for home listings and endorsements, so make sure you understand that you may not be seeing the entire inventory of available facilities.
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The current issue of Health Affairs has an overview of the market for assisted living facilities. They generally can be found in more affluent communities. The overview includes a table showing how many large (25 units and up) complexes are in each state and the ratio of such living units to each state's population of people aged 65 and up:
|Assisted Living Spaces in the United States*|
|*As of 2007. Only facilities with 25 or more units are included. Density is the number of units per 1,000 persons in each state aged 65 and older. Source: Health Affairs.|
Minnesota is far and away the most well stocked state in terms of assisted living facilities, and has nearly five times the national average, expressed as a percentage of persons aged 65 and up. Virginia and Oregon posted about twice the national average, and other well-represented states were Nebraska, Washington, Pennsylvania, and North Carolina. Hawaii, Connecticut, West Virginia, and Louisiana, by contrast, all were well under half the national average. Keep in mind that this inventory excluded facilities with fewer than 25 living units. Some states may rely more heavily on small assisted living complexes.