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Alternative living arrangements
For when you need more help
Some seniors choose — and are able — to stay in their own homes. Others may decide that a different living arrangement better meets their needs as they get older.
Why move?
- You're ready to leave the yard work behind so you can concentrate on your golf game.
- You live alone, and household chores and other responsibilities are becoming more difficult to manage on your own.
- You've recently suffered a bad fall and can no longer climb the stairs to your bedroom.
- Your mother has dementia and can't live alone, and you are unable to care for her in your home.
- Your father has a health problem that requires ongoing medical care.
Shared housing
One type of shared housing is to bring in a roommate who can help with light chores or other services in return for reduced rent. This can be especially attractive for people living near colleges or universities.
Another arrangement might include 2 or more unrelated older adults sharing a home, chores, and possibly other agreed-upon services.
There are agencies that can match seniors with shared housing information and contacts. Contact your local Area Agency on Aging or visit the National Association of Area Agencies on Aging to find an agency in your area.
Retirement communities
These can be seniors-only buildings, neighborhoods, or whole communities. They usually include a wide range of activities, services, and events geared toward active older adults.
Many offer trips, golf and fitness activities, entertainment, classes, clubs, and different interest groups.
Some also offer graduated levels of care, if and when it's needed. Those that do are often known as continuing care retirement communities.
"Seniors only" apartments
These kinds of apartment complexes can offer added security for those who no longer want to live alone in their home and also provide a variety of outings, entertainment, clubs, and services.
Assisted living and residential care
These facilities can include apartments where people who need some daily assistance receive personal help, meals, and housework but are otherwise independent. Board and care homes, where 4 to 10 residents needing some nonskilled care live together, also offer assisted living. The workers in these facilities may live in the home, or there may be several workers who rotate throughout the day.
In-law apartments
Some families build or have in-law units on their property. Seniors can live independently but still be close to their families in case of emergency.
Home care and home health services
Local agencies can provide a range of home care and home health services, from help with light housekeeping, chores, and bathing to short-term medical or rehabilitation needs. Some of this work requires that the workers be licensed by the state. Medicare pays only for some specific types of home care. Look for Kaiser Permanente partner organizations in your area.
Skilled nursing facilities
People needing skilled nursing assistance, such as intravenous medications or rehabilitation following an operation, may need to spend time in this type of facility. This kind of care is often available in other settings, too.
Nursing homes
For some people, living at home or in another semi-independent setting may no longer be possible. A nursing home may be appropriate if someone needs ongoing assistance with eating, hygiene, and medications.
You can find additional information about long-term care options and insurance at Medicare.gov.
End-of-life care (hospice arrangements)
Hospice care is for people in the final stages of a terminal illness. Treatment focuses on relieving symptoms, helping a person to be physically comfortable, and providing emotional and spiritual support.
Hospice care is provided in the place a patient is living. It allows a person to remain at home or in another personal, comfortable setting, such as a relative's home or board and care facility, during the last days of life. Hospice care also supports caregivers and families with bereavement counseling and other services.
Kaiser Permanente's Hospice Program is a Medicare-certified program providing end-of-life and palliative care services to Kaiser Permanente members and their families in some of our regions. Services include physician treatment, nursing, social work, and chaplain consultation.
Admission to the Hospice Program requires written certification from the attending physician and a medical director of hospice or physician member of the hospice interdisciplinary team.
Talk with your doctor about hospice services available in your area.
For Kaiser Permanente members living in Northern California, learn more about hospice services in your region by visiting kp.org/hospice/ncal.
Other places to find help
CalQualityCare.org
Village to Village network
Hospice website (for Northern California members)
Reviewed by Tracy Lippard, MD, July 2019