Housing Options: A Glossary
A framework for understanding your choices
Once upon a time, nursing homes were the only option for seniors who could no longer live on their own. These days, housing options come in a variety of forms, and though some of the names sound alike, states often refer to them in different ways. Here we offer a glossary of terms we’ve found—something to give you a framework for understanding the kinds of housing people can consider as they age. We’ll add to this list and modify it as needed. For more information, see the Source list at the end of this article as well as other articles related to housing on the Silver Planet Web site.
Accessory apartments: Units that have been added on to, or created within, a single-family house. The eating, bathing, and sleeping areas are separate from those in the main dwelling. Generally, children, close relatives, or friends of the older person occupy one of the structures. This option allows older people to live independently but close to those who care about them. Accessory apartments are also referred to as mother-daughter homes.
Adult family care (AFC): Homes that offer individuals the opportunity to move in and share the home of a caretaker who provides needed assistance and supervision. Participation in the family and community are encouraged. Seniors have the right to be part of the planning of their treatment, to access shared areas of the house such as the kitchen and living room, and to make choices with respect to services and lifestyles. These homes are supervised by a “sponsor agency.”
Adult family homes (AFHs): Residential homes licensed to care for up to six elder residents. They provide housing and meals, and assume general responsibilities for the safety and care of the residents. Additional services may include varying levels of assistance with personal care, nursing care, and medications. Some AFHs also provide specialized care to people living with developmental disabilities, dementia, or mental illness.
Affordable housing/affordable senior housing: These are usually apartments in high- or mid-rise buildings that have been specially designed for, and are limited to, people who are at least 62 years old or have a disability. There are income limitations for eligibility for this type of housing, and the rents are usually subsidized, with the amount of rent based on household income. In some buildings, recreational activities and support services such as meals, housekeeping, or transportation are provided. Fees for services may be included in the rent or charged separately. Government housing assistance is available to eligible low-income and very-low-income elderly persons 62 years of age and older through the U.S. Department of Housing and Urban Development (HUD), including the HUD 202 Program, which offers rental assistance for seniors who meet eligibility requirements. (Also called public housing or subsidized housing.)
Alzheimer’s/dementia care facilities: Many assisted living communities will accept early-stage residents, but these facilities are another option. Patients with early-stage Alzheimer’s disease may be accommodated in a congregate or independent wing of a multilevel campus. As the disease progresses and patients develop argumentative behavior and wandering habits, Alzheimer’s communities are the best option.
Assisted living: These communities serve people who are no longer able to live in their own homes but do not need constant care. Assisted living facilities may be part of a retirement community or nursing home, or they may stand alone. They offer single or double rooms, or sometimes even suites or apartments, depending on a person’s needs and ability to pay. There’s 24-hour on-site staff, group dining, and activity programs. Assistance is offered for activities of daily living, such as dressing, bathing, taking medicine, laundry, cooking, and getting around. (Sometimes called boarding homes, although those facilities are not required to provide nursing services. Ask what type of license the facility has.)
Cohousing: Either intergenerational or older adult communities that feature small homes built close together, allowing more room for open space and courtyards, and with a common house as the focal point. The common house is the social center, with a dining room, kitchen, lounge, recreational facilities, and other features. Group meals prepared by the residents are served there a few times a week. Residents in cohousing value living in community, and meet regularly to solve problems and develop policies, making all decisions by consensus. Currently, there are only three senior cohousing communities in the United States; more are in the planning stages. (This is considered an intentional community, one created by people with a common vision.)