Group Housing Offers a Middle Ground of Options for Seniors (1999)

Between 10 and 50 percent of the nursing home population may be there unnecessarily. Group housing offers an attractive alternative for older people who cherish their privacy yet would benefit from daily emotional or physical support. So why hasn't it caught on? Peter S. K. Chi got a big surprise as he was crunching numbers from U.S. census data to see what communities are most likely to develop group housing options for the elderly. It wasn't that only certain types of communities support older Americans living together that startled Chi. He already knew that. Rather it was that so few communities, of any stripe, bothered to offer this alternative at all. had anticipated that the percentage of Americans over the age of 65 living in group housing arrangements, in shared residences or assisted-living facilities, for example, would be low - 3 to 4 percent, or slightly less than the 5 percent who live in nursing homes, explains Chi, a professor in the Department of Policy Analysis and Management who specializes in studying elderly housing issues. Instead, I found that regardless of region, metropolitan status, or size of place, less than 1 percent of the elderly live in group housing. While surveys of older Americans show that more than half of the men and women over 65 acknowledge having at least one disability that limits their day-to-day activities - be it preparing meals, using the phone, dressing, or getting around the house - the vast majority, nearly 95 percent, go it alone. For most people there's no stop between leaving a single-family dwelling (either owned or rented) and placement in a nursing home. And while supporting research has yet to be done, there is much concern, says Chi, that a significant number of older people seek institutionalization in nursing homes prematurely because either their current housing is no longer suitable or home-based health care and other services aren't available in their community. Estimates suggest that between 10 and 50 percent of the nursing home population is there unnecessarily. Group housing offers a middle ground that is attractive to older people who cherish their privacy and independence yet would also benefit from some emotional or physical support during the course of the day. Various types of shared living arrangements are flexible enough to offer a continuum of services depending on the residents' level of need. what is technically called congregate housing, individuals live in their own quarters but share at least one meal a day together. They may also choose to participate in organized social activities. The idea is to provide a group setting for people who can no longer manage in their own homes but are otherwise functionally independent. A major advantage to congregate housing is that it mitigates the loneliness that so often accompanies aging in America. Assisted-living arrangements are the next step. For those with significant physical or cognitive challenges, group home arrangements can provide considerable supervision along with housekeeping services and meal preparation. At the next level, personal care assisted-living facilities offer individual apartments or rooms along with meals, housekeeping, transportation, and continuous personal care services, ranging from assistance in managing money and taking medications to help with bathing and dressing. Group housing, in all of its various guises, offers many advantages to older Americans, says Chi. Companionship for one. Affordability for another. If you look at the visiting nurses program as a model for providing care, you find that because the nurses have to travel from one individual residence to another miles apart, they can serve only two or three people a day, Chi points out. In a congregate situation nurses could serve twice as many people if not more. Service delivery, along with the bulk purchase of medications and other supplies, can be much cheaper. …