It’s Not Your Grandma’s “Old-Folks Home”

Nursing home model evolving into improved living environment

One of the most enduring legacies of the 1960s and ‘70s was the “bad old days” of poor nursing home care. Nursing homes were this country’s first official experiment in caring for frail older people, yet they couldn’t have done a worse job.  The government agencies in charge were like deer in the headlights, unable to make them better. Thankfully, decades of incremental changes have made nursing homes better. While still a work in progress, many are now more caring.

In the long run, though, the most important reason eldercare has improved is because, inch by inch, we have more nursing home alternatives – in-home care, retirement communities for elders who are healthy and independent, and assisted living communities and adult family homes – both for frailer older people who need more care. Rather than having one choice like we did 50 years ago, we can now choose from a variety of care and housing options, based on our needs, pocketbooks, and preferences.

But here’s even better news, and it’s hot off the press: our care choices are about to explode.

Why? Blame it on the baby boomers (in a good way, of course). Beginning sixty-nine years ago, nearly 80 million babies were born from 1946 to 1964, the largest generation in American history. The youngest is now 50. Eight thousand turn 65 every day. Soon they will be the largest, oldest generation in history, and they’ll want and need – and demand, as boomers have always demanded – a wide variety of good quality services as they age.

It’s already happening.

Overnight, the bar has been raised in many of our most traditional care settings.  Long a source of complaints, meals have become more nourishing and tasty. Apartments – once the size of postage stamps – are getting larger. More communities now welcome pets. Activities focus on brain health, physical health and fun, not just bingo.  Residential niches are being developed to serve the needs of special populations, such as gays and lesbians and cultural ethnic groups.

And don’t most of us want to live where we won’t have to move as our needs change – meaning we want the care to come to us? That’s happening, too. Although some retirement communities have long required you to move out the minute you lose your keys, for example, more are offering varying additions of assistance so you can stay longer.

Continuing Care Retirement Communities (CCRCs) are one of the oldest eldercare models in the United States, built on the principal that residents can move in healthy, then stay until the end.

Usually the most expensive choice, CCRCs are leading the way for older people of means to enjoy many elements of high end living that never existed in retirement communities before – fine dining by culinary-school trained chefs, sumptuous décor from top designers, gorgeous views, Olympic size swimming pools, and beauty salons that pamper you to your heart’s content.

One of these is Mirabella Seattle, a CCRC that was built in 2008 and is already expanding to give its residents more choices. “We emphasize whole person wellness here, “ says Steve Brudnick, Executive Director, “bringing together a myriad array of activities – yoga, water aerobics, meditation, and art classes – to serve the whole person physically, socially, emotionally, spiritually, and intellectually.”

Other trends:

~ Naturally Occurring Retirement Communities (NORCs) are apartment buildings where a large number of residents have grown old together.  By introducing an array of social services, education, and health care management, residents can remain independent and healthier longer.

~ The “Golden Girl” model, named after the 1980s TV sitcom starring Betty White and a few of her chums, involves friends sharing a house and meals. If it reminds you of the communes from the 1970s, it’s no surprise – and for much the same reasons: companionship and lower living expenses.

~ Co-Housing involves planned communities of homes that are clustered on a single campus, where residents (sometimes a variety of ages, other times just older people) live near each other in privacy, while meals, chores, gardening and other activities are shared.

~ The “Village” model of care began in the Beacon Hill neighborhood of Boston in 2001. From a central hub, village members are provided lists of vetted providers (from light-bulb replacers to plumbers to dog walkers to drivers) and social activities that keep people living in the neighborhood longer. Once rare, about 150 Villages have popped up around the country. There are three in Seattle.

Like never before, older people today have some amazing choices in how and where they spend their last decades, their third act. Keep your eyes open, for it can be a fun time to explore the possibilities.  Grab a friend (or two) and have lunch at a nearby retirement community, ask lots of questions, and keep track of the answers.  Knowing what your real choices are now – exploding that old nursing home myth – can open you up to a great new adventure.