According to the U.S. Census Bureau, by 2050 more than 20% of the American population will be over the age of 65. This translates into 88 million people. The nation's 90-and-older population has nearly tripled over the past three decades to roughly 1.9 million in 2010. This number is expected to quadruple over the next four decades. Elderly people need different levels of care, and therefore require different facilities. The market is opening up for seniors and their families looking for options beyond nursing homes. Many seniors see nursing homes as the end of the road. In fact, a survey conducted by Clarity and The EAR Foundation in 2007 found that seniors fear death less than nursing homes. Such is the general image of nursing homes.

Home Care
Groups like Meals on Wheels provide meals to elderly people who cannot make their own. This service is conducted by volunteers, many of whom are elderly citizens themselves. Likewise, there are services that provide nurses and doctors who will make regular house calls. This option can be considered for seniors who need attention and help rather than constant medical attention.

Holistic Care Programs
Medicare offers the "Program for All-inclusive Care for the Elderly" or PACE. This service helps seniors receive medical care while they live in communities rather than in nursing homes. If the senior is over 55, lives in a PACE area and has access to Medicare or Medicaid, he or she is eligible for PACE. Those who meet the criteria can then receive healthcare from professionals and organizations affiliated with PACE. This program caters to small groups of individuals, which means greater personal attention is provided. PACE helps take care of other services like dental, eye and hearing care. Medical transportation, hospital transportation and physiotherapy are all undertaken by the PACE program.

Subsidized Housing Care
The U.S. Department of Housing and Urban Development (HUD) provides subsidized housing to seniors with low incomes. However, there are often long wait lists.

Senior Apartments
Apartments for seniors over 55 are available. These apartments have senior-friendly amenities. Communal eateries, transportation and recreational activities are made available to residents. Retirement housing that includes townhouses, condominiums, and that have maintenance and recreational facilities are also available.

Assisted Living Facilities
Some seniors require assistance with day-to-day activities like doing laundry and making meals, but do not need medical assistance and can function independently. An assisted living facility works wonderfully in such cases. Assisted living facilities can help individuals who might not be very mobile, but enjoy socializing and interacting with others. Seniors who live in assisted living facilities pay rent and extra charges for other services.

Board and Care Homes
Many seniors need a higher degree of care than residents in an assisted living facility. They need help bathing, going to the bathroom and walking. However, Medicaid or Medicare won't cover them. In this kind of facility, seniors are watched over 24 hours a day, but they do not need medical assistance. Homes that have fewer than six elderly individuals living there are sometimes called adult family homes. Homes that have seven to 150 residents are called board and care homes.

Continuing Care Retirement Communities (CCRCS)
This alternative allows for the transition from apartments to assisted living to nursing home all within the same campus. Admission charges could be in the range of $150,000 to $400,000 or more. On top of that, there are monthly rates of $1,200 to $3,500 or more. It is not a viable option for seniors with low incomes. This format is undergoing a change thanks to the recession. The various facilities at a retirement community can now be made available at the senior's home. Nurses, caregivers and therapists come into the senior's home to aid him or her. With housing out of the picture, costs are reduced dramatically. The admission charges can be $5,000 to $150,000, plus monthly fees of $190 to $584. If a senior has an accident that requires hospitalization, CCRCs will cover it.

The Bottom Line
As the geriatric population of the country increases, there will be a proportionate increase in the diversity of facilities offered to senior citizens. This increase in the senior population also means senior citizens will become more vocal in the kinds of facilities they would like to use in their twilight years.

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