Living Arrangements for Older Adults
Many frail. older people live alone or in a family setting where care is provided informally by family or friends. Relatives (especially women) provide most of the care. Many women caregivers are employed outside the home; some are still raising a family. Recently. the responsibilities of informal caregivers have become more complex. For some frail. older persons. family members are often involved in nursing regimes-such as chemotherapy and tube feeding-that were previously performed in hospitals. Only about 5 percent of frail. older persons are currently in nursing homes (Portraitists, 2002).
Support Services, Homemaker Services, and Day Care
Support services help older individuals cope with the problems in their day-to-day care. These services are very expensive even when they are provided through state or federally funded programs. hospitals. or community organizations. For older persons. homemaker services perform basic chores (such as lighr housecleaning and laundry); other services (such as Meals on Wheels) delivermeals to homes. Some programs provide balanced meals at set locations. such as churches. synagogues. or senior centers. However. some of these programs have been criticized for their failure to provide meals that take into account the diverse ethnic backgrounds of the people they serve (Gelfand. 2003).
Day-care centers have also been developed to help older persons maintain as eunuch dignity and autonomyas possible. These centers typically provide transportation. activities. some medical personnel (such as alicensed practical nurse) on staff. and nutritious ious meals. Most centers are very expensive-in some cases. $700 or more per month for a five-day week (Benokraitis, 2002). In some slates, Medicaid covers the fees of older persons living below the poverty line; however, only one-third of older persons who are poor receive Medicaid (Neuschler, 1987).
Some older adults remain in the residence where they have lived for many years-a process that gerontologists refer to as aging in place (Atchley and Barusch, 2004). Remaining in a person’s customary residence is a symbol that he or she is able to maintain independence and preserve ties to his or her neighborhood andsurrounding community. However. either by choice or nec ssity, some older adults move to smaller housing units or apartments. This type of relocation frequently occurs when older people are living in a residence that does 1I0t meet their current needs. Moving to another location may be desirable or necessary when their family has grown smaller, the cost and tlme necessary to maintain the existing residence become a strain on them, or Individuals experience illness or disabilities tthat make it difficult (or them to remain in the same location. More housing alternatives are available to middle income and upper-income older people than to lowing come individuals. These include retirement communities such as Sun City. where residents must be age 55 or above. (Sun City is the name of several privately
owned retirement communities located in such states as Arizona and Texas.) Residents of retirement communities purchase their housing units and in some i instances pay additional fees for the upkeep of shared area sareas and amenities such as a golf course. swimming pool, or other recreational facilities. Typically, residents of planned retirement communities are similar to one another with respect to race and ethnic background and social class. Most retirement communities do not provide support services such as health care ortransportation. People needing assistance with daily activities or desiring the regular companionship of other people may move to an assisted-living facility. Some of these facilities offer fully independent apartments and provide residents with support services such as bathing, help with dressing, food preparation, and taking medication. Some centers provide residents with transportation to medical appointments, beauty and barbe.