Continuing Care and Retirement Communities

A wide variety of arrangements for meeting the housing needs of older Americans have been devised. For the more socially oriented and physically capable, there is shared housing in which 5-15 unrelated people live together and share household expenses and chores. For those with a strong desire for privacy, an option is an ECHO house —a small, temporary living unit in the yard of another single-family dwelling. Another possibility that may work well as long as the resident continues to feel like a homeowner rather than a boarder or renter is an accessory apartment built by middle-aged adults in the home of an aging parent.

Depending on his or her physical condition and financial status, a older adult may decide to live in a congregate housing community, a continuing-care retirement community, or a retirement village. As a rule, the more active, less sociable orientation of men causes them to experience more difficulties in adjustment to relocation to age-segregated "retirement" or senior housing. Men often react with outright resistance, on the one hand, to resignation, on the other, when moving to a retirement home or long-term care facility (Barer, 1994).

Tenants in a congregate housing community have their own apartments but take their meals in a common dining room. This arrangement, which is appropriate for older adults with mild physical impairments, provides both housekeeping and security. Unfortunately, the increased dependency produced by having most of one's needs taken care of by someone else can lead to a more rapid deterioration and a decline in a person's competence level.

A greater range of services is provided by a continuing-care retirement community (CCRC) than offered by a congregate housing community. CCRC residents pay a sizable initial fee plus a monthly maintenance fee for food, rent, utilities, maid services, and nursing care. The residents, who are assured that their needs will be met as long as they live, are typically in their seventies, unmarried, childless, well-educated, and higher than average on the socioeconomic scale.

Although residents of congregate housing or CCRC communities may be characterized as "slow-go" (and some even "no-go"), most residents of retire ment villages are definitely "go-go." Communities designed exclusively for adults developed initially after World War II and have blossomed in the southern and western regions of the United States in particular. Examples are Sun City near Phoenix, Leisure Worlds in California, Park West in Miami, and The Sequoias in San Francisco. Many retirement villages are quite luxurious, providing heated swimming pools, tennis courts, golf courses, bowling greens, restaurants, libraries, classrooms, medical clinics, closed-circuit television, and security guards, who patrol within the community walls around the clock. Of course, such luxury is not for everyone, even those who can afford it. Playing and relaxing, and no longer being a part of the business and bustle of the world, may become tedious and stultifying to capable, creative individuals. Furthermore, the perception of older people as flocking in large numbers to retirement communities is largely inaccurate. Only a small percentage of older people move to retirement communities. The great majority are interspersed among the general population consisting of all age groups.

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