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Although the majority of people want to age in their own homes for as long as possible, at some point they may want or need to consider alternatives. There are many different types of housing specifically for older adults. These housing options are typically age-restricted, such as for people age 55 and older. Below is an overview of the most common types of senior housing, with a focus on California. It is important to note that terminology and regulations vary from state to state. Services, amenities, admission requirements, and payment options vary by facility or building.

55+ Apartments

apartment building

55+ apartments cater to active, independent older adults (age 55 and older) who are often looking to downsize and/or live in a community with other older adults. Apartments and condos are the most common types, although there are some age-restricted planned communities with full-sized homes. Services and amenities vary. Residents are typically responsible for housekeeping, dining, and transportation. Apartment and condo buildings may handle maintenance. Generally, no personalized care services, such as medication management or assistance with hygiene, are offered.

55+ apartments are purchased privately, similar to buying a home. Long-term care insurance or other types of insurance will likely not cover any property-related costs.

Independent Living

Independent living (IL) communities cater to older adults (in most cases, age 60 and older) who are looking to downsize to a residence where housekeeping, dining, transportation, and recreational activities and other social engagement opportunities are provided. IL units range from studios to 2-bedroom/2-bathroom or larger, and communities range in size from 10 units to 100 or more. Residents of these communities are generally physically and cognitively healthy and independent, and need no or minimal assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

IL communities are typically privately paid, with a monthly fee (based on the unit size) being the most common. Medicare and Medi-Cal (California’s Medicaid program) generally do not pay for IL, and long-term care insurance coverage varies.

Although there are standalone IL communities, senior living communities with multiple levels of care (independent living, assisted living, and memory care) are becoming more common. Most IL communities are licensed and regulated by the California Department of Social Services, as Residential Care Facilities for the Elderly (RCFE).

Assisted Living

Assisted living (AL) communities cater to older adults (in most cases, age 60 and older) who have physical and/or cognitive health issues and need regular assistance with ADLs and/or IADLs. AL units range from studios to 2-bedroom/2-bathroom or larger, and communities range in size from 10 units to 100 or more. AL communities provide housekeeping, dining, transportation, and activities and other social engagement opportunities. They also provide additional personalized care services such as medication management, bathing or dressing, and generally will have limited nursing staff. Residents of these communities may have a wide range of physical and/or cognitive health conditions, with the most common being dementia and limited mobility.

person with stethoscope around neck holding older adult hands

AL communities are typically privately paid, with a monthly fee being the most common. The monthly fee is usually based on the size of the unit and the level of personalized care services needed. Medicare and Medi-Cal generally do not pay for AL. Long-term care insurance may cover a portion of the cost, if certain requirements are met.

Although there are standalone AL communities, senior living communities with multiple levels of care (independent living, assisted living, and memory care) are becoming more common. AL communities are licensed and regulated by the California Department of Social Services, as Residential Care Facilities for the Elderly (RCFE). In California, AL communities may offer a wide range of services, including caring for individuals in wheelchairs or who are bed-bound or on hospice. Check with the individual facility first.

Board & Care

Board and care (B&C) facilities cater to older adults (in most cases, age 60 and older) who have physical and/or cognitive health issues and need regular assistance with ADLs and/or IADLs. B&C differ from assisted living in that they are typically individual family homes, with no more than six residents. Residents may have a private or shared room and most often share bathrooms; the staff generally lives on site. B&C provides housekeeping, dining, transportation, and activities. They also provide additional personalized care services such as medication management, bathing, or dressing. Residents of B&C may have a wide range of physical and/or cognitive health conditions, with the most common being dementia and limited mobility.

B&C facilities are typically privately paid, with a monthly fee being the most common. The monthly fee is usually based on the size of the room and the level of personalized care services needed. Medicare and Medi-Cal generally do not pay for B&C facilities. Long-term care insurance may cover a portion of the cost, if certain requirements are met.

B&C facilities are licensed and regulated by the California Department of Social Services, as Residential Care Facilities for the Elderly (RCFE). In California, B&C facilities may offer a wide range of services, including caring for individuals in wheelchairs or who are bed-bound or on hospice. Check with the individual B&C first.

Memory Care

close up image of a bed and pillow with a wheel chair in the background

Memory care (MC) communities cater to individuals with moderate to severe forms of dementia and Alzheimer’s disease, who need regular, specialized assistance and monitoring. MC provides housekeeping, dining, transportation, and activities and other social engagement opportunities that are specifically tailored for people with dementia, in a secured environment. They also provide additional personalized care services such as medication management, bathing, or dressing.

Specialized memory care can be provided at both Residential Care Facilities for the Elderly (RCFEs) and skilled nursing facilities (SNFs). Memory care at an RCFE may be appropriate if the person needs a higher level of care than assisted living or a board and care facility can safely provide. Memory care at a SNF is generally appropriate for people with the most severe cases of dementia and/or who require 24-hour nursing care for additional health issues.

Memory care at an RCFE is typically privately paid, with a monthly fee being the most common. The monthly fee is usually based on the size of the unit and level of personalized care services needed. Medicare and Medi-Cal generally do not pay for memory care at RCFEs. Long-term care insurance may cover a portion of the cost, if certain requirements are met. Memory care at a SNF may be paid privately, or covered by long-term care insurance or Medi-Cal. Medicare will likely not cover memory care at a SNF, particularly if the resident is custodial (long-term).

Although there are standalone memory care communities, senior living communities with multiple levels of care (independent living, assisted living, and memory care) are becoming more common. Memory care at an RCFE is licensed and regulated by the California Department of Social Services. Memory care at a SNF is licensed and regulated by the California Department of Public Health.

Skilled Nursing Facilities

Skilled nursing facilities (SNF) cater to individuals with serious health conditions and/or symptoms who require 24-hour nursing care. SNFs typically offer shared and private rooms, and range from 10 residents up to 100 or more. SNFs provide housekeeping, dining, transportation, and activities and other social engagement opportunities that are tailored to the resident’s needs. They also provide nursing care, therapy, and additional personalized care services such as medication management or assistance with toileting and hygiene. SNF residents may be of any age and may stay for short periods or long term (custodial).

SNF care may be paid privately or by Medicare, Medi-Cal, or private insurance. Medicare covers only short-term care, while Medi-Cal will cover custodial care.

SNFs are licensed and regulated by the California Department of Public Health.

Continuing Care Retirement Communities (CCRCs)

Also known as “Life Plan Communities,” Continuing Care Retirement Communities (CCRC) cater to older adults (in most cases, age 60 and older) who are looking to downsize and be able to remain in the same community as their health and care needs change. CCRCs provide independent living, assisted living, and skilled nursing within a single community. In some CCRCs, the resident may be able to receive most types of care in their unit. In others, the resident may need to move within the community, as the different levels of care are provided in separate buildings.

CCRCs are generally privately paid. Typically, a resident will pay a large one-time, upfront entrance fee and then regular monthly fees. The monthly fee is usually based on the size of the unit and level of personalized care services needed. Long-term care insurance, Medicare, and Medi-Cal may cover certain types of care, such as skilled nursing.

CCRCs are licensed and regulated by the California Department of Social Services.

Subsidized Housing

There are several subsidized housing options for very low-income older adults, typically administered by the city, county, or state government or the U.S. Department of Housing and Urban Development (HUD).

The Housing Choice Voucher Program (HCVP), previously known as Section 8 housing, provides rental vouchers to qualified older adults to be used at any type of housing, including both public and privately-owned housing, that meets HCVP’s requirements. Older adults who use this program are generally physically and cognitively healthy and independent, and need no assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Section 202 Supportive Housing for the Elderly provides affordable housing with support services to qualified older adults ages 62 and older. Older adults who live in Section 202 housing are generally physically and cognitively healthy and independent, but may require some assistance with ADLs and/or IADLs. Support services may include housekeeping, cooking, transportation, other personalized care services, and case management.