With our population both growing and aging, the demand for senior housing is soaring.
Consider the numbers behind the demand:

• Currently, 10-12% of the population is over 65 years of age and that number is expected to double in roughly 25 years. That means 1-out-of-5 Americans — some 72 million people — will be 65 years or older by 2030.
• In 2004, the preliminary estimate of life expectancy at birth for the total population reached a record high of 77.9 years—demand will only increase.
• The age group 85 and older is now the fastest growing segment of the U.S. population.
• Already, one in four American families cares for an older relative, friend, or neighbor since caretaker responsibilities are often shared.
• An estimated nine million Americans live more than 100 miles away from dependent parents, making sourcing and screening for appropriate housing an even greater challenge.

At one time or another, almost all physicians are asked about finding suitable senior housing and care for a patient or a patient’s loved one who can no longer live independently at home. Responding appropriately is a challenge due to the complexity of the patient’s needs and the range of housing and care options available today.
Very few medical practices have the staff or time to spend with families to work through the various care and housing alternatives.

With facilities continually closing and opening, there’s a 10-20% change in senior housing each year. Couple this fact with the various license names for the same category of housing (small-scale residential care facilities are called Adult Family Homes in Washington while the same type of housing is called Residential Care Facility for Elderly in California,) and the fact that there are 139 different license types across the US; it is not surprising that many physician practices are challenged by this complexity of senior housing.

Elder housing issues
Here are just a few of the basic points that should be addressed to determine an optimal fit between patient and facility.

• The location of the facility and proximity to the senior’s family.
• The license and certification of both the facility and its staff.
• Costs: how they are structured (all inclusive or add on services) and payment terms.
• Whether they accept Medicaid pay residents.
• Healthcare services available for specialized needs (e.g. Alzheimer’s and Parkinson’s, 24/7) and the professional qualifications of the staff.
• Room types and arrangements, e.g. cooking facilities, roommates, private/shared rooms, wheel-in showers, etc.
• Meals, including dietary restrictions and preferences, hours of availability, serving and seating arrangements.
• Security for both the individual’s safety as well as personal possessions.
• Activities at both the facility and nearby areas.
• Transportation provided by facility to medical appointments and local attractions.
• Community characteristics and culture, e.g. languages spoken and religious preferences, Gay, Lesbian, Bisexual and Transgender orientation, etc.
• Amenities you might not think about (e.g. individual temperature controls, cable television, internet access, windows that open, music or art therapy, quiet areas, etc.).

The list above is just the beginning. The checklist that frequently determines whether residents and their families are satisfied with the arrangement covers the softer, more personal issues that often get overlooked in the haste to make arrangements. Do they allow pets? Do they allow residents to personalize their living space with their own belongings?

As a trusted and knowledgeable source Physicians and other healthcare workers are in a unique position to encourage families to check for quality measures by directing them to www.medicare.gov, www.dshs.wa.gov and their local ombudsman to perform reference checks with current and past residents and families. If a senior can be safely maintained in their home, referrals to home health agencies in their local community can be a viable alternative.

Traditional ways of dealing with the challenges and why they’re not working

Frequently, physicians refer the senior and their family to local professionals such as discharge planners, care managers, private placement coordinators or Area Agencies on Aging. Others may provide printed directories of information by offering a limited list of facilities in the area (usually only those who advertise).

Most of these advocates are required to spend considerable time calling or faxing various facilities to determine the fit and availability. They are usually familiar with their local community providers but lack the ability to source and screen options outside their service area easily and quickly. The process is time consuming, inefficient and onerous as they try to compare and contrast the care and lifestyle information necessary to evaluate the ideal quality fit for the senior.

New resources offer better solutions

Fortunately the situation is improving. As the demand for housing sky rockets, so does the need for immediate access to an unbiased and current comprehensive online database of senior housing options. An increasing number of Americans turn to the Internet in their quest for objective housing and health related information.

Online information sources that provide lists of facilities are typically free to you, your staff and your patients. Using these websites can greatly improve your efficiency and that means more time spent on your core practice. The caveat is that most of the privately owned sites are biased. They only list those facilities that advertise – a small segment of the full housing range available. Few of these commercial listing services make available the detailed information known about the facility and few update their database of licensed facilities on a frequent basis.

For example, in Washington state there are more than 3,400 elder care facilities--when you count independent living and assisted living facilities, residential care homes, skilled nursing facilities and adult family homes--yet far fewer than 500 are found on most of the commercial websites.

Another online resource is placement services that are compensated by the senior housing facility for placement of the senior resident, but only if they are paying with private funds. If the senior resident is Medicaid eligible, these elder placement services cannot accept a commission fee from the facility due to the Fraud and Abuse Laws.

Senior Services, the largest non-profit agency serving seniors in Washington State, faced this challenge. They have seen a 200% percent increase in the number of visitors on their website during the past four years; many of them seeking senior housing related information.

Realizing that they could not keep up with the complexity and expense of building and maintaining a comprehensive, up to date database, Senior Services chose to partner with SNAPforSeniors, a free, online senior housing search and matching resource that lists all licensed housing providers in the U.S. and shows those currently accepting new residents. Their database, www.snapforseniors.com can be accessed directly, or through the Senior Services website, www.seniorservices.org.

Similar to a real estate Multiple Listing Service, SNAPforSeniors asks what the consumer or caregiver wants and needs. It then provides a comprehensive list of facilities that best match those criteria. In a user friendly way the website offers far more information than what is available through the numerous individual websites that Washington state offers. The SNAP website’s features include:

• A comprehensive, national listing of all licensed senior housing communities in all 50 states, not just those that pay to be listed—some 65,000 in all;
• It is free to consumers, discharge planners and non-profit advocates;
• Web site tools help consumers develop a short-list of qualified options and become more informed about important considerations for making the right senior housing decision.
• Sophisticated software then matches a senior’s specific lifestyle and care level needs with best-choice facilities;
• The site does not discriminate between private pay and Medicaid pay in identifying housing options;
• Any housing provider, including independent communities, can have an online listing for their facility, along with a very detailed profile, at no cost;
• The website allows facilities to post vacancies for a small additional fee, a major benefit when patients or caregivers need immediate placement;
• Some facilities include photos and virtual tours so users can get a better feel for their facility;
• The up-to-date online source continually refreshes its database with licensed facilities and independent living communities;

In addition to Senior Services, Seattle-based SNAPforSeniors has a public/private alliance with most of the local Area Agencies on Aging in Washington.

A single objective online information source with the most current housing information

Recently, a local Seattle company launched a national information source that aggregates and standardizes licensed housing information from 216 data sources. At no charge, doctors and their staff can access on their own or refer patients to:

• Limit a search to one or more housing categories (e.g. assisted living/residential care, independent living or skilled nursing)
• Filter a search by specific license types
• Expand or narrow a search area geographically
• Find step down care for post acute illness or hospitalization

Another valuable feature for the medical community is the ability to find which facilities offer qualified care for special disease needs (e.g. Alzheimer’s, Parkinson’s, cancer, AIDS, etc.) Additionally, there are numerous on-site links to other government and healthcare websites that provide more information about these specific issues. With this new online resource, you will find that you are able to quickly, efficiently and responsibly fulfill your obligation to your patient, and make better use of your time.

Elder housing is the final chapter in care giving

“Identifying the best elder-housing options for a patient or their caregivers is a complicated and time intensive activity for doctors to get involved in,” said SNAPforSeniors CEO Derek Preston. “Helping them find the facility that will do the best job of meeting their physical and mental needs is just an extension of providing ongoing quality healthcare. With easy access to objective and current information available through our website, doctors and their staff can respond more effectively to families’ requests for guidance in a time of difficult life transition.”

FOOTNOTE

Eve M. Stern, President and Chief Operating Officer of SNAPforSeniors. She holds a Master’s degree in Health Science Administration from SUNY Stony Brook and a Bachelor’s degree in Nursing from Columbia University.

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