As a rule, real estate agents don’t get involved in rentals in San Diego. Sometimes people tell me that they would like to rent in a senior community for a while, and see if they like it. Unfortunately, rentals in these areas are scarce, and there is no central database or Multiple Listing for rentals.
The best advice I can give is to check out the local classified ads to see if anything is available for rent. If I were looking for my own mother, this is what I would have to do.
Try here first: Craigslist http://sandiego.craigslist.org/
There are two local newspapers, and both place their classified ads online. Search for “Senior Rentals” at the following websites:
San Diego Union Tribune http://www.utsandiego.com/news/real-estate/
For senior apartment rentals, try the excellent list at http://www.sandiegoeldercare.com.
Assisted Living in San Diego
Why choose assisted living? For some seniors, it provides an excellent housing option that meets many essential needs, including:
- A more comfortable “homelike” environment, often including private rooms or separate apartments.
- Provides help with daily living chores, but not full-time medical/nursing care.
- A good solution when family members are geographically far-flung or otherwise unable to provide the assistance needed.
- Less expensive than a nursing home.
It’s a Complex Decision
Since different facilities offer significantly different services and features, comparing them is seldom a simple task. Discourage your clients from choosing a community based solely on proximity to family. It’s a higher priority to focus on finding the best facility for their loves one, both now and with enough flexibility to accommodate needs that may develop in the future.
It’s easy to be wowed by the fancy lobby and beautiful grounds offered by some assisted living communities. This “frosting” effect can make it harder for clients to ask the tough questions they need to ask – and have answered.
The labels assigned to different types of assisted living communities vary from state to state. As a general rule, however, there are four types:
Continuing Care Retirement Communities (CCRC’s) – At these communities, residents can move into increasing levels of care ranging from independent adult, to assisted living, to full nursing care, as their needs evolve.
Assisted Living Type A – These facilities accept residents who are mobile, don’t require 24/7 monitoring. They also must be able to follow directions and can evacuate the facility quickly, without assistance, in case of an emergency. These clients may need help with some personal care tasks, medication dispensing, and simple cooking/cleaning tasks, but they are still quite independent.
Assisted Living Type B – The residents in these facilities are often unable to move about without assistance, have difficulty understanding or following directions, or may need memory care. They require round-the-clock monitoring and would need assistance to evacuate in case of an emergency. In effect, they require all the assistance of individuals in Type A facilities as well as other specialized services.
Assisted Living Type C – “Board and Care”. These facilities are usually limited to just a few individuals (typically six) and may be run by an individual in a private home.
It’s an Expensive Decision
According to the most recent Cost of Care Study released by the LTCG (Long Term Care Group, Inc.), the average annual cost of a one bedroom apartment is an assisted living community is $50,940, or $4,245 per month. In comparison, the cost of a private room in a nursing home averages nearly twice that, or $97,612 per year. These fees, however, vary wildly by location. In Washington, D.C., for example, that one-bedroom assisted living apartment will cost over $97,000. New Jersey, Alaska, Massachusetts, Connecticut, Maine, Maryland, New York, Delaware and Hawaii all rank among the most expensive states for assisted living.
In addition to the cost of “room and board” in an assisted living community, residents may need help with extra services that are charged “a la carte” over and above the basic monthly cost.
Most assisted living facilities do not accept Medicare, but will accept long-term care insurance to help defray the substantial costs. (Payment options may change if a resident subsequently moves into the progressive or nursing care sections of a facility, assuming these are offered.) Some assisted living facilities also work in conjunction with hospice care, which will accept Medicare and other health insurance payments.
Some states offer Medicaid waiver programs to help low income individuals pay for assisted living. To find out if your state offers this, go to CMS.gov and type “assisted living waivers” in the search box, or contact your Area Agency or State Office on Aging.
It Should be an Informed Decision
Assisted living communities were originally designed for independent living. In recent years, however, assisted living has become more integrated with nursing care facilities or as one level of service with CCRCs. Now, mobility/physical impairment and memory care units are being added to many assisted living facilities.
These additional services, along with cooperative agreements with hospice care, mean seniors can often stay in as assisted living situations longer than before, although that may require moving to another part of the facility as their health declines and their needs increase. Stand-alone assisted living facilities offer one state of care, and it’s not necessarily the final state.
Whether or not a facility is licensed to provide health care and skilled nursing services will determine how they are regulated. Assisted living facilities that only have a nurse on the premises during the day (and perhaps on call after hours for email or phone questions) are NOT considered skilled nursing facilities, since they do not offer round-the-clock skilled nursing services. This also means they don’t fall under the same regulations as a nursing care facility or a nursing home.
This lack of regulation may put a greater burden on families to understand assisted living regulations in their state and to determine which facility is the best choice. There may not be an obvious way to “grade” or rank potential options, but you can determine how easy it is to access the records in your state by visiting www.aplaceformom.com/assisted-living-state-licensing.
How To Find Assisted Living in San Diego
A local resource that lists all the available housing alternatives is at http://www.sandiegoeldercare.com. It lists retirement apartments, board and care homes, intermediate care facilities, and skilled nursing facilities in San Diego. There’s chapters about hospice, in-home solutions, healthcare services, and more.
To talk with a real live local person regarding housing options for assisted living in San Diego County, visit the Elder Answers site: Find Assisted Living in San Diego or give Lise a call at 619-538-9155.
Another excellent way to find the right place is to call the people who know all about the different options available. Visit Infinite Care Advocates, or talk to Lyn directly at 858-674-6903.
For an excellent list of assisted living options including prices, visit SeniorAdvisor.com.
Questions and Considerations for Selecting an Assisted Living Facility in San Diego
When interviewing potential assisted living facilities, it’s a good idea to have a standard list of questions to ask each facility so you can make relevant comparisons. This may include:
- What levels of care does this facility offer? What abilities and degrees of self-sufficiency are required of residents? What happens when these abilities change?
- Do you conduct an initial assessment prior to admission? How often are assessments repeated? Are they written and available for the family’s review?
- What is your staff-to-resident ratio during the day? At night?
- Is a nurse onsite around-the-clock? Does a physician regularly visit the facility? How are medical emergencies handled?
- Who administers medications? How is this information recorded? Can it be reviewed by family members at any time?
- What experience and training does your staff possess? How much ongoing training is required?
- What type of apartments and/or living units are available? Is there a waiting list? What is the estimated time before you can accept a new resident?
- What is the monthly cost? Do you have a written list of what’s included and which services cost extra? What other fees might be assessed?
- What are your billing and payment policies? What is your discharge policy?
- How often is the facility assessed? By what organizations? Are the findings made available to families as a matter of course?
- Is the facility attractive, in excellent repair and clean – inside and out?
- Is the staff friendly? Were you welcomed when you arrived? Does the staff and the executive director address residents by name? Are interactions between staff and management professional? Are members of the staff warm toward the residents? Do they greet you as you tour?
- May you visit with residents anytime you like?
- Is the food attractive? Does it taste good? Are families permitted to review the menus?
- Are the residents happy? Do they appear to have excellent care from the staff? Do they interact and seem to enjoy each other’s company?
- Are you comfortable here? Do the staff and residents seem comfortable? Does it seem like a good “fit”?
Visit each facility at different times – during activities and meal times, for example – and seek feedback from residents and their families on these and other considerations.