The Continuum of Senior Living: From Independence to Hospice 

When considering housing options, seniors can consider options like selling their house outright, moving in with family, downsizing to a smaller home, moving into an assisted living facility/nursing home, joining a retirement community, selling to a family member, or exploring "aging in place" solutions with home modifications to support their needs depending on their health, financial situation, and desired lifestyle.   The following are some of the broader stops along the continuum. 

Aging in Place 

Aging in Place refers to the ability of a person to remain in their own home while receiving the necessary support and services to maintain their independence and quality of life. 

Given the choice, 90% of adults would prefer to age in place independently and comfortably.  

Aging in place can provide an enhanced quality of life with seniors remaining in familiar 

surroundings which contribute to emotional well-being and life satisfaction.  Staying in one’s 

community also allows for continued engagement more often with established social networks. 

And finally with the average Massachusetts assisted living residence and private nursing home 

costing $6400 and $13,400 per month respectively, investments in modifications to stay at

 home can be cost effective. 

Continuous Care Retirement Communities (CCRC) 

A continuing care retirement community (CCRC) is a senior living option that provides seniors 

with the opportunity to live in one location for as long as they need. Typically they offer

 Independent and Assisted Living options with some level of on-site healthcare services, and

 access to doctors and nurses.  Some, not all, CCRCs offer Memory and skilled nursing care 

with 24/7 access to medical professionals.  The benefit of CCRCs is that they allow residents to 

choose what level of help they want through the various stages of the aging process, without the 

necessity of moving from one location to another.   

CCRCs allow families and residents peace of mind, knowing that loved ones will have all the support they require no matter their ongoing needs. Often by the time a senior makes the decision to move from their home, they are already facing a complex but not fully realized profile of needs, and a CCRC allows for a menu of services to be utilized. 

Level 1: Independent living 

Independent living or senior 55+ residences cater to seniors who are largely self-sufficient and can manage their daily activities independently, but may prefer to leave behind the burdens of homeownership and enjoy amenities such as prepared dining options and social or recreational opportunities. Older adults who are active and healthy enjoy the continuing care retirement community facilities and maintenance-free advantages while living alone in their preferred home. 

Level 2: Assisted living 

If a loved one’s level of care requires greater assistance, assisted living can provide round-the-clock custodial and medical services. Staff members are available to assist with activities of daily living, such as bathing, dressing, or medication administration, for residents to be as independent as possible. Assisted living may be provided in the form of apartment-style housing, either entirely private or semi-private. 

Level 3: Memory care 

Seniors who are experiencing memory loss as a result of dementia, Alzheimer’s disease, or other cognitive disabilities may choose to move to the on-campus memory care facility at the continuing care retirement community. Residents are cared for by specially trained staff who prioritize comfort, engagement, and safety. 

Level 4: Skilled nursing care 

Skilled nursing care, like assisted living, involves medical and custodial services 24 hours a day, seven days a week. However, skilled nursing pertains specifically to rehabilitation services and short-term care. For instance, residents requiring post-surgical wound treatment, physical or speech therapy following a stroke, or IV medication administration might stay in the skilled nursing facility of a community care retirement complex. 

Hospice Care 

Hospice care focuses on comfort and quality of life for terminally ill individuals, with a life expectancy of six months or less. Hospice care is provided by a team of professionals, including doctors, nurses, social workers, counselors, and volunteers, who work together to meet the patient's physical, emotional, and spiritual needs. Hospice care also provides support for the patient's family and caregivers, helping them cope with the emotional and practical challenges of end-of-life care and bereavement support for up to one year. 

Hospice care can be provided in various settings, including homes, nursing homes, and specialized facilities. Services include: pain and symptom management, medical supplies and equipment, counseling and spiritual support, respite care and specialized therapies. 

Exploring Options and Transitions with your Aging Loved Ones 

• When Should Elderly Parents Stop Living Alone? - LINK 
• How to Talk to Elderly Parents About Assisted Living - LINK 
• 13 Tips to Help a Parent Transition into Assisted Living with Care & Respect - LINK 
• 7 Ways to Help Your Parents Smoothly Transition to Assisted Living - LINK 
• Is it Time for My Parent to Move Into Independent Living or a retirement Home? Let’s Talk about Aging Parents - A Real Life Guide to Solving Problems with 27 Essential Conversations, by Laura Tamblyn Watts 
• How To Move Your Parents. - Marty Stevens-Heebner the president of NASMM - LINK 

Downsizing & Decluttering 

6 Tips to Help Senior Parents Declutter and Downsize - LINK 

Hoarding & Seniors: What Families Need to Know - Hoarding among seniors is more than clutter—it can impact their health and safety. This video shares practical tips to help older adults manage hoarding behaviors compassionately. Learn how to spot hoarding, understand its causes, and approach decluttering with care. If you’re navigating this challenge with a loved one, this guide offers actionable steps to ensure a safer home and better quality of life. LINK 

Selling, Transferring the Family Home 

5 Things to Consider when Selling a Home to Pay for Assisted Living - LINK 

Moving Parents In With You 

For more resources and information, see section on Caregiver support - LINK 

Guides as you prepare to move in a parent: 

• 10 Factors to Consider Before Moving Your Elderly Parents In - LINK 
• What to Consider Before Moving Your Senior Loved One into Your Home - LINK 
• 8 ESSENTIAL Tips for Moving a Senior Parent Into Your Home | A Place for Mom - LINK 

Here's a breakdown of other helpful resources and considerations: 

Government and Local Resources: 

• Eldercare Locator: This is a great starting point to find local resources, including services for older adults and their families, such as home care, transportation, and caregiver support. Eldercare Locator (.gov) - Phone: 800-677-1116 
• National Family Caregiver Support Program (NFCSP): This program provides grants to states to fund supports for family and informal caregivers.  Website: Administration for Community Living (ACL) (.gov) 
• Aging and Disability Resource Centers (ADRCs): These centers can help older adults and those with disabilities, and their families, make decisions about long-term care and access services. Website: LINK 
• Medicaid Home and Community Based Services (HCBS): This program offers opportunities for older adults and people with disabilities to live in their homes with support. 

Considerations for Moving an Aging Loved One In: 

• Assess Needs: Determine the level of care your loved one requires and what support you can realistically provide.  
• Home Modifications: Consider necessary modifications to your home to ensure safety and accessibility. For more information about how to make home modifications, see the safety section in Aging in Place , LINK 
• Assistive Devices: Explore the use of assistive devices to help your loved one maintain independence and safety in the home.  
• Financial Planning: Explore options for covering caregiving costs, including government programs, long-term care insurance, and other financial resources. 
• Professional Help: Consider hiring in-home care professionals or consulting with geriatric care managers or social workers.For more information about in home services, see the safety section in Aging in Place , LINK
• Family Communication: Have open and honest conversations with your family about caregiving responsibilities and expectations.  Don’t be afraid to have the crucial conversations.  See Let’s Talk About Aging Parents, by Laura Watts on how to approach some of these more difficult discussions with older family members. 
  • Checklist for Moving Elderly Parents: 6 Practical Things to Consider When Moving an Aging Loved One, by A Place for Mom - LINK 

Considerations for the Moving Process 

Helping elderly parents move can bring them closer to family, ensure a safer home environment, and lead to a more active lifestyle. Whether your parent is transitioning to an assisted living community, moving into your home, or downsizing to a senior apartment, these six tips can help you plan. 

• Senior Move Managers:  Consider hiring a senior move manager to help with the packing, moving, and settling in process. Website: National Association of Senior Move Managers (www.nasmm.org) 

Researching New Housing 

Monthly Assisted Living Residences. Lunch and Tour

The Jenks Shuttle is on the road, visiting local assisted living and senior living residences in the area. We will visit a different place each month. - Contact Suzanne Norton for more information. snorton@winchester.us. 

Certified Senior Advisors

There is a network of Certified Senior Advisors who offer free referral services to seniors seeking out information about independent, assisted living and memory care residences in your areas.  Provital is one such service in the Winchester area, but other Certified Senior Advisors in your area can be found HERE. 

Researching Memory Care Residences- 10 Questions to Ask When Considering a Memory Care Facility - LINK 

Resources 

• Medicare Nursing Home Compare: - LINK 
• Assisted Living Locators: Jon Younger 978-553-1130 
• Care Patrol (781) 496-2600 
• Provital Services (781)262-8309 
• A Place for Mom (866) 671-3802 
• Your Local Council on Aging 
• Mass ALA( Massachusetts Assisted Living Association) (781) 622-5999 
• Housing Navigator Ma- https://housingnavigatorma.org/ 
• Massachusetts Association of Residential Care Homes (MARCH): MARCH (Massachusetts Association of Residential Care Homes), established in 1991, is the only organization solely representing rest homes and the residential care community. MARCH is a 501(c6). The mission of the organization is to encourage financial viability, support and advocacy and increased visibility and recognition of the cost-effective quality of care offered residents in a home-like setting within the long term care continuum. - Phone: 978-502-9561 - LINK 

Assisted Living and Nursing Homes in Winchester & Neighboring Communities 

The Gables: Independent and assisted living facility for seniors. Offer entertainment and recreation activities, assistance with medical care, daily living activities, and rehabilitation services.  - 299 Cambridge St. Winchester, MA - Phone: (781) 756-1026 - LINK 

New Horizons at Choate : Independent and assisted living facility for seniors. Offer entertainment and recreation activities, in addition to assistance with on-site medical care, daily living activities, and memory care services. -  21 Warren Ave. Woburn, MA - Phone: (781) 932-8000 - LINK 

Winchester Mount Vernon House: Assisted living facility, offering meals service, on-staff nurse, and assistance with activities of daily living. -  110 Mount Vernon St. Winchester, MA - Phone: (781) 729-0497 - LINK 

Aviva Country Club Heights, Woburn - Assisted lIving with Memory Care - 3 Rehabilitation Way Woburn, Woburn. 

Youville Place, Lexington - Assited Living with Memory Unit 

OTHERS - Suzanne Norton