The Silver Tsunami is coming, and its members are healthier and living longer than any generation before them. Luckily, a marketplace full of options for how and where to live out the golden years is waiting for them. From services that offer help at home to resort-like communities that include on-site education and libraries, the Cincinnati area is teeming with choices in senior living.

Good thing. Ohio ranks sixth in the nation in size of its aging population, with more than 2 million people age 60 and older. In addition, the age 60-plus and 80-plus populations are projected to grow by 44 percent and 22 percent, respectively, by 2020.
“There are many more offerings than ever before,” explains Laura Lamb, vice president of residential housing and health care for Fairfax-based Episcopal Retirement Homes, which operates several senior living facilities in the region, including the Marjorie P. Lee Retirement Community in Hyde Park and Deupree House in the Hyde Park-Oakley area. “Even 10 years ago we didn’t have swimming pools, massage therapy and therapy on-site. We now have that as well as chapels and event centers and people coming in for entertainment.”
According to people like Lamb, this amenities-filled lifestyle is exactly what retirees today want, whether they’re active and social or have some physical issue slowing them down.
Independence is key, and retirees are looking to find it, regardless of their care needs, by living at home, in active communities, condominiums with small yards or upscale campuses that address health requirements as they arise.
An Array of Options
The image of retirement communities as “old-age homes” is now all but extinct with the lush housing options available today. And rather than decreasing independence, experts say moving to a retirement site of a senior’s choice often increases independence by promoting interaction with others and putting the focus on enjoyable activities rather than the burdens of daily life.
“The No. 1 thing I hear from people when they move into independent living is that they waited too long,” Lamb says. “The comment reflects the fact that we enable them to maintain their lifestyle while getting rid of the worries that come with owning your own home, (such as) lawn maintenance, property taxes and driving to the grocery.”
Without those worries, living in retirement allows people to regain some of the freedom they might have given up as homeowners. For instance, many aging adults have trouble driving at night. They might start giving up opera or symphony tickets without even realizing they’re isolating themselves. In most retirement communities, transportation and entertainment is provided.
But, understandably, seniors are often reluctant to move. In-home services such as those provided by Home Instead Senior Care help aging adults manage daily living in place. Recently, an 80-year-old woman who fell off her bicycle and broke her arm called Home Instead because she didn’t want to leave home, but needed help with cleaning and other chores until her arm healed.
“At some point, seniors find themselves stuck with a set of unacceptable alternatives,” explains Jim Burton, owner of Home Instead Senior Care in Cincinnati. “If they stay at home, they’re at risk. If they go into a nursing home, they’re leaving their home of many years. Our service allows them to stay home for as long as possible.”
For example, if a senior must give up his or her driving license because of failing eyesight, that’s not, in itself, a reason to leave home. Caregivers can provide transportation to the grocery store and other errands and help with home chores. If a senior falls and breaks a hip and the family has not decided how to provide long-term care for their loved one, home care can create a safe environment while family members come up with a solution.
Home Instead caregivers also serve clients after they’ve moved into senior housing facilities.
“We have quite a few clients with various levels of care within the facilities,” Burton says. “They’re people who live in independent cottages on the campuses and want help.” Often, the seniors have become friends with their caregivers over the years and want to continue seeing them regularly.
Not Too Early To Plan
For those who’ve decided to move, the homework needs to start long before moving day or a crisis, such as a broken hip or death of a spouse, occurs.

While the maze of resources is overwhelming, the best place to start might be the Council on Aging of Southwestern Ohio. The nonprofit organization has nearly 40 years of experience serving older adults and caregivers. It’s also the central authority for seniors and caregivers in Butler, Clermont, Clinton, Hamilton and Warren counties. Those five counties are home to more than 252,000 adults age 60 and older
“Our mission is to keep older adults in their homes as long as possible,” says Laurie Petrie of the Council on Aging. The council works to accomplish that mission by helping families find services that address the needs of their loved ones and navigate the maze of finances and housing.

Petrie warns people to begin planning early for long-term care by researching insurance, which is cheaper the younger you are when you buy it. Learn about the various housing options, too, by visiting facilities and asking questions. Ohio publishes a guide to long-term care planning that the council distributes, as well.

“There is probably a 60 percent chance that I will need long-term care (when I get older),” Petrie says. “How am I going to pay for that and what might my options be? All things being equal, what are my preferences?” These are questions, she warns, people should ask themselves years before it becomes an issue.

Many facilities in the area are expanding, and it’s worth it to visit a variety of them to see which ones you or your parents might like. Some of the campuses in the region include the well-appointed Maple Knoll Village near Glendale and the Knolls of Oxford, operated by LifeSphere and centered on a wellness-based lifestyle. Kensington Place will soon open on the Maple Knoll Village campus. Also new, Deupree House is expanding with a nursing care option in Deupree Cottages.

Another luxury site, The Stratford at Kenwood, will open a 20-acre campus late in 2009 with on-site educational offerings, programming and five food venues, according to Mark Marron, director of sales and marketing for The Stratford at Kenwood. The site is on Kenwood Hills, overlooking Downtown and the hills of eastern Hamilton County.

But it’s difficult to consider your choices without first understanding your finances. Payment for such facilities is complex and varied. Some accept subsidies, while others have monthly fees or down payments. Others have a variety of plans, including large down payments or monthly fees. “We’ve realized over the years that you have to provide options,” Lamb explains.

Even with the alluring attributes, however, moving out of your home is a daunting decision. Experts recommend taking it slowly. When is the right time to move? “I think every person has a different answer to that,” Lamb advises. “The tipping point is really safety. But absent a safety issue, we call it a near miss. That’s what triggers phone calls to us. My husband fell down the steps, and he wasn’t hurt. The adult child usually comes to us when there’s a crisis.”

So, don’t wait that long. “You have to have a retirement plan. Planning where you’re going to live shouldn’t be done during a crisis. Don’t let your children decide,” Lamb warns. “Tour the places. Make sure your family knows what your desires are. Independent living gives you the peace of mind that your needs are going to be taken care of as they change.”

Retirement Options
Don’t feel pressured to make a decision right away on where you, or your loved ones, should live.

The range of choices and rapidly expanding offerings can be very complicated, with various rules for certification, licensing, capacity and types of available care. Because of this, old descriptions have become outdated. So, the Council on Aging of Southwestern Ohio recently updated its definitions for senior living. Its new list includes:

Continuing Care Retirement Communities: Designed for lifelong living options, these communities include housing for independent living, assisted living and nursing home care. Residents live in different housing on campus as their needs change. CCRCs are typically more expensive than other living options, but offer contracts that promise to provide shelter and care for a prescribed period of time, usually the life of the resident. Facilities on CCRC campuses that offer personal or skilled care are licensed.
Assisted Living Facilities: Residents typically have their own private units with a bedroom, bath and kitchenette, so they’re able to maintain their privacy and independence but still receive help for daily living such as housekeeping, dressing and bathing. Amenities vary, and some assisted living facilities may be part of a larger Continuing Care Retirement Community.
Congregate Housing: These senior housing developments include private apartments and common areas for socialization, but few or no supportive services. Some units or facilities may be subsidized.
Nursing Home: This is a licensed facility that provides 24-hour care for patients who require constant supervision.
Residential Care Facility: (formerly known as a Rest Home) Licensed by the Ohio Department of Health, this facility is able to house up to 17 unrelated adults.
Retirement Communities: These communities are typically large, self-contained campuses with a variety of living options that don’t include personal or skilled nursing care (unlike Continuing Care Retirement Communities). They’re often the choice of retired, active, older adults who want to live independently in a community with their peers, own or lease a home, and not worry about lawn or property maintenance. These communities are not licensed or accredited (unless personal or skilled care is offered).

Senior Apartments: Designated for seniors only, these apartments might be equipped with assistive technology. Subsidized or low-income units also might be available.  Subsidized Housing: The U.S. Department of Housing and Urban Development gives funds to apartment owners who lower the rents they charge low-income tenants who meet income limits and pay rent based on their gross monthly income.

A Conversation Worth Having
Let’s face it: No one wants to talk about the days when scaling stairs will become an impossible feat, a large yard will require too much energy to maintain, and memory loss could potentially escalate into a real problem. But while conversations about issues related to aging, such as living arrangements and finances, are difficult for adult children and their parents, they are necessary. And they should be conducted sooner rather than later.

“It is so important for people to plan ahead before they’re in a situation where they need care immediately,” says Laurie Petrie of the Council on Aging of Southwestern Ohio. Petrie says she often sees adult children who are concerned because their parents have fallen or are exhibiting signs of memory loss. The children often believe their parents need help, but their parents might not agree.

Besides the difficulty of approaching the conversation, the topic is complex and often daunting. How to plan the finances? Where to get documents for power of attorney? How should you bring up funeral planning? And, most importantly, when exactly is the right time to begin talking?

“We run into it all the time,” explains Jim Burton, owner of Home Instead Senior Care in Cincinnati. “Any admissions director in town will tell you that he or she often sees family members come in with mom, and mom’s already told the kids she is not moving. There is this lack of intergenerational communication. We’re meeting with families who are trying to address how to keep their parents safe and allow them to make choices.”

Home Instead has developed what it calls the 40/70 Rule: If you are 40 years old or your parents are 70 years old, it’s time to begin researching these topics and starting the conversations. But who should begin the talk: the adult child or the parent? “The adult in the relationship,” Burton says, laughing. Home Instead also has a web site ( with tips to help facilitate the discussion.
If you’re an adult child and think your parents will be sensitive about this, don’t jump in without planning. Timing is critical. Rather than pushing the issue, look for opportunities to bring it up.

“Dad, what happened to the car?” could be an opener if your father has had an accident. Or, if you notice lapses in memory, you might suggest your mother visit a doctor to get it checked out, assuring her that it’s probably nothing but you’d feel better if she went.

The conversation should cover a range of issues, including:
- Finances and how housing and long-term health care will be paid
- The whereabouts of financial information, such as bank account numbers and 401k information
- The preparation of legal documents, including a living will and medical power of attorney
- Lifestyle preferences when and if they can no longer live on their own. Would they prefer to remain at home, if possible, with the help of elder services such as Home Instead? If that’s no longer possible, would they rather live with a family member or in an independent or assisted living facility? Which one? Visit several facilities and give preferences and alternatives for different situations, such as memory loss or physical disability.
- Health information and a list of medications. In an emergency, you might not be able to access this information, so have it ready and keep it updated.
Adult children should be open-minded and remember that parents are adults. Although the child wants to help them, parents’ wishes and opinions matter. State observations and ask for solutions.
And likewise, parents who want to discuss these subjects with their children should be assertive and look for areas of agreement. Discuss alternatives that will allow you to be independent rather than in situations where everything is done for you. Be proactive and visit retirement facilities in the area to see what you like.
Also, ask for help. Professionals and the Council on Aging have information and support, and the internet is home to a wealth of tips and information. Visit to get started.

Lifestyle Communities Bridge the Gap
The time between having a busy home nest and needing old-age nursing should mean many years of active, fulfilling living. At least that’s the American dream for many of us, including the millions of baby boomers approaching or entering retirement years.

As adults consider retirement living options, they find out there are all kinds of mixed-needs communities and facilities. Some will include totally independent cottages or condos near to places where a variety of care or support services are offered, often called transitional or assisted-living residences.
But there’s also growth in residential developments that are built and marketed with older residents in mind. There’s no one term for these places, but one that seems to be gaining common acceptance is “lifestyle community.” The typical characteristics also appeal to young professionals, “single-again” adults and semi-retired people, including those working from home:

• Single floor plans: no stair climbing necessary
• Maintenance-free exterior: lawn care and other neighborhood jobs are taken care of by a community association and paid by homeowner dues
• Customize, customize: Builders often offer the kinds of alterations and amenities their target clients want. Wide doorways and grab bars for when grandpa visits in his wheelchair? Check. Extra bedroom for when the grandkids visit? Check. Bigger kitchen for entertaining? Check.
• Community social center: a clubhouse for parties and meetings, a pool and tennis courts, even exercise rooms and hiking trails are common offerings
• Some golf course communities offer these kinds of transitional living residences.

Some lifestyle communities consist of condominiums (detached or attached), others may be landominiums with the owner having title to a single-family residence and the lot it sits on.

There’s no one official term for these kinds of developments, according to the Multiple Listing Service of Greater Cincinnati. In real estate listings, some are identified as landominiums, lifestyle ranches or patio homes.

Lifestyle communities in the Tristate area include The Fairways at Walden Ponds in Fairfield Township, Heritage Pointe in Mason, Liberty Grand Villas in West Chester, Woods on Wilkens in Deerfield Township and Villages of Classic Way in Hamilton Township.