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Readers Respond to Elderly Housing Series

October 14, 1990

I commend The Times for its series on housing choices and options faced by older Americans.

However, the last story ("Caring Communities" by David W. Myers, Sept. 30), which was designed to cover a range of supportive housing alternatives, contains a confusing description of continuing-care facilities and failed to identify several important emerging housing types for the older frail person.

To describe a life-care or continuing-care retirement community as a "hybrid of congregate care (homes) and a hospital" is an overgeneralization. Hospital-type services are rarely provided on a continuing-care campus. Furthermore, the article states residents must move out of a continuing care facility to seek nursing care. This is erroneous because life-care or continuing-care facilities contain nursing care as part of the services they provide.

Several new and important types of supportive housing aimed at specific sub-populations of older adults were missed. For example, there was no reference to residential housing programs for the cognitively impaired Alzheimer's victim.

But most important was the lack of discussion about the emergence of assisted living or sheltered-care facilities. These are targeted toward older frail persons who need assistance with personal care (dressing, ambulation, grooming and bathing), but are not sick enough to warrant admission to a nursing home.

In the past, the only alternative for older frail persons with personal care needs was placement within a nursing home. Board and care providers have traditionally been poorly equipped to deal with this level of care.

European prototypes and assisted-care apartments within continuing-care facilities in the United States have provided the best models for these residentially scaled and appointed environments which are more attractive and less expensive than a nursing home.

Oregon, a state with progressive elder-housing policies, has revamped its entire system of long-term care to accommodate this residential alternative to the nursing home. In California, however, restrictive building code interpretations and regulatory policies have made it difficult for this housing type to flourish.


Los Angeles

Regnier is an associate professor of architecture and gerontology at USC.

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