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Caregiving

Growing Old With Grace

Stay at home and get the help you need.

The latest innovation in senior living -- for your parents or yourself in the decades to come -- is to stay in your own home. And it's getting easier, and more affordable, to grow old gracefully, thanks to exciting alternatives to traditional institutions that are already springing up around the country.

Move in with friends

One innovation is co-housing. With this approach, families buy individual homes but share in the management of the community, as well as chores, expenses, social activities and some meals, which are served in a common building. Although co-housing can accommodate several generations, it has recently emerged as a way for like-minded people to tackle growing old together. For instance, at ElderSpirit, an age-restricted community in Abingdon, Va., "we expect to be like extended family, to do for each other what children would do for their own parents," says Dene Peterson, 77, one of the founders.

Elder co-housing communities do not yet provide formal health care, but some of them are considering setting aside space for live-in caregivers. Housing costs generally track local prices (some communities include subsidized units). ElderSpirit, which is fully subscribed, charges $300 to $485 a month for one-bedroom rental units; one- and two-bedroom houses recently sold for $90,000 to $113,000. In Silver Sage Village, in Boulder, Colo., house prices average $570,000. For more information and a list of co-housing communities, go to www.eldercohousing.org.

Call for delivery

If you live in an area that has a lot of other retirees -- known as a naturally occurring retirement community, or NORC -- you could remain at home with the help of programs that bring services to you. For instance, Jewish Family Service of Los Angeles coordinates transportation, health monitoring and social activities for the Park La Brea community, where many residents have lived for decades. About 80 NORCs across the country enjoy similar setups. To find a program near you, call your local agency on aging or go to www.norcs.org.

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In the Beacon Hill neighborhood of Boston, seniors took matters into their own hands by founding Beacon Hill Village, a network that coordinates taxi service, weekly shopping trips, household help and social activities for subscribers in the central Boston area. Members, who must be 50 or older, pay an annual fee of $550 per person or $780 per couple; services are either included in membership or offered at a discount. For details, contact Beacon Hill Village at 617-723-9713 or bhvillage@aol.com.

You could also have a for-profit company deliver help to your door. Sunrise Senior Living offers in-home care in Atlanta, Boston, Chicago, Philadelphia, Boca Raton and Tampa, and some suburbs of New York City and Washington, D.C. Services include medication management, light housekeeping and personal grooming; fees range from $16 to $22 per hour. A few national franchises, such as Home Instead and Comfort Keepers, also deliver nonmedical home care. Hourly rates generally run $16 to $25.

Find a Green House

The Green House Project breaks up big, institutional nursing homes into groups of cozy houses, each with ten bedrooms that open to a living room with a fireplace. The Green House Project already operates in Tupelo, Miss., and it is building 26 other locations. Staff members, two to a house, manage tasks as they come up, rather than by the clock. Residents hang out by the hearth, help with the menu planning, and raid the fridge when they feel like it. Says Doug Pace, of the American Association of Homes and Services for the Aging, "If residents want chocolate at 10 p.m., why shouldn't they have it?"

For all the relaxed atmosphere, you can count on skilled nursing even if your health declines. Care covers the full spectrum of nursing, says Robert Jenkens, manager of the Green House Project. "It's not just for people who are relatively unimpaired." Costs are comparable to those of traditional nursing homes, and all Green Houses will accept medicaid. For information on locating or starting a Green House in your area, go to www.thegreenhouseproject.com.

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Build a Wendy house

Here's a novel idea: Install a tiny house on your adult child's property, move in, and reap the payback for all those child-rearing years. Little houses in the backyard -- also known as granny flats and, less whimsically, accessory dwelling units -- make sense for seniors who want privacy but need help close at hand. Some of them are darned cute; check out the models at www.tinyhomes.com, which run from 300 to 1,000 square feet and start at $39,000 (shipping and hookups can add $10,000 or more to the tab). You can also find out more about the buildings in A Tiny Home to Call Your Own, by Patricia Foreman and Andy Lee (Good Earth Publications, $20).

Sweet as they sound, Mini-Me houses often encounter neighborhood opposition and unfriendly zoning laws. Still, some California communities, including Santa Cruz and Sonoma County, encourage such dwellings as a way to increase affordable housing. California has passed legislation that prevents local jurisdictions from prohibiting the units, and Seattle may soon allow detached accessory units in the southeast part of the city. For guidance on the design and the permit process for accessory dwellings, go to www.ci.santa-cruz.ca.us/pl/hcd/ADU/adu.html.

As AAHSA's Pace says, the elder-care industry has made efforts over the past decade to take the drear factor out of senior housing. "I think we're past the tipping point," he says.