So far we have talked about ways to modify your home, types of equipment available to aid independent living, services such as "Meals on Wheels" and transportation, and the levels of home care and nursing services available for in-home living.

What's the next step when more care is needed than can be furnished safely at home?

Most people struggle with this decision because they feel that their choices are limited to in-home care or a nursing home. For many people, neither option is appropriate or acceptable.

In the comfy coziness of our own home, we all feel safe and secure. Being able to maintain ourselves is extremely important to us as individuals and to our society. There is a significant increase in the rate of recovery for individuals in an in-home situation as opposed to an institutional setting. This has led to the development of a variety of home care services, assisted living and retirement communities to provide alternative living arrangements and care for the individual in managed, comfortable and familiar environment.

The demand for continuing care communities exceeds the available supply and most facilities have waiting lists for vacancies. As long as the services are priced within the means of the people being served, these communities will continue to provide a reasonable alternative for secure and independent living.

While there are some differences between these options; and they each offer a range of service plans that can accommodate each individuals needs, they all have one thing in common - independent living in a place of your own without the burdens of home ownership. No more grass to mow, leaves to rake or snow to shovel! Let's explore some of these "home-like" living options.

Independent Living/Retirement Communities: These are usually a complex of private condominiums or apartments in a safe, secure environment for those individuals who still maintain a fully independent lifestyle. They usually provide a range of educational and social programs to enhance the quality of life of their residents.

Assisted Living: These facilities are designed for those individuals who need or desire some assistance in their daily living activities. In addition to private living facilities and the programs listed above they often provide: meals, transportation and some on staff aides.

Intermediate Care: This is appropriate for those who can still get around on their but require regular assistance in daily living activities and some nursing care or supervision.

Skilled Nursing Care: This option is for those who require medical and nursing intervention in a safe living environment. Nursing care is provided around the clock on a continuing basis.

Some of the resources available locally are:

Loomis House (Holyoke) and Loomis Village (South Hadley): Loomis is a continuing care retirement community that provides 24-hour assisted care through an array of residential choices and a full range of supportive services. Our residents can be secure in the knowledge that as their needs change those needs will be met.

The Lathrop Communities (Northampton & Easthampton): Lathrop offers a combination of single-story townhouses and apartments for independent living. Their goal is to provide the best possible price for the level of service that is required.

Rockridge Retirement Home (Northampton): Rockridge is a retirement community which offers just enough assistance so that today's seniors can retain their independence while enjoying the security of knowing that emergency assistance is close at hand. Rockridge is a member of the New England Deaconess Association.

For a more complete list contact the Council on Aging or your local Elder Services Agency.

Many of the local facilities offer a combination of independent living, assisted care and nursing care in order to meet the changing needs of their residents. Some of them provide full-time medical and nursing staff while others utilize the services of third-party outside contractors. While the approaches may be different, their philosophies and commitment are remarkably similar.

This series has covered the continuum of options for continuing care. Deciding which choice is appropriate can seem overwhelming. Your local elder service agency can provide you with guidelines for conducting an assessment to determine the individual's level of independence and make recommendations on the appropriate level of care that is needed. Help your loved ones continue to live independent, secure and satisfying lives.