While the majority of older adults live in independent, free-standing housing throughout their lives, advanced age necessarily increases the likelihood that an individual will benefit from an enriched supportive living environment. Congregate housing responds to the needs of persons 65 years and older who wish to have a limited set of support services available to them in their own separate apartments. Congregate housing, as conceived of here, is noninstitutional and should not be equated with nursing home care or homes for the aged, which represent settings in which more intensive services, health and medical in particular, are required because of an individual’s level of functional impairment.
The underlying philosophy reflected in the congregate housing concept is that the older individual or couple should be able to have a range of services and amenities available while still maintaining substantial independence and autonomy. Such housing is meant to be comfortable, clean, safe, and affordable.
Congregate apartments may be rental or ownership units. Also called enriched housing, clustered housing, or sheltered housing, congregate housing has been shown to result in substantial cost savings as compared with the expense of nursing home care. It has also been argued that this type of housing can help prolong independence, provide companionship, and otherwise buttress an older adult’s personal support network, thus reducing isolation and increasing opportunities for socialization.
Congregate care can be offered under public or private auspices and may be subsidized by government programs such as Section 8 of the Federal Housing Authority. The congregate housing concept first surfaced in 1963 as a specific recommendation made by President Kennedy to Congress. It was not until 1970 that Congress included construction funds for congregate housing as part of the 1970 Housing and Community Development Act. Legislative support was further affirmed in Section 7 of the Housing and Community Development Act of 1974. In 1978, federal legislation authorized the Congregate Housing Services Program (CHSP) as Title IV of the Housing and Community Development Amendment. That legislation authorized contracts with local public housing agencies and nonprofit corporations to provide congregate independent living service programs. The CHSP program was the largest experiment ever undertaken by the federal government aimed at integrating housing environments and social and human services. Substantial impetus arose from the belief that individuals should have a range of options available to them in terms of housing choices. The promise that such housing would represent a low-cost alternative to institutional care represented an additional factor in driving this legislation.
There are usually income eligibility guidelines in public congregate care whereby residents are able to reside in such buildings for approximately 30% of their income, including rent, utility, and services. If it is a private, for-profit facility, depending on the services offered and the region of the country, monthly rent could range from $700 to as much as $2,500.
Congregate housing is an appropriate option for individuals who are relatively independent but would benefit from any and all of the following services: built-in safety features; laundry service; building security; transportation to shopping areas and medical appointments; housekeeping services; social, health promotion, and recreational programs; meal programs (the availability of one, two, or three centrally delivered meals a day); emergency call systems should a medial crisis arise; and social services in general. While health care is not a congregate housing option, individual residents often are able to pay for their own home health visiting nurse or aide.
References:
- The National Resource Center on Supportive Housing and Home Modification, http://www.homemods.org/
- Regnier, V. (2002). Design for assisted living: Guidelines for housing the physically and mentally frai New York: Wiley.
- Zimmerman, S., Sloane, P. D., Eckert, J. K., & Lawton, M. P. (Eds.). (2001). Assisted living: Needs, practices, and policies in residential care for the elderly. Baltimore: Johns Hopkins University