BY MARIO BOUCHER
Senior homes are transforming their image just in time for a “booming” generation seeking high-quality health care while maintaining an active lifestyle into their golden years. Long-term care can cover many services tailored to meet each person’s unique needs to maintain the best quality of life.
Levels of Care
“Long-term care” refers to needs beyond what health insurance may cover if age, illness, disability or cognitive impairment interfere with a person’s ability to handle their own care. The level of service a client needs is determined by whether that individual can live independently at home with in-house services or requires care at a nursing facility. Some people find in-home care enough to suit their needs. These people can live day-to-day at home and only require a certified, trained caregiver to visit and assist with services as needed, including money management, medications and medical care, personal hygiene, meal preparation and other household chores.
The next level is assisted living: An individual moves into their own apartment within a facility that operates a kitchen and dining room, and has centralized staff to provide support services. For example, a nurse may pop by once or twice weekly to help with specific needs.
If more assistance is required, a skilled nursing facility with either a private or shared room offers a full nursing staff and daily checks to ensure that residents are comfortable. These facilities can also provide other health services, such as physical therapy and social and entertainment activities. Specialized nursing care can also include memory care, oriented specifically for patients with dementia, Alzheimer’s Disease or other memory issues.
Finding the Right Care
“You do not have to navigate this process alone,” says Kay Castillo, executive director of Friends of Residents in Long Term Care, a nonprofit organization committed to advancing the quality of life for North Carolinians using senior living facilities. “While we cannot provide recommendations of facilities in the area, we have numerous resources on our website to help you better understand long-term care.” Organizations like this one can help families find the right place for their loved ones to live and navigate potential problems that may arise.
“Another important thing you can do is find out more about the financial options available to help cover the costs,” says Steven Hahn, communications director for AARP North Carolina. “Long-term care insurance is one way you can ensure that you’re prepared for long-term care needs and reduce the chances that you’ll need to rely on loved ones for care or financial assistance. The best way to determine what long-term care protection options are right for you is to speak with a qualified professional who is well-versed in long-term care and takes the time to understand your individual needs and circumstances.”
Different Types of Care Facilities
Hillcrest, Avendelle Assisted Living and Cambridge Village Optimal Living are three locally owned and operated examples of the many different types of facilities seniors and their families may encounter as they look for local care options.
Hillcrest, which has locations in Raleigh and Durham, offers varying levels of care including everything from in-home care to high-quality residential nursing care. Founded in 1951, Hillcrest was the first certified senior care facility in North Carolina and remains family-owned and operated by the third generation of the founders’ families: CEO Ted Smith and CFO Bill Hoover. “We offer a full range of high-quality senior care services, including 24/7 residential skilled nursing, after-hospital short-term rehabilitation, assisted living and outpatient physical therapy,” says Smith.
Hillcrest provides various levels of in-home care, from respite care for people whose caregivers need breaks to consistent in-home companion care tailored to each individual’s needs. “Hillcrest Home Health provides care for adults in their own homes throughout Wake, Durham and Orange counties,” says Smith. They also provide assisted living, allowing people to live on-site independently with some support. Finally, they provide skilled, regular nursing care with medication assistance and other support services. “We believe our signature Elegant Care sets us apart from other providers, especially the large corporately owned businesses,” says Smith. Hillcrest Raleigh at Crabtree Valley provides care on a private, park-like campus surrounded by gardens and walking paths.
In 2005, founder and CEO Esther Cromwell opened Avendelle Assisted Living, a neighborhood-based model for senior living. Avendelle residents live in houses located in residential neighborhoods. The goal is to create a place that feels like a home rather than a facility.
Cromwell founded Avendelle after researching senior care facilities for an elderly, widowed neighbor. She produced an alternative model focusing on independence, personalized care, comfort, and a close-knit atmosphere within a smaller, residential-style setting. Avendelle “redefines senior care by offering a uniquely intimate, home-like environment tailored to each resident’s individual needs,” says Cromwell. Offering a high staff-to-resident ratio, Avendelle focuses on fostering strong connections between staff and clients and delivering care in a way that respects each person’s routines and preferences.
“This intentional structure enables us to respond quickly and meaningfully to health concerns, personal comfort and emotional well-being, allowing our residents to feel genuinely seen and valued,” says Cromwell.
Cambridge Optimal Living offers a hybrid approach to senior care with the goal of allowing residents to live in their own apartments with increasing access to care as needed. This means they can age in place rather than moving to different spaces for different levels of care. “Senior care options in Wake County include a wide range of services to meet the diverse and evolving needs of older adults,” says Nicci Franklin, Cambridge’s chief marketing officer.
The independent living rentals allow residents to benefit from the facility’s amenities and space while paying for only the care they need. “Cambridge communities offer personalized options, flexibility, and a community-centered model that focuses on holistic well-being,” says Franklin.
Cambridge Optional Living offers resort-style retirement communities in Apex, Raleigh and Wilmington. Services are designed to support exceptional health for residents, including a proactive approach to wellness with state-of-the-art fitness programs, on-site health care and spa services.
These are three of many different types of senior living options available in the Triangle. They are meant to illustrate the different kinds of options available, and you will doubtless find other models as you explore. Keep looking and try to find the model that best supports your particular situation and your or your loved one’s individual needs.
Envisioning the future of Senior living
According to a report by the United States Census Bureau, one in five Americans will be at least 65 years old by 2030, and an estimated 19 million people will be 85 years of age or older by 2060. With a growing senior population, what will high-quality care look like?
The health care industry is embracing in-home electronic monitoring—motion monitoring and biometric measuring devices, for example—to track status and communicate in real-time, often combined with telemedicine. The next few decades could see the use of robotics in senior caregiving.
“Technology will play a crucial role, integrating health monitoring tools, telemedicine, and even AI-supported health insights that allow caregivers to anticipate residents’ needs proactively,” says Cromwell. “This technology won’t replace human interaction but will empower caregivers to provide better, more responsive care.”
Ultimately, programs by caregivers—the human kind—will encourage physical and mental activities and an emphasis on community and social engagement through fitness, creative arts and lifelong learning, key to providing comfort and emotional well-being for seniors.
Franklin adds that senior living will continue to change based on the aging population’s needs. “There will continue to be an emphasis on options for seniors to age in place with a heightened focus on proactive wellness,” she says. “Technology will continue to play an integral role in senior living, and people will trend toward active living with an emphasis on amenities.”
RESOURCES
Here are some websites to help seniors and their families find the information they need.
North Carolina Department of Health and Human Services: ncdhhs.gov/imstillhere. Here you can find North Carolina’s Multisector Plan for Aging, which will help implement key needs for older adults over the next 10 years.
Wake County, Resources for Seniors: resourcesforseniors.org.
Central Pines Regional Council: centralpinesnc.gov/aging-human-services, including a long-term care ombudsman (a person who researches and resolves complaints).
Residents’ rights for nursing homes and adult care homes in North Carolina: ncdhhs.gov/divisions/aging/long-term-care-ombudsman-advocacy-residents-long-term-care-facilities/residents-rights.
Friends of Residents in Long-Term Care:
forltc.org and forltc.org/resources.
AARP long-term care overall guide: aarp.org/caregiving/long-term-care.
Hillcrest Raleigh: hillcrestnc.com/home/raleigh-nc.
Avendelle Assisted Living: avendelle.com.
Cambridge Village: cvsliving.com.
