Publication Date: March 2022
Copyright 2022 by the New York State Bar Association.
ISSN 1530-3926 | ISSN 1933-8406 (online)
I. An Historical Lack of Accommodative
Older adults and persons with disabilities are all too often unable or no longer able to live in their homes. Tragically, once a person begins that journey, they become separated from their spouse, family and community. These individuals transition from their homes to senior housing or assisted living and finally to nursing homes. There is a need for accommodative housing that facilitates appropriate care and maximum quality of life by providing the ability to remain in a desirable home environment that maintains family structure and connection to communities. There is a further need to preserve assets and resources to avoid Medicaid or if nursing home Medicaid eligible lost pursuant to poverty requirements. This article is focused upon those needs with a method of addressing them with the potential of reducing Medicaid costs. It is time for community-based alternatives that are not dependent upon government funding or large-scale investment. Rather than a cycle of dependency, the following proposal presents an opportunity to shift from transitional custodial care and facilitate greater personal and financial independence.
Many people move into custodial care because their homes can no longer accommodate their functional limitations or service needs. Upon selling their home in preparation for the move, planned or eventual impoverishment begins. In addition to the financial consequences of moving to congregate care, a person sheds home, spouse and community when they are least capable of mentally and physically adjusting to new environments with increasing levels
of dependency. The proposal was developed with the goal of encouraging the development of housing through privately owned small condominium community residence suites of accommodative design where couples can age in place through end of life. The accommodative design also allows opportunities for young adults with disabilities to live in integrated communities, perhaps with their aging parent. Additionally, these residences can be incorporated with
affordable housing, retirement communities, or designed for particular social or religious affiliations. Rather than requiring the substantial investment for custodial care, the small economy of scale makes the residence suitable for any urban or rural community.