Congregate housing includes a range of living options. The most common form is an apartment complex of older adults that provides a level of sup­port, such as shared meals. Congregate housing is often the least expensive form of supported living for older adults, as the cost is typically subsidized by various government agencies and nonprofit orga­nizations. Because of its affordability, it is an espe­cially important option for low-income older adults who need some support to remain out of a nursing home. However, there is a shortage of congregate housing in the United States.

Traditional congregate housing differs from assisted living in terms of the level of services pro­vided. Although many traditional congregate hous­ing complexes do not include individual kitchens and provide shared meals, the level of medical assis­tance, for example, is lower than in assisted living. Congregate housing facilities do not provide 24-hour medical services on site. However, newer congre­gate housing complexes are including higher levels of other service, so the distinction with assisted liv­ing is being blurred.

The service coordination that is provided in con­gregate living accomplishes several things: interface with housing officials, individual service plans for residents, coordination of shared activities (e. g., cleaning common spaces), and mediation of resi­dent conflicts. Most congregate housing complexes require that residents be capable of independent living and not require continual medical care, be medically stable, know where they are and ori­ented to time (e. g., know today’s date and other key time-related information), show no evidence of disruptive behavior, be able to make independent

162 CHAPTER 5 decisions, and be able to follow any specific service plan developed for them. If at some point a resident no longer meets one of the criteria, he or she is usu­ally required to move out.

The decision to move into congregate housing is usually done in conjunction with one’s family, and is typically a response to a significant decline in functioning or other health-related problem (Sergeant & Ekerdt, 2008). Families are generally satisfied with the outcomes following the move (Williams et al., 2008).