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Maryland's premier Long-Term Care insurance agency

An Alphabet Soup of Long Term Care Choices: Are ADUs the New ALFs?

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Decades ago, when someone needed long term care, it would often be provided at home. The only other option was to move to a nursing home, which most believed was a choice of last resort. Although nursing homes are still frequently seen as one of the less desirable options when it comes to long term care, what has changed is the laundry-list of home-based care and senior housing options.  

Home-based care is no longer limited to relatives, neighbors, and—for the wealthy—private duty nurses. There are now non-skilled paid long term care workers who provide everything from companion care to help with bathing, dressing, housekeeping, and shopping.

But perhaps the biggest change in the last few years is the proliferation of assisted living facilities. Although regulations in different states vary somewhat, generally, assisted living facilities (ALF) provide a place to live for those who would prefer not to shoulder the burdens of living in a single family home, but are likely years away from needing nursing home care. 

The most attractive assisted living facilities combine the look and amenities of a private club with a robust schedule of social offerings. Gone are many of the mundane tasks of keeping a household. Tickets to a concert – check! Movie showings and exercise facilities – check, check! Van transport to shopping centers, medical centers, and private dining rooms for family gatherings – check, check, check!

It all sounds really good, and—in many cases—it is.  

These days, many purchasers of long term care insurance picture themselves eventually moving to assisted living. They know that, once a policyholder qualifies for long term care, most policies cover not only the cost of a la carte long term care provided in assisted living, but reimburse for room and board as well!  

It’s no wonder that for those seniors who prefer not to stay alone in their own home, assisted living has become the de facto gold standard housing choice.

However, that may be about to change. Whether it has to do with long-forecasted labor shortages (exacerbated by the ongoing pandemic)—or it is the result of other economic trends—it’s clear that a new housing option is gaining traction. It can provide most of the “age-in-your-own-home” benefits without some of the problems of a stand-alone single- family home. It’s called an accessory dwelling unit (ADU for short). 

An ADU is a second small dwelling built either on the same grounds as a single-family home, or attached to it.

Some people are developing ADUs in or next to their adult child’s (or a relative’s) home. Their plan is to bring in paid professional home care—to their ADU—when it’s needed. Others plan to stay in their own home, and build an ADU for eventual use by their caregiver. The ability to offer a paid caregiver subsidized or free housing could be a great benefit to both the person needing care (proximity of caregiver) and for the attractiveness of the employment.

Nationally, and in many jurisdictions across the U.S., initiatives to allow zoning for ADUs are proliferating.

Are ADUs the new gold standard housing choice for seniors in the know? And will ADUs usurp ALFs? Maybe.  

In any case, with all the variety of lifestyle choices now available, isn’t it nice to know that the comprehensive long term care insurance policy you purchase today covers care in the setting YOU desire, regardless of what that is? 

If you have any questions about your long term care options and the insurance that can help fund it, please don’t hesitate to reach out. Baygroup Insurance can be contacted at or call us at 410-557-7907 for more information.