The “Silver Tsunami” is upon us: every day in the United States, 10,000 people turn 65. According to the Administration on Aging, those over 65 represent more than 15% of the population; that will swell to more than 20% of the population in the next decade. Americans who reach the age of 65 have an average life expectancy of an additional 19.4 years, according to the Centers for Disease Control and Prevention. Among older people, especially for those who are physically frail, intervening illnesses and injuries significantly increase the chances of developing a new or worsening disability. It is important to be aware of the options you or an elder family member have before it is too late.

As we ourselves are swept away, or find ourselves caring for aging family members, we sometimes fail to take advantage of help that is available because we are simply unaware of what’s out there. Possibly, you need help during the day to care for your mother while you work; is Adult Day Care an option? Or maybe your father is in the hospital after a fall and needs rehabilitation, but you don’t know what to ask for or how to choose the right facility. Perhaps your parents – or you and your spouse – need some help while one or the other is recovering from an illness, and didn’t know many assisted living communities offer respite or temporary care to get individuals back on their feet before they go home on their own.

We can never be fully prepared for how the tsunami will affect us, but there are some things that can be done that will lessen the stress when difficulty strikes. Doing your homework before a crisis is key to making good decisions that everyone can live with. Visit an Adult Day Care Program before you need it, to get a loved one used to the idea of attending; or do a trial day if the program allows it. Consider Assisted Living options, visiting several as you plan. This could help keep your loved ones living independently longer. Visit several rehabilitation centers or nursing homes to know what you want before you’re presented with the need to make a quick decision about future care. Seek the help of a Geriatric Care Manager or Social Worker to discuss what you may need, and how you can get it. Finally, put finances in order, so you know what coverage and/or funds are available and how to access them before the wave comes to shore. Being unprepared can lead to delays in getting the care that is needed, an unnecessary loss of personal assets, and an enormous amount of stress.

Armed with an understanding of available healthcare options is a good first step to being prepared when the tsunami hits. Some terms that may be helpful include:

Assisted Living

A residential option for those needing minimal assistance with Activities of Daily Living (ADLs). Generally, meals, some personal care, and activities are provided. Most are private pay; however, some accept Medicaid. Might offer a temporary stay option to help bridge the transition from hospital stay to home.

Adult Day Care

An outpatient program that individuals may attend either for socialization only, or for prescribed health care services. Transportation may be provided.

Social Model: Provides individuals, often those with mild to moderate dementia, with socialization and meals in a supervised setting.

Medical Model: Provides healthcare services, including dispensing medications and physical therapy, in addition to socialization and meals. Typically staffed with nurses and can be covered by Medicaid.

Continuing Care Retirement Community (CCRC) or Life Plan Community

Retirement communities that offer an active lifestyle in an independent living apartment, with the security of higher levels of care available should residents need them in the future. Various contracts allow for prepaid healthcare or a fee-for-service option.

Home Care

Skilled (i.e. nursing, therapy, social work) and unskilled (i.e. aides and companions) services provided to the individual in their home. Paid by insurance, Medicare, Medicaid, or out-of-pocket, depending on circumstance.

Hospice Care

Provides support and palliative care to people in the final stages (approximate six months or less) of a terminal illness. Hospice care can be provided in the home or in a facility and might include physical support and emotional and spiritual counseling for the patient and family members.

Palliative Care

Specialized care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness with a goal of improving the quality of life for both patient and family. Palliative care is provided by a group of doctors, nurses and other specialists who work with the patient’s primary care team to provide an extra layer of support and can be provided along with curative treatment.

Respite Care

Temporary or short-term care provided to the patient at home or in a facility so that the primary informal caregiver can take a break or attend to personal matters.

Skilled Nursing Facility/Nursing Home

Provides 24-hour-a-day nursing care on an inpatient basis. Staffed by RNs/LPNs with physicians on staff or on-call.

Short-Term Rehabilitation

Services provided within a nursing home or rehabilitation center setting with the goal of being able to return to the community within a short period of time (average length of stay is 18 days) after rehabilitation is complete.

The reality of life is everyone is going to hit the Silver Tsunami at one point. Without doing your research in advance, you may get caught in the undertow. Avoid drowning and explore your options.

If you or someone you know is in need of care, contact Gurwin at (631) 715-2000 or visit our website at

Dorian Froelich, LMSW

Chief Social Work Officer

Gurwin Jewish Nursing & Rehabilitation Center