Imagine a place that offers independent, affordable, apartment style living, where you have your own place, but don't have to cook, clean, do laundry or mow the lawn.

Imagine a place where you have assistance available to you if you need it 24/7.

Imagine a place that offers all the activities you enjoy like bingo, exercise, crafting, shopping, and also has interesting people your age who would be delighted to spend time with you.

For people over 65, the place is not in your imagination. It is a reality today and is called assisted living.

In the past, there were no facilities to bridge the yawning gap between living at home and living in a nursing home. Often an individual would be healthy, but just had difficulty with meal preparation, personal care, and/or maintaining their home.

Realizing they needed to address this vital gap, the Community Care Program (CCP) was created in 1979 by Public Act 81-202. The whole point of CCP was to prevent premature and unnecessary institutionalization of seniors by providing in-home and community-based services.

While core CCP services are homemaker, adult day service and case management, other services were provided on a demonstration basis in limited areas of the state.

Assisted Living

By combining apartment-style housing with personal care and other services, assisted living aims to preserve privacy and autonomy while emphasizing health and wellness, so that residents can live independently and take part in decision-making, with their privacy, dignity, individuality and personal choice intact.

Offering three hot meals served buffet or restaurant style, free laundry and housekeeping services, local transportation, numerous exercise and leisure activity programs, emergency call systems within each apartment, medication management, CNA's, nurse consultants, and limited assistance with bathing and dressing; assisted living is a fantastic housing option for the elderly, one that unfortunately far too many elders refuse to consider.

Often the studio, one and two bedroom apartments are given unfurnished to residents, who can then do it up as they like, so that they feel more at home. Apartments are designed with safety, convenience and accessibility in mind - such as switches and plugs in front of cabinets, user-friendly door knobs, higher outlets that are easier to reach, and walk-in closets and baths that are wheelchair adaptable. While microwaves, fridges and coffee pots are provided, stoves are usually not allowed due to safety concerns.

Supported Living Facilities (SLF's)

As an alternative to nursing home care for low-income seniors and those with disabilities under Medicaid, the Supportive Living Program, was developed about seven years ago, as an affordable assisted living model, administered by the Department of Healthcare and Family Services.

"Assisted and Supported Living Facilities are virtually the same concept; yet they differ in how the services get paid for," explains John Smith, the executive director of the Egyptian Area Agency on Aging.

While SLF's accept Medicaid, assisted living facilities cannot. However, some assisted living facilities have special programs for those who cannot afford full freight. "Its important to note that SLF arrangements are also required to have at least 25 percent of their apartments available for very low income people with limited or no assets," says Smith.

Could Southern Illinois support assisted living facilities for low income seniors?

Statistics indicate that Illinois is home to over 2 million people over the age of 60.

The Coming Home program was created by The Robert Wood Johnson Foundation to fund the development of rural community-based systems of chronic care for the elderly at five sites across the country. The NCB Development Corporation team, working with the Foundation's staff, came to the conclusion that the best way to provide care for chronically ill, low-income rural elderly people was to build affordable assisted-living facilities.

Research shows that the Shawnee Corporation conducted a feasibility study that demonstrated that Southern Illinois could actually support several assisted-living facilities for low-income seniors. Of the 45,984 people in a four-county area, 18 percent were seniors, and 77 percent of the senior population had an income below $15,000 a year.

Furthermore, Shawnee's preliminary assessment found that other community-based organizations were interested in participating in such projects. Eventually, these groups came together and formed a new nonprofit entity - the River to River Residential Corporation - to work with Coming Home to create affordable models of assisted living throughout Southern Illinois.

Sherry Hamlin, executive director of the River to River Residential Corporation explains that they are part of a program that was a demonstration project through the Department of Aging that provides comprehensive care in a residential setting (CCRS).

Financed with assistance through the Illinois Housing Development Authority, 400 such programs were approved statewide in this project, out of which only six were chosen for the demonstration project. Three of the chosen six belong to the River to River Residential Corporation, which is a matter of deep pride for Hamlin.

Current CCRS's include River to River's Big Muddy River Apartments in Murphysboro, River to River's Hurricane Creek Apartments in Herrin, River to River's Cache Valley Apartments in Ullin, CJE's Weinberg Center in Deerfield, Luther Center in Rockford and Fox River's Fox River Apartments in Olney.

Truly affordable assisted living is a reality today

"There is a growing need for affordable assisted living facilities within the State," says Hamlin. "When elderly people are forced to live at home, it can be dangerous for them. Low income seniors are often forced to go into nursing homes, since they are just bound to a place that accepts Medicaid, if they have no money. Facilities like ours are beginning to change all that now."

Smith served on the CCRS board for a while. "Ten years ago, we had no affordable assisted living facilities for low income seniors in this region," he says. The closest was in Salem and Cape Girardeau. "We partnered with several area organizations and companies and proved to entrepreneurs that affordable, assisted living is financially doable in Southern Illinois."

"It's a social model, not a nursing home model," emphasizes Smith. While low income seniors can thus choose an SLF, moderate income seniors can look at CCRS facilities, while the upper middle class and the rich can always use private pay.

"It's thrilling to have assisted living facilities that serve a variety of incomes today," says Susan Patterson, program manager, of the Egyptian Area Agency for Aging.

"We've come a long way from the days where the only alternative was long term care facilities, which were set up to deal with major illness. Assisted living gives more choice and independence to seniors today and is definitely a very attractive option," says Patterson.

Shawnee Alliance for Seniors

Margie Kemp, project development and training specialist has worked at Shawnee Alliance for Seniors, in Carterville for 23 years. An independent agency with no vested interest, Shawnee Alliance for Seniors executes a couple of functions for assisted living facilities.

"We perform a 'choices for care' screening for everyone going into an SLF and inform the individual and family of all the options, so that they can make informed decisions," says Kemp. This is a State requirement for anyone over the age of 65.

"We also determine what level of service a person - who is approved for an apartment by the River to River Residential Corporation - needs after an assessment," says Kemp.

"At this point there are no plans for expanding CCRS in Illinois, as far as I know. But I would love to see it grow and expand," says Kemp.

River to River Residential Corporation: Murphysboro, Ullin, Herrin

With a total of 166 apartment units across the three facilities in Murphysboro, Ullin and Herrin; River to River provides affordable, assisted living in a beautiful setting that most first time visitors mistakenly think they cannot afford, only to be pleasantly proven wrong.

Donna Cunetto, marketing coordinator of the River to River Residential Corporation says, "Our residents have their own apartment, form a community and choose a positive lifestyle that promotes health and well being in their senior years."

"Often seniors get socially isolated and then find themselves getting back to their social life once they come here and make some friends and figure out what activities they want to participate in," says Cunetto.

"A woman lived in the country, in a huge house that she had raised her family in," says Cunetto. "Her family had expressed concern for her being able to physically take care of a big house and she knew she needed to make a change, but kept putting it off."

"One night she saw a car in her driveway that didn't leave. After half an hour she called the police. She found out that the people were making Meth in the car."

Concerned for her safety, the woman visited the River to River Residential Corporation right away to inquire about assisted living and moved in a week later. "Most cases aren't that extreme, of course," says Cunetto. "Most are just looking for an easier, safer, healthier lifestyle."

Brookstone Estates: Harrisburg, Fairfield, Effingham

"There are a lot of older people living at home, alone and having a hard time with cooking or even eating alone," says Keesha Wood, regional manager, Brookstone Estates, Harrisburg.

"People over 65 come to us and say they are tired of maintaining their yard and struggling with keeping their house in order. Assisted living is such a nice, viable option for them."

Brookstone Estates has 16 assisted living facilities in Illinois, with 46 apartments available in each facility.

"Our residents are pretty independent," says Wood. "They may just have problems with small things like tying their shoelaces or buttoning their shirts, which we can easily help them with."

Prairie Living at Chautauqua: Carbondale

"Our building is run like a resort," declares Joan Patton, director of marketing and sales, Prairie Living at Chautauqua, Carbondale. Opened in November 2004, the beautiful and well maintained SLF has a total of 75 apartments.

"A lot of people think assisted living will have a nursing home atmosphere," says Patton. "But that is simply not true. The main goal is to let people be independent as long as possible, in an environment where they can thrive" she says.

While 60 percent of her residents pay through Medicaid, Patton says that strangely enough, the people who choose private pay have a longer waitlist, than those who pay via Medicaid.

Often income-based housing can have a negative connotation. "But there is absolutely no difference in the quality of service we offer for private pay or Medicaid residents," says Patton. "In fact we have to convince people all the time that they can indeed afford this," she says.

Sometimes residents come to Patton and ask her if they can still do something, like having an overnight guest or going out on their own. "I tell them; of course you can do anything. There are no rules, as long as you are safe. This is your home," she says.

Green Tree: Mt Vernon

"I just had a lady who was a 101-years-old, pass away," says Paulette Wolff, executive director of Green Tree, Mt. Vernon. "People say that she lived as long as she did because she was here with us, than if she had stayed at home."

"All the medication reminders, social activities and the wonderful quality of life we gave her did make a difference."

With 86 apartments and 96 total residents, Green Tree is the only state licensed assisted living facility in Jefferson County, according to leasing counselor, Jerry Jones. Some residents live as couples, but Jones is careful to emphasize that sharing of private apartments is not allowed, unless it's a specific request.

Putting the average age of residents at 86, Wolff says theirs is not a supportive living facility. "Green Tree is strictly private pay," she says.

New Assisted Living Facility: Carmi

Christian Homes recently broke ground for a new and as yet-unnamed SLF in Carmi. Ruth Dowdy, admissions and marketing director says the $5.1 million project will have 49 units, in a beautiful three-storeyed building.

With spacious rooms that will be larger than what State requirements necessitate, the new community will utilize existing property near the current Wabash Christian Retirement Home.

Tips on choosing the right facility

Start looking for a facility before you actually need it, because that way you have all the time in the world to make the right choice and are not forced to choose in a pressured situation.

* Be honest about what your needs are.

* Choose a housing option that will let you age in place, without having to make a major move.

* Meet current residents and talk to them. Since they live there, they could give you valuable insights.

* Go in and have a meal - food is important and you need to know if you will like the food served at the facility beforehand.

* Find out what their policies are: Do they allow pets? Is smoking allowed?

* Does the facility provide assistance with the things you need help with?

* Is it a clean place? Does it smell good? Are the grounds well maintained?

* Are the staff polite and friendly?

81-year-old Anna Lee Barnum had a fall recently. "I haven't learnt where my butt is and where my feet's at!" she exclaims. "Damn stupid of me, I tell you."

Residing at Prairie Living at Chautauqua, a supportive living facility in Carbondale, she got medical help immediately and is doing fine now. A feisty, good humored lady, she is dressed in a white sweater, with several interesting rings on her fingers.

Having come all the way from Alaska, she says she used to live in Southern Illinois a long time ago. "I was totally exhausted when I finally got here after a five day journey," she says. "But my son had set up my room and even bought me a chair that lifts me up and down. I love it."

"My kids traveled 60 miles to work every day in Alaska and in winter it was just not a good idea to stay home all by myself," recalls Barnum. "So I told my kids, I'm an old woman now for Pete's sake. I have a right to enjoy my old age. I don't care if I have to live in a pup tent, but just get me the hell out of Alaska!"

Admitting that her son, who now lives in Carterville, chose the facility for her, she says, "If it's safe and clean that's all I needed to know."

"I like it here - no one bothers me and it has worked out pretty good," she says. "I'm totally happy sitting in my room, watching TV or socializing when I feel like it. It's like being by myself and that's important to me."

* Brookstone Estates, Effingham: 217-347-5871

* Brookstone Estates, Fairfield: 618-842-5875

* Brookstone Estates, Harrisburg: 618-253-5870

* Christian Homes, Carmi: 618-382-4644

* Egyptian Area Agency for Aging: 618-985-8311

* Green Tree, Mt Vernon: 618-244-5580

* Prairie Living at Chautauqua, Carbondale: 618-351-7955

* River to Rivers - Big Muddy River Apartments in Murphysboro: 618-684-5818

* River to Rivers - Cache Valley Apartments in Ullin: 618-845-3399

* River to Rivers - Hurricane Creek Apartments in Herrin: 618-988-9540

* Shawnee Alliance for Seniors: 618-985-8322