The challenges of housing Maine’s senior population as it expands in the coming decade cannot be understated. It will require a series of targeted investments, in smaller, centrally located homes that allow seniors to age in place; in the integration of housing and health care for seniors; and in the nurses and health aides who help every step of the way, and who are not present in sufficient numbers.

And it will take new approaches, such as the “household model” for assisted living, in which residential homes are repurposed as small-scale group care facilities, an alternative to institutional facilities that can provide great comfort to seniors in the right situation.

Maine Public Broadcasting recently profiled one such home: Elm Street Assisted Living, an 1800s-era house in Topsham with spots for six elderly women. For about the same cost as an institutional facility, there is at least one staff person on at all times to cook, clean the house and help bathe the residents and dispense their medications.

As described in the report, the women of Elm Street are not lost in the crowd, as they may be in a larger facility with 100 or more residents and ever-rotating staff. They are close with each worker, and each other, eating and chatting around an actual dinner table, commenting on the cooking being done just across the room, even joining in if they like.

The close attention and small staff-to-resident ratio breed familiarity, which is one of the main selling points of the household model. Staff members really get to know the residents and better monitor their ups and downs.

The surroundings can be beneficial, too, with home decor replacing the hospital-like corridors of rooms of a typical nursing home. Household facilities often are better able to meet specific needs, such as dietary restrictions or disabilities, as well.

Small-scale facilities are not for every senior. Quality between facilities can vary more widely than at larger, corporate-owned facilities, which are often chains, so they require close inspection by families.

There are typically fewer amenities, such as games or excursions, at smaller facilities, too, and they may be less able to handle more intensive medical problems.

For those reasons, the household model may work better when the residents are relatively equal in mobility and cognitive ability. Someone who is very active may get bored surrounded by just a few other people, all of whom are less active than she is. However, a small facililty of residents all suffering similarly from dementia may be able to provide more comfort and activity to each resident, and still make them feel a part of the group.

That kind of option is needed in Maine, just one of a few necessary to help seniors stay comfortable and nourished through old age.