Long Term Care

Long term care is often equated in the public mind with skilled nursing facilities, but there are actually many different long-term care options on a continuum of the level of care and independence. Long-term care is available for the elderly, but also for younger people who varying levels of disability or even temporary illness. Some people stay in long-term care only while they are recovering.
When shopping for long-term care, consumers need to look into the quality of care and their budgets. Optimally, families will consider long-term care options before a crisis arises.

In-Home Care

The first level of care is home care. Home care involves family caregivers and sometimes home health aides providing various levels of support. The ill person may need help just with errands or may need help remembering to take their medication or help with bathing and other dangerous activities. Home care allows families to evaluate and provide for the patient’s individual needs while still allowing their elderly relative some independence and the consistency of their home setting. It may be challenging at times to know what the elderly person needs, so geriatric care managers, or aging life managers can help families to decide how much care and what kind a person needs. They can also provide ongoing assessment and emotional support. They can advise the family on how to reduce safety hazards in the home. With this advice and support, people can remain at home for longer, which is generally the healthier option.
There are organizations that can help you find a geriatric care manager, as well as area agencies on aging.

Community Services

Community services act as an adjunct to home care. They can range from adult daycare, meal programs, senior centers, and transportation.

Adult Day-Care or RESPITE CARE

Adult daycare provides relief for caregivers and provides health support and opportunities for socialization in a safe environment. Adult daycare is often provided during normal business hours. Like with other forms of care, there are levels of adult daycare depending on the needs of the patient. According to the National Caregiver’s Library, “the average participant in this type of program is a 76-year-old female who lives with a spouse, adult children, or other family or friends. About 50 percent of these individuals have some form of cognitive impairment and more than half require assistance with at least two daily living activities.”

Supportive Housing Programs

State and local governments sometimes offer supportive housing programs through Housing and Urban Development (HUD). Residents live in their own apartments, and some programs offer assistance with meals, housekeeping, shopping, and laundry.
Retirement Living/Independent living communities vs.

Assisted living – Residential

Independent living apartments are ideal for seniors who do not need personal or medical care but who would like to live with other seniors who share similar interests. In most independent living facilities seniors can take advantage of planned community events, field trips, shopping excursions and on-premise projects. Independent living is the most hands-off senior living outside the home. It does not generally include any sort of medical care, including help remembering medications. The focus is active living and convenience, a shared experience of like people. There are exceptions, however. Usually meals are offered depending on the elderly person’s preference. Independent adults may find that they don’t interact with staff all that much. Living in a community may take strain off family.
These apartments are not licensed or regulated. Because they are more a lifestyle preference than a medical need, federal and state programs are unlikely to cover the cost.

Senior Retirement Communities

On the other hand, in assisted living, seniors live in an apartment or other home that is close to services and other seniors. Different assisted living facilities may offer very different options and assistance, so be sure you’re clear and compare apples to apples when you are looking at prices. There is often a higher level of help available around the clock, including help with shopping and meals, housekeeping, medication management, bathing, and making appointments. Assisted living provides some medical and supportive care, but is a step down from nursing care, where people often need constant, intensive medical care and even help to move. Staff in assisted living facilities will check in with the resident to make sure they are doing well and communicate with family about ongoing needs or changes. The benefit of assisted living in the homey atmosphere with supervision.

Making the choice to pick a nursing home?

A choice between independent living and assisted living comes down to how serious medical conditions are and how much they interfere with the activities of daily living. Assisted living, which actually provides some care, will be more costly than independent living.
Some of the factors that might lead you to decide on assisted living include a doctor’s concern over your ability to live completely independently; the cost of in-home care; a condition that might be progressive such as certain cancers or dementia; increased fear over everyday activities and their safety (such as a tendency to leave the stove on, or the concern over falling in the shower).

Continuing Retirement Care Communities (Lifecare Communities)

There are communities that recognize that some people will need varying levels of care during their retirement. You can start in independent living and transition to assisted living and then skilled nursing if you require because of deteriorating health. All of these are provided on one campus. This is called “aging in place.” The surroundings will remain familiar, preventing the jolting adjustment needed when moving from a typical independent living facility to assisted living. They may require buy-in or an up-front annuity purchase followed by monthly payments which cover services, amenities, and needed medical care.
It may benefit some seniors to start with the lowest level of care, simply reducing isolation by living in a “retirement village” or 55+ community and having recreational outlets offered to them to increase activity levels, but in an environment in which one can easily transition into higher levels of care with age or illness.

Skilled Nursing Facilities

When people use the term “nursing home,” they sometimes mean any of the care options considered in this article. An actual skilled nursing facility is meant for someone who cannot live independently anymore, often with significant medical needs.

This might be a permanent option for elderly people with chronic health problems, but might also be a good option for someone recovering from surgery or significant illness. Nursing homes often provide rehabilitation services. Temporary or periodic care is also called “respite care” or just short term rehabilitative stays. You should find out how many people the rooms are shared with. Nursing homes are the most expensive facility discussed so far.

Alzheimer’s Care or Memory Care

You may be planning for yourself or a loved one at risk for dementia or Alzheimers. Memory care facilities provide 24-hour support in a closed facility. Typically, life for these residents is highly structured to protect the residents’ safety and to increase their quality of life.

Memory care can be delivered within one of the facilities we have discussed; assisted living facilities and nursing homes sometimes have units that specialize in memory care. There are stand-alone facilities for memory care, as well. Alzheimer’s care is a growing segment of the senior housing market, with the number of units rising 55 percent from 2013 to 2018.

Residential care homes

There are different kinds of residential care homes, where a group of people live in private homes with live-in caretakers. Research these homes carefully, as they differ widely as to whether nursing care is included.

Two types of residential care homes are enriched housing and family-type housing.

Family-Type Homes
Family-type homes offer long-term residential care, housekeeping, and supervision for four or fewer adults unrelated to the operator. The department of Social Services oversees its operations.

Enriched Housing
Enriched housing is not for profit housing, private or public, where seniors live in residential care that is part of a community. The housing is provided for five or more adults, normally 65 or older, and provides care like housekeeping and personal care. They are licensed by the State Department of Health and normally offer at least one meal per day. This is similar to the “family-type homes” offered in some areas and overseen by Social Services, which provide care for four or fewer adults.

Adult foster care (aka Medical foster care)

Residential care homes are growing in some states. One form is the Medical Foster Homes Program run by the VA, which as of now is a small but growing program.
Other adult foster care programs also exist and have a trained caregiver to care for adults who have less complex medical needs than those in nursing homes but need to have someone available in case of emergency and to help with some activities of daily living. The noninstitutional setting can be ideal. These programs are not covered by Medicare. Traditionally, these programs were for adults with cognitive problems, but are increasingly in demand for the elderly. While assisted living facilities sometimes provide care for a large number of people, adult foster care is a more home-like setting for six or fewer people.

Government Assisted Facilities and Programs

In some states, relatives can provide foster care services to family members and receive some government funding, including:
• Connecticut
• Louisiana
• Indiana
• Massachusetts
• Ohio
• Oregon
• Rhode Island
• Texas
• Washington

The aim of adult foster care is to still allow independence where possible, while still ensuring the adult has the help they need and support and safety. Foster care may feel more like home rather than a large, faceless facility. They can also be less expensive. Foster care is ideal for someone who does not need nursing but needs help with cleaning, meal preparation, and errands.

Hospice Care

When a person is at the end of their life, with six months or less to live, hospice care can provide comfort, pain relief, help with everyday activities, and emotional support for the patient and their families.

Hospice care is available in many environments from hospitals to the patient’s own home. Hospice organizations can also provide “respite care,” to give the caregivers a break from the emotionally and otherwise challenging task of caring for loved ones at the end of life. Hospices can also provide support to the family after the patient’s death.

Picking the right nursing home Conclusion

Senior organizations can help you to navigate the various kinds of long-term care facilities and programs that exist. It is important to research them carefully for price, level of care, and amenities. Consider whether they accept Medicare, Medicaid, and/or Supplemental Social Security. If you need more assistance in making a decision, consider talking to your doctor and family members. There is a program for everyone check their reviews, ask lots of questions and make several visits day and night!