There are many different living options for people who are no longer able to live independently, or who require more care than the average family can give. About 70 percent of people over age 65 will require some type of long-term care services during their lifetime. The process of choosing can be overwhelming.
To begin, it’s important to know the differences among various terms. Each type of facility offers different benefits and levels of care, and often must follow different rules and government guidelines in order to maintain its certification and/or funding. The quality of individual facilities varies, as well. Some are wonderful, but many (way too many) are horrific. (On the HensonFuerst website, we provide guidance about how to choose the best-rated care in your area, and we’ll also discuss these topics in detail in future blogs.)
To help ease the confusion, here are some definitions of commonly used terms:
“Long-term care” is an overarching term used to describe any service (including many of the services listed below) designed to help people who have chronic illness, disability, dementia, or other condition that requires on-going help. Long-term care services can be provided anywhere, including in the individual’s home or in a residential facility.
Continuing Care Retirement Communities (CCRCs)
CCRCs offer multiple levels of care–Independent Living, Assisted Living, Skilled Nursing Care—housed in different areas of the same community or campus. As the personal and medical needs of residents change, they have the opportunity to move to a different care facility while remaining in the same community—social connections remain in place, friends can stay friends. CCRCs provide residential services (including meals, housekeeping, and laundry), social and recreational services, health care services, personal care, and nursing care.
If you are considering a CCRC, be sure to check the associated nursing home, in person and on the Nursing Home Compare page on www.Medicare.gov. A CCRC contract usually requires you to use the CCRC’s nursing home if you need nursing home care. And some CCRC’s will only admit people into their nursing home if they have previously lived in another section of the retirement community, such as their assisted living or an independent area. CCRCs usually require a large lump-sum entrance fee, and residents must pay a monthly fee. (Licensed as nursing homes/residential care facilities or as homes for the aging.)
Independent Living Community
Independent living communities typically provide meals in a restaurant setting, housekeeping, transportation and various social activities. While there may be wellness programs, care services may or may not be available for an additional charge. These communities are often part of a Continuing Care Retirement Community. (Not licensed.)
Assisted Living Facility
These communities promote independence in a private residence setting, a kind of “home with services” for people who are generally well but still need help with everyday tasks. There is an emphasis on privacy and choice. Residents typically have private locking rooms (unless shared by choice) and private bathrooms. Personal care services are available on a 24-hour-a-day basis. Residents have access to assistance with meals, bathing, dressing and/or medication as needed. In addition, transportation and social activities may be available (not all facilities offer all services, so ask for a list of services in writing). Assisted Living facilities may stand alone, or they may be part of a Continuing Care Retirement Community. There is usually a monthly fee, plus additional fees for added services. (Licensed as residential care facilities or as rest homes.)
Skilled Nursing Facility
Skilled nursing facilities are nursing homes that are certified by Medicare to provide 24-hour nursing care and rehabilitation services, in addition to other services. Many of these communities offer short term, comprehensive rehabilitation programs on an inpatient and outpatient basis. They may be stand-alone facilities, or part of a Continuing Care Retirement Community. (Licensed and regulated by state public health departments.)
A nursing home is a facility licensed by the state to offer 24-hour skilled nursing care and personal assistance. For people who don’t need to be in a hospital but still require round-the-clock care, a nursing home provides nursing care, personal care, room and board, supervision, medication, therapies and rehabilitation. Rooms are often shared, and communal dining is common. Some nursing homes have special care units for people with Alzheimer’s disease or other serious memory disorders. (Licensed as nursing homes, county homes, or nursing homes/residential care facilities.)
Alzheimer’s or Memory Care communities are a type of service, not particular facility. They provide specialized services to meet the needs of individuals with dementia, brain injury, or Alzheimer’s disease. These services may be provided by an Assisted Living, Skilled Nursing or Residential Community.
These facilities offer 24-hour supervision and supportive services for people who don’t need on-going medical or nursing care. They provide housing, meals, activities, and medication administration.
Hospice provides care for individuals who are terminally ill, including health services, volunteer support, grief counseling, and pain management. Although most hospice programs are only allowed to offer services to people who are thought to have less than six months to live, some hospitals are providing hospice to people with a documented terminal illness who need palliative care. These services can be provided in a person’s home, a hospital, or a long-term care facility.
Adult Day Care
Even though the name sounds a bit condescending, Adult Day Care can be very helpful for adults who are functionally impaired, but who want or need an alternative to live-in care. These programs run during the day (much like child day care), and provide variety of health and wellness, social, and related support services in a safe, protective setting.
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