INDEPENDENT LIVING COMMUNITIES

Are for very independent seniors who live in private apartments. You can live in a community like this with certain medical conditions( ex. Diabetes) even if you are not able to self administer your insulin. Nurses from a third party providers ( Home Health Companies) will come in your home to check your sugar level and administer the insulin. Check with your chosen home health company on pricing but most of the time it is covered by your health insurance (Medicare, Medicaid or other type of insurance). A variety of apartment sizes are available from studios to large two bedrooms. Fine dining services are offered with custom-designed meal packages. Often, residents can choose to pay for a specified number of meals per day. Frequently, there are numerous social outings and events to choose from with some boasting of world class chefs and fitness centers with indoor swimming pools and spas. Also Known As: Retirement Communities; Congregate Care; Retirement Living Payment Options: Most of the Independent Living Facilities are private pay. There are some that could be government funded. After you complete and submit the application for placement in a facility, you will be contacted only by the senior communities in your chosen location.

ASSISTED LIVING FACILITIES

Are communities designed for seniors who are not able to live independently but in the same time they don’t require the high level of physical and medical care to be accepted in nursing homes. You could find Assisted Living Facilities based on the level of care (I or II), budget, your preference (large- 50 beds and over facilities or smaller and cozier -6 bed or less facilities). While in a large senior care facility you will find a large variety of activities and entertainment, in a smaller care facility you will find more people to cater to your personal needs and more of a home-like environment. Selecting a elder care facility should be based on your primary need (psychological or physical). Certain “included in price” services are similar in the large and small Assisted Living Facilities as housekeeping, assistance with medication administration and activities of daily living, three meals and snacks, furnished bedrooms or apartment( but you can always request to bring your own furniture to make you feel more at home), laundry services ,staffing available 24 hours. Some facilities may provide licensed nursing services and others may use nursing services through third party providers as Home Health Services. Accommodations varies from private apartments to single private or double shared occupancy rooms. Also Known As: Assisted Care Community Payment Options:  Is usually private pay but some assisted living facilities may accept Medicaid and Medicaid Waiver Programs. If you have long term care insurance you will receive monetary compensation for residing in an Assisted Living Facility.

ADULT FAMILY HOMES

Depending on the state, they may have different names as Adult Care Homes, Board and Care Homes, Group Homes, etc. and they are usually 5 beds or less. Some states may have them all assisted living, adult family, group homes as different entities with separate rules and regulations. In some sates these senior care facilities could be under state law, county or only city law. Each care facility should inform you upon admission(brochures should be available as well) which authority to notify in case of elder abuse or in the event that you want to find out the rules and regulations of that facility. The services provided by these facilities are similar to the assisted living facilities with the exception that certain programs( long term care insurance, Medicaid Waiver ,etc) may not offer monetary compensation toward your care unless you are living in an Assisted Living Facility. Always check with the facility if they are an accepted member in these programs. Some care facilities accept seniors/disabled people on hospice care. Also Known As: Board and Care Homes; Group Homes; Residential Care Homes Payment Options:  Usually private pay/ Sometimes Medicaid.

NURSING HOMES or SKILLED NURSING FACILITIES

Provide 24 hours skilled nursing care. Seniors/ disabled people, generally with high level of physical or mental care or with complex medical conditions  that requires 24 hours skilled nursing care, will not be accepted in Assisted Living Facilities and they will go to Nursing Homes, or they can choose to stay home with 24 hour in house nursing care provided by Home Health Services or Nurse Registries. Nursing Homes are required by federal law to have licensed nurses on duty 24 hours a day.    Some nursing homes provide short term rehabilitation services for which the payment is usually covered by the health insurances but if you continue the therapy beyond the approved days from the insurance you will have to pay privately. Residents typically share a room but some have private rooms and are served meals in a central dining area unless they are too ill to participate. Activities are also available. Some facilities have a separate unit for Alzheimer’s patients. Also Known As: Convalescent Care; Nursing Center; Long Term Care Facility Payment Options:  Can be private, Medicare or Medicaid.

REHABILITATION SERVICES

Can be as an inpatient offered by a Rehabilitation Facility and  Nursing Homes or outpatient offered by an Outpatient Rehabilitation Center and Home Health Care (in house). This type of service is provided short term to patients who got weaker after a surgery or hospitalization, after hip, leg, arm or any other surgeries. Payment Options:  Is usually covered by Medicare, Medicaid, other health insurance for a limited time. Medicare will cover up to 100 days in a calendar year while HMO will cover usually about 10 days. More therapy beyond that point will require private pay.

CONTINUING CARE RETIREMENT COMMUNITIES

Sometimes referred to as life-care communities, continuing care retirement communities or CCRCs, are communities for seniors that usually have three levels of residence: active retirement/independent living, assisted living, and skilled nursing or nursing home. The benefit of a CCRC is that it offers a wider spectrum of care, so that once a senior moves into the community, he or she will be able to receive appropriate care as his or her needs change.   The living arrangements of each (active, assisted, and skilled nursing) are designed to accommodate the needs of the resident appropriately, with a variety of safeguards and preventive measures in place. The appeal, of course, is that little transition will have to be made during a progression from stage to stage throughout their lives.

HOME HEALTH CARE

Home Health Care allows old people to remain in their own homes while receiving the assistance they need to help them remain independent. Typically, home health care services involve providing assistance with Activities of Daily Living (ADLs) such as bathing, dressing and meal preparation or Instrumental Activities of Daily Living (IADLs) such as transportation, paying bills, making appointments and simply being there to provide companionship and emotional support.   Home Health Care services range from once a week to 24 hours a day depending on the needs of the client. It is an in house service provided at doctor’s recommendations if you want for your insurance to cover the expenses. Their services include help with activities of daily living through home health aids( caregivers), therapy services provided by licensed physical, occupational or speech therapists, nursing care by licensed RN’s and LPN’s. Social services and psychiatric services can be provided as well. Also Known As: Home Care; In-Home Personal Care Payment Options: Regularly is covered by Medicare, Medicaid or private health insurances. Always check payment with your chosen company before agreeing with the service.

Many of the senior care communities described above may offer DAY CARE, RESPITE CARE, HOSPICE CARE and/or ALZHEIMER'S CARE

RESPITE CARE   Provides a temporary break for caregivers by allowing a patient to have a short-term stay in a community that can meet their needs or it can be a short term recovery after a discharge from a rehabilitation center when the resident is not strong enough to return home independently.   Many adult family homes, assisted living facilities and nursing homes have a respite care program. Residents typically stay from a week to a month or even more, depending on their situation. They receive all of the services of the community. Respite stays may also serve as a “get acquainted” period for the senior. Many residents find that they enjoy their stay and decide to move in soon after the short-term visit. Also Known As: Short-Term Stay Programs Payment Options: Private pay or, sometimes, Medicaid or other government funding option.

DAY CARE   Provides relief for family members who take care of their loved ones at home and either they have to work during the day or they want their loved ones to interact with other people or participate in activities provided by a day care center. Day care can be provided in day care centers (offers a wide variety of activities but it is usually a limited amount of hours per day) or in adult family homes and small (6 bed or less) assisted living facilities( which concentrates on personal care and it could be for much longer period of time and the resident will benefit from all services provided by the facility). Payment Options: Day care centers payment could be covered by Medicare or Medicaid or it could be private pay. Most of adult family homes and small assisted living facilities would be private pay or some government funding( Medicaid Waiver).

HOSPICE CARE   Hospice care is about helping patients live each day of their lives to the fullest extent possible, and providing support to both patients and families. Hospice care takes place in the comfort of your home, but it can be provided in any environment in which you live, including nursing homes, assisted living facilities, and residential care facilities.   Hospice is not only for terminally ill patients. Patients that suffer from congestive heart failure, dementia, and other medical conditions can receive hospice care. Some patients improve and are discharged from hospice. Patients may come on and off hospice care, and re-enroll in hospice care, as needed.   The hospice team (which includes nurses, social workers, home health aides, chaplains, and bereavement counselors) visits patients intermittently, and are available 24 hours a day/7 days a week for support and care. If a patient condition worsen, hospice will provide around-the-clock care until patient's condition improves. Payment Options: Hospice care is a Medicare benefit. Most private insurers also cover hospice care as well. Hospice care services are paid for as long as the patient continues to meets the criteria necessary. Patients can be on hospice care for years if needed.

ALZHEIMER'S CARE   Numerous senior housing options for people with dementia or Alzheimer’s are available. With memory impaired people, it is important to have 24-hour support and structured activities to ensure their safety and quality of life. Many families try to care for their loved ones at home, which can be extremely difficult given the skill that is required to care for a person with memory problems.   If you need to consider a community, understand that Alzheimer’s care is delivered in the assisted living setting, as well as in nursing homes and occasionally in personal care homes. Generally, the residents live in semi-private apartments and have structured activities delivered by trained staff members. Most of these living environments have secured or locked areas to ensure no one wanders off. Many times, within the secured areas, residents have access to outdoor walking paths or gardens. Also Known As: Memory Care/Unit; Dementia Care Payment Options: Usually private pay. Some facilities may accept Medicaid or other government funding option( Medicaid Waiver).

	Independent Living Communities	Assisted Living	Nursing Home	Alzheimer’s Care
Cost Per Month	$1,000 – 4,000	$1,000 - 6,000	$4,000 - 12,000	$2,000 - 8,000
Meals Per Day	Meal Plan Options	3+	3+	3+
Medication Observation	Varies	Yes	Yes	Yes
Medication Administration	Varies	Some Yes	Yes	Some Yes
Personal Care	No	Yes	Yes	Yes
Mobility Assistance	Some Yes	Yes	Yes	Yes
Accepts Wheelchairs	No	Some Yes	Yes	Yes
Alzheimer’s/Dementia Care	No	Yes	Yes	Yes
On-Site Nurses	Yes	Some Yes	Yes	Some Yes
Transportation	No	Some Yes	Yes	Some Yes
Incontinence Care	Yes	Yes	Yes	Yes
Housekeeping	No	Yes	Yes	Yes
Personal Laundry	No	Some Yes	Yes	Some Yes
Private Pay	Yes	Yes	Yes	Yes
Government Funding	Some Yes	Some Yes	Yes	Some Yes
Medicaid	No	Some Yes	Yes	Some Yes
Long Term Care Insurance	No	Yes	Yes	Yes
Veteran Aid & Attendance	Yes	Yes	Yes	Yes