Navigate This Guide
Types of Senior Living
– Which Senior Living Option is Right?
How to Pay for Senior Care
– Medicare and Medicaid
– Insurance and Benefits
– Private Pay
Alzheimer’s and Dementia Care
Hospice or End of Life Care
Types of Senior Living
You know your loved one needs care, but the number of options is overwhelming. It’s hard to know what level of care each senior living option provides and which one is right for you and your loved one. To guide your family in making a decision, here’s an analysis of the different types of senior living available.
Everyone wants to age in place and very few people want to leave their home. Home care can preserve your dignity and allow you to stay safely at home. The terms Home Health Care and Home Care are both used to describe these services. Nurses, doctors and the industry are slowly differentiating these terms:
Home Health Care – Tends to be short term in nature, involves skilled care, and is covered by Medicare. Home Health Care is often referred to as “Medical”, “Skilled” or “Certified”. Home Health Care includes wound care, pain management, injections, occupational therapy, physical therapy and skilled nursing. If any skilled care is needed, the physician will write an order for the service with a definite time period, usually short term in nature, i.e., “IV therapy for 2 weeks.” At the end of the period, the physician will reevaluate the order. It also tends to be quick, in and out visits.
Home Care – Also called “non-medical care”, “in-home care”, “unskilled care”, and “custodial care”; tends to be long-term in nature, involves unskilled caretaking and is not covered by Medicare. It is probably what you think of when you hear either of these terms. Home care focuses on helping seniors with the daily activities they need to engage in life and remain safe and healthy. The tasks include things like bathing, transferring, toileting, continence, medication assistance, companionship, meal preparation, light housekeeping, transportation and errands. Family members or professional caregivers, who do not have a medical license, can perform these tasks. This service is client driven as you determine the tasks and times. It also tends to require longer visits. And don’t forget, that Home Care can be added to any of the facilities below. Many times home care can prevent you from leaving your independent or assisted living apartment. Some dementia patients can be kept in assisted living and not move to a nursing home when they have one on one supervision and help. Some incontinent clients can stay in assisted living with additional laundry services from a home care agency. Even in the nursing home, if your loved one deserves special attention, home care can provide it. We will go wherever you call home. That is what we do! Take a look at our services page to learn more about the types of home care services we offer throughout Dallas, Fort Worth and Weatherford Texas.
Senior apartments – Can be rented or purchased by seniors over a certain age (usually 55 or 62). The apartments usually have modifications to make them more suitable for older adults like limited or no stairs and handrails in the bathrooms. They’re ideal for active seniors who don’t need help with personal care.
Independent living communities – Are great for seniors who are active and independent, but would benefit from amenities such as housekeeping, prepared meals, transportation, and on-site activities.
Assisted living facilities – Are for seniors who want to enjoy aspects of an independent lifestyle, but still need some help with personal care tasks like bathing and dressing.
Nursing homes – Provide more medical assistance than an assisted living facility. Residents receive supervision and nursing care 24 hours a day. Nursing homes can offer complete medical care up to services offered by a hospital. They may also have a rehab floor.
Residential care homes – Have live-in caregivers and offer many of the same services as nursing homes and assisted living facilities. Usually ten or fewer seniors live in each care home, so they provide a more intimate, homey setting than large senior living facilities.
Continuing care retirement communities – Allow seniors to change the level of care they receive while staying in the same community. They offer separate buildings for everything from independent living to 24-hour nursing care.
Memory care – Is designed to meet the needs of persons with Alzheimer’s or dementia. Nursing homes and assisted living facilities often have memory care units. They provide supervision and care 24 hours a day to keep your loved one safe.
Respite care – Is temporary care that’s arranged to give caregivers a break. Respite care can be short-term care provided in the home or at any of the senior living facilities above.
Adult day care – Is a type of respite care that gives caregivers a break during daytime hours. Adult day centers like the Rose Cottage in Fort Worth, Texas provide enriching activities, opportunities for socialization, and compassionate care to older adults. Combined with home care at night, adult day care may prevent your loved one from being institutionalized.
Which Senior Living Option is Right?
Now that you know what all of the options are, consider which one is right for you and your loved one.
Think about your current living situation and needs. How well are you managing on your own? Are there signs that needs aren’t being met, like weight loss, poor hygiene, mood changes, or a recent fall? If so, you may need a higher level of care from a professional caregiver, assisted living facility, or nursing home.
If your loved one manages their activities of daily living well on their own, more independent living options may be right for them. To help you decide what’s best, here’s some more information about in-home care and senior living facilities.
If the need for the more medical Home Health Care is clear, the physician will order it and recommend several specific agencies. In most cases, it is the physician who recognizes the need. However, unskilled Home Care is often overlooked as a real solution for seniors to age in place. In many cases, unskilled Home Care is the missing piece of the puzzle!
If you or your loved one are basically healthy but need help with personal care and maintaining your home, Home Care is what you need. We can help with bathing, transferring, toileting, continence, medication management, companionship, meal preparation, light housekeeping, transportation and errands.
Home Health Care and Home Care are not mutually exclusive. Depending on your situation, you may need both. For example, after surgery, you may need physical therapy which is a Home Health Care service. However, you may also need someone to cook your meals. This is a Home Care service.
Home care can meet the needs of almost any senior. But as the need for skilled medical care goes up, so does the cost . So, if your medical needs are so acute that you require skilled care around the clock, it may be more cost effective to be in a nursing facility with access to RNs, PT and other specialists. However, Medicare covers the skilled medical services at home if the person is home bound. It also covers the unskilled care after and the unskilled services for a short term after a hospital visit — until you are back on your feet. However, Medicare won’t cover long term home care, or around-the-clock care. And, Medicaid will cover only the very poor.;. So if your loved one needs 24-hour access to health care professionals like nurses, physical therapists, respiratory therapists, social workers, etc., it may make more financial sense to move them to a nursing home.
If your loved one needs less medical care, like help with personal care, housekeeping and errands for a few hours each day, it may be more affordable to keep them at home. Many seniors prefer to age in place in their own homes and neighborhood communities, so Home care would be the option you should strongly consider for your loved one.
If you need more information about your in-home care options in Texas, call us at 877-921-9500 to get your free, no-obligation assessment.
Senior Living Facilities
Even seniors who are independent and active can start to feel isolated at home. Losing the ability to drive can cut them off from friends and activities they used to enjoy. In this situation, moving into a senior apartment or independent living community can be a positive life change. It will give your loved one a chance to socialize with other people their age and participate in lots of on-site activities.
For seniors who are less independent, there are senior living options that will give them the same chances for socialization with the added support they need.
Assisted living communities are ideal for seniors who need help with some personal care tasks like bathing and dressing, but don’t need the more skilled nursing care that’s provided at nursing homes. Seniors typically live in their own apartment, which gives them a greater sense of independence. These communities have planned activities both on and off the premises, so there’s plenty of opportunities for fun and socialization.
If your loved one has complex medical needs that require regular skilled nursing care, a nursing home may be a better option. Seniors who have acute heart, lung, problems, might feel more comfortable in a nursing home where they’ll receive round-the-clock care and supervision. Seniors in nursing homes either have a private room or share it with another person. Activities are plentiful and tailored to the physical abilities of the residents.
How to Find a Senior Living Facility
Finding the right senior living facility can be a challenge. There are so many communities out there, which makes it hard to narrow down your search. Asking for recommendations from friends or healthcare providers is a good place to start. Then you can expand your search by using a map like this one to find senior living communities near you and look up reviews of them online. Caring.com and the Medicare Nursing Home Compare website have lots of helpful ratings and reviews of senior living facilities.
Based on these reviews, you can make a short list of communities that you want to tour with your loved one and schedule the appointments. While you’re there, you should evaluate the cleanliness of the facilities and ask residents and their families what they think of the community and the level of care provided. You should also ask the administrators important questions like what the caregiver to resident ratio is, how long caregivers spend with residents each day, and what kind of services are offered.
Don’t feel rushed when it comes to choosing a community. Visit the top contenders on your list multiple times to get a better sense of what living there would be like for your loved one. Visit them at off times like weekends and nights. Here is a checklist. You won’t regret being thorough and taking the time to really weigh this important decision.
How to Pay for Senior Care
How you’ll pay for your loved one’s care is likely at the top of your mind. Here are some of the options.
Medicare and Medicaid
Medicaid will pay for most types of facilites. Medicaid will pay for some home care but not all agencies will accept it.To qualify, your loved one can’t have a lot of income or assets. Many people will spend down their retirement nest egg and then get on Medicaid to cover the costs of their care.
Medicare will pay for Home Health Care, if ordered by a physician. They will also pay for limited short term Home Care if ordered by the physician, you are home bound and after a hospital stay. Let’s say, a bath twice a week. Once your loved one is better, you will need to pay for the bath yourself.
Insurance and Benefits
Veteran’s benefits, long-term care insurance, and life insurance can also help pay for care. Veterans or their surviving spouses may be eligible for additional assistance beyond their pension amount. Long-term care insurance will usually cover care in a nursing home, adult day care center, assisted living facility, or at home. Long term care insurance is not your health insurance or Medicare Advantage. It is a separate policy you would have had to purchase when younger specifically for long term care. Whole life insurance policies can also be cashed in to help cover care costs.
Your loved one’s pension, Social Security payments, retirement fund, reverse mortgage and savings can all be used to pay for long-term care. To fill in the gaps, family members may choose to contribute some of their own income or savings.
Alzheimer’s and Dementia Care
You may be able to care for your loved one with minimal assistance when they’re in the early stages of Alzheimer’s and dementia. But when their symptoms progress from mild forgetfulness to more advanced confusion and behavioral changes, they’ll need more supervision
To make things easier on you and your family, you should develop a care plan for your loved one that anticipates the progression of their disease to moderate and severe levels.
You should start gathering information about home care providers, adult day care facilities, assisted living facilities, and nursing homes in your area that specialize in caring for seniors with memory problems. Planning in advance gives you more time to decide which providers and facilities might be best for your loved one when they need more support.
Consider these factors:
- How will your loved one react to a new environment, new faces and lots of stimulation?
- Home care can limit these challenges. Your mom will know where the bathroom is and will be surrounded by items that are familiar.
- Memory units in assisted living and nursing facilities can help to overcome this by allowing your loved one’s familiar items and minimizing the stimulation or including proper stimulation. Memory units have become experts and are very good at dealing with this.
- If your loved one’s medical needs are paramount, you may need to consider a nursing home where they have hospital like facilities. However, some Alzheimer’s patients can be forgotten in a nursing home that does not specialize in dementia. Dementia patients do not complain or may not be able to express their needs.
- What safety risks does each senior option present?
- Home care can minimize the risks of falls, pneumonia, UTIs, and disease resistant infections by providing one on one care with limited exposure to these infections.
- Facilities can reduce these risks. However, you should ask and check out their statistics with regards to each risk.
- These safety risks may also be reduced in a small residential care home.
It’s also important for you loved one to get their legal and financial matters in order. You should ensure that their will is updated and that they have a living will if they want one. Your loved one should also decide who they want to make their medical and financial decisions when they’re no longer able and execute power of attorney and medical proxy. In Texas, you should also consider a Do Not Resuscitate (DNR) document.
Hospice or End of Life Care
It’s hard to talk about end of life care, but it’s an important conversation to have with your aging loved one. Hospice agencies can help with this discussion. They are also experts at pain management, spiritual needs and preparing your loved one and their family. You can and many people do go on and off of hospice care if they get better. Do not wait too long to obtain hospice services. These services are covered by Medicare.
Ideally, you should know what their healthcare wishes are for the end of their life and what kind of funeral arrangements they’d prefer. Your loved one should also consider drafting a living will that states their healthcare wishes and choose their medical proxy, the person who will make their medical decisions when they’re no longer able.
Your loved one’s preferences will help guide you in choosing end of life care for them. Living wills let you know whether or not to take extraordinary measures to prolong their life. They also include information about the kind of comfort care your loved one wants and where they’d like to receive it. Knowing that you’re executing your loved one’s wishes can give you a little bit of comfort during the end of their life.
The National Caregivers Library has extensive resources for caregivers and more information about senior living facilities.
Visit Paying For Senior Care to learn more about payment options.
Visit the Alzheimer’s Association for more information about memory care options.