Most seniors do want to remain at home, understandably so. Home is, or should be, our “happy place”.  For many seniors home is a place they worked hard to pay for, maybe even build and maintain for a long long time. But staying at home is not always the safest, most cost effective, or preferable decision for some situations. There may come a time that you are tasked with the duty of researching and choosing a senior community for your loved one.

Ever wondered the difference between Nursing Homes and Assisted Living? If you didn’t know there was a difference you are not alone. Many people will lump all senior living communities into one category of “retirement homes” or “rest homes”. The truth is, the differences vary as much in types of senior living communities as fingerprints do in humans! And many people’s perception of what these communities are like is outdated and inaccurate. So how do you know which is best for your aging loved one or where to start?

Let’s start by narrowing down the categories into those that are truly the most applicable in today’s senior living community landscape of options.

  1. Active Living/Active Adult Communities/Independent Living Communities- These communities are usually age restricted, (generally 55+) and minors are prohibited from being permanent residents. Residences usually include single family homes or condominiums that are either owned by the tenant or rented on a monthly basis, and amenities such as a workout facility, clubhouse, golf courses, tennis courts, walking trails, business centers, and pools are often available. HOA fees usually include a higher level of general maintenance and security than your average neighborhood. These communities are not health care facilities. The residents should live independent lifestyles but if care is needed, they would need to locate, hire and utilize said care in their own private residence. Some independent living do communities offer some contracted services on site.
  2. Assisted Living/Memory Care- Assisted Living Communities are licensed by the state to provide levels of assistance with daily activities such as bathing, dressing, toileting, transferring, and medication administration. While they are not 24 hour nursing facilities, most do offer some level of nursing supervision/presence daily. This type of community typically offers one or two bedroom apartments, balancing personal space with the security of having staff available around the clock to help if needed. Usually included in rent is some or all meals, served in a common dining space, housekeeping services, laundry, exercise programs, and recreational activities. Some are all inclusive while others work on more of an a-la-carte model. In some facilities, the basic fee covers all services. There may be additional charges for services on an as-needed basis. Memory care is a type of assisted living community, offering disease specific care from staff who have been trained to work with patients suffering from memory impairments such as Alzheimer’s.
  1. Nursing Homes/Skilled Nursing Facilities- A skilled nursing facility is licensed to provide around the clock nursing care for those who need a higher level of care. The facility must have a licensed physician always on call. These communities meet all of the same custodial needs as Assisted living, and also have the capability to provide more intensive medical care as needed. Some individuals go into Skilled Nursing Facilities short term, to receive intensive therapy following an illness or injury, so they can gain strength to return home. Others who need this level of care constantly may become permanent residents of the Nursing Home. Nursing homes generally do accept Medicare and Medicaid funding.
  2. Continuing Care Retirement Communities – CCRC’s often combine any or all of the aforementioned levels of care. The services are generally not all offered under one roof, therefore the residents receiving care would have to move from one area of the community to another as their care needs change. There are many different types of contracts for CCRCs but most consist of a Buy-In Structure and/or Monthly Payment Structure.

Once you understand the different types of communities, and which would be the most appropriate to meet your loved ones needs, you can narrow down your search by location, price, and business model. Soliciting the assistance of a geriatric care manager or assisted living placement specialist could be drastically helpful. If you are already using in home care, ask the nurse or Administrator for guidance. Chances are, they have clients who have transitioned to a number of them and perhaps even provide services in some, so they are likely to have some helpful information they can share.

About the Author: Pam Reynolds, CMC is the President and co-owner of Allegiance Aging Care Services. Pam has spent almost fifteen years working in senior care including long term care facilities and home health care. Her higher education is in Social Work, and she has been credentialed as both a certified Geriatric Care Manager and Licensed Assisted Living Administrator. Read more about Pam and her team of Aging Care Professionals here



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