Determining Type of Care?
How do I determine what type of senior housing arrangement is best?
After familiarizing yourself with the types of residential care, it’s time to conduct a thorough inventory of the senior’s wants, needs and goals. Some key issues to consider:
- Temporary versus long term care: An older person may go to a nursing home for rehab following a surgery or stroke, then return home. In other circumstances, a senior’s needs are better served by planning a move into a situation that is likely to remain the same for the many years to come.
- Independence: Can the senior live alone, and more importantly, does he/she want to? Or would living in a more service-oriented environment be more nurturing?
- Privacy: Independence and assistance generally form a continuum: privacy decreases as the need for assistance increases. If the senior's desire for privacy is paramount, independent living, assisted living, or a Continuing Care Retirement Community would all be preferable to a board & care home or a nursing home.
- Needs for personal care: How much and what kinds of personal or “custodial care” are needed or desired? There are online needs assessment questionnaires to help determine this and then match the care needs with the right type of housing.
- Needs for medical care: If the senior has a chronic illness that necessitates special medical care, or ongoing services of medical professionals, independent living and even assisted living may not be suitable.
- Costs: Learn about the financial aspects of senior housing to determine what options are affordable for you.
- Walk through and evaluate several care facilities or senior communities that seem suitable. Reviewing facility comparison checklists can help you determine which type of environment fits the senior resident’s requirements and preferences.
- Seek guidance from professionals who are experts in senior housing issues such as medical social workers, case managers or geriatric care managers. They can help with all phases of this process: identifying goals and values, assessing needs, determining what is affordable, and suggesting appropriate facilities.
Types of personal care provided by senior living facilities
Personal care (also known as custodial care) encompasses what are known as "ADL”--activities of daily living. These commonly include:
- Cooking and cleaning
- eating
- bathing
- dressing
- using the toilet
- getting around the house (mobility)
Additional personal care support may provide assistance with:
- transportation around the community
- medication reminders
- finding companionship
- participating in social and recreational activities
While an independent living senior community does not provide personal care in the home, the various types of assisted living facilities do.
Types of community services and activities provided by senior living facilities
Depending on the type of senior housing one chooses, optional community services may include:
- Communal Meals
- Housekeeping
- Laundry
- Local transportation
- Exercise facilities, such as pools, saunas and exercise machines
- Arranging for personal or medical care
- Libraries
- Beauty shops
- Gardens
Activities can include:
- Recreational, educational, and social events
- Activity rooms or clubhouses
- Golf courses
- Tennis and shuffleboard courts
- Health and exercise programs or classes
- Chapels and religious services
Independent living facilities are most likely to offer some or all of the above community services, health and recreational/spiritual activities. Assisted living and Continuing Care Retirement Communities may adapt the services offered to meet the specific needs of the seniors living in their facilities. Nursing homes also have a range of services and social activities adjusted to suit the limitations of the residents.
Types of health services provided. When is a Nursing Home necessary?
If a senior cannot live alone due to forgetfulness, frailty, or a chronic medical condition, assisted living facilities can be explored, but a Skilled Nursing Home might be the only option. Only nursing homes have the medical professionals on staff to address ongoing medical needs, with a care plan supervised by physicians and Registered Nurses on site 24 hours per day. In addition to assisting with custodial care, a nursing home may provide:
- Interim medical care (after a hospital stay for an illness or procedure)
- Rehabilitation services: occupational, physical, respiratory and speech therapy
- Pharmacy, laboratory and radiology services
- Therapeutic recreational and educational activities
- Transportation on a limited basis
- Laundry service (often for an extra cost)
- End of life care (hospice)
- Respite care (relief for caregivers)
Not all nursing homes provide all these services, so it’s important to find the facility that provides the type of care needed. Also, some nursing homes specialize in certain kinds of care for special needs such as:
- Kidney dialysis treatment
- Alzheimer's and dementia care
- Respiratory care
- Parkinson's care