Sunday, February 22, 2009

Senior Care Options and Tips

Long Term Care Options
Today there are multiple choices for senior care. The options available may be dependent on health status, and financial resources. Below is a brief description of types available that I will further define in future blogs. The choices are listed by level of independence, beginning with the most.

I frequently meet families confused about the options, and planning an option that would not serve their loved one's needs. Care options in many cases can be combined to encompass all the senior's needs. When choosing care, it is usually best to choose a company that specializes in one or two services, and provides excellence, rather than offering too many services, and unable to service each with high quality. You will also want to find out if the company you choose can refer you to services they don't provide. If they take into account all the client/patient's needs, and not just what they can assist with. For example, does the assisted living refer to home health and private duty if care needs change? Can the home health agency refer a group of visiting physicians, should it be too difficult to get out to a doctor's office? Does the private duty agency assess equipment needs and refer to a medical supply company? Do they refer to home health when they see the client decline, or have a change in health status? A person's care frequently involves a team approach to improve their quality of life. So, when you are choosing any of the listed options, make sure they are knowledgeable to assess and address all aspects of care, and have trustworthy and reliable resources.

Senior Apartments- Independent living with minimal care options. Sometimes referred to as retirement living. Apartments typically are modified with grab rails in the bathrooms, pull cords for emergencies, and may include some activities. Housekeeping and meals are not included, or typically offered.

Assisted Living- These facilities are set up like apartments, and can range from studio, to a larger type apartment, usually with a small kitchen. Services include housekeeping, meals, medication administration, bathing, activities, and may have on-site beauty shops and clinics. They are designed for independence with supportive services. Services are typically charged in an ala-carte fashion.

Private Duty Homecare- This type of homecare is nonmedical in nature, and can assist anyone from independent to completely dependent. Services include companionship, bathing, meal preparation, errands, transportation, and medication reminders. Agencies will have some variations in what services they provide, and some states mandate what services can be provided. Private duty homecare frequently works in conjunction with home health, or hospice, and can also be provided in an assisted living when the care recipient's care needs exceed what is available.Resources available at

Adult Day Programs- Available in different community locations, these programs provide activities, meals, and socialization. Some programs will offer medication administration, day trips, transportation to and from the program, or specialize in memory care. Typically acceptance is based on a fair level of independence.

Home Health Care- This is a Medicare benefit that is accessible after a change in health status, diagnosis, and/or hospitalization. It can provide Nurses, Therapists, Social Workers, and Nurses Aides. It is temporary, short term, and is limited to guidelines defined by Medicare. It requires the patient to be homebound, only leaving home for medical appointments.

Sub-acute or Rehabilitation- This is generally a unit in a long term care facility or nursing home that specializes in improving debilitated patients with the goal of returning home. Most patients are sent to this type of facility from a hospital discharge, but may be sent after an emergency room visit that doesn't qualify for a hospital admission. Services include Physicians, Nursing, all Therapy disciplines, Social Work, and Nurses Aides. This care is considered temporary, and also falls under Medicare guidelines.

Nursing Home- This type of care is generally long term. Rooms can range from private to 4 bed rooms. All services are offered. Physician, Nursing, Therapy, Social Work, Nurses Aides, and Activity Directors. Most nursing homes also offer beauty shop services, and on site specialty appointments, such as dental, podiatry, ophthalmology, and hearing. It is all inclusive care.

Hospice- Hospice is a complete service for the terminally ill. This service can be provided in the hospital, any type of care facility, at home, or in a hospice facility. Most hospice services take place in a patient’s home. Hospice takes a team approach, with the focus on comfort, quality of life, and support to the patient and family. Services include Nurses, Social Workers, Nurses Aides, Spiritual Care, Volunteers, Bereavement, and Physicians available for consultation. Hospice will provide any equipment, or medications related to the terminal illness without cost to the patient or family.

Memory Care- Independant standing facilities or units in long term care facilities specializing in Alzheimer's or Dementia. The services provided are the same as a nursing home, with the addition of specific
environmental measures best suited for the safety and comfort of the patient's. The staff is generally trained to work specifically with memory impairment, although there is no specific licensing for memory care.

Continuing Care Communities- This type of care can be provided in levels from independent, to assisted living, rehabilitation, to nursing home. Rather than move facilities when a new level of care is needed, you can remain in the same complex of care. There is usually a buy in to live in this type of community. Buy in fees and monthly fees differ, depending on the community.

There are thousands of websites providing information to assist with your care options. To narrow the overwhelming choice, two sites I particularly like are-AGIS you will find further details, as well as checklists when looking into options.

f you have questions or comments, feel free to email me at


  1. Thanks for sharing so much valuable information. This is very comprehensive.

    I can tell that Visiting Angels is interested in helping caregivers as much as seniors. One valuable tool for stressed caregivers is a little book called YOU WANT ME TO DO WHAT? Journaling for Caregivers (ISBN # 978-1-60696-297-8). It offers encouragement, instructions, and over 200 sentence starts to help anyone begin processing feelings and reactions.

    Wouldn't this be a great thing to give caregivers who come to Visiting Angels?


  2. I think you are an amazing women! Words can not express how big your heart is! Your going to make a difference, your going to save lives! I am so proud of you and I look up to you! You are my role model! Love Ashlee

  3. These are such amazing services! Everybody wants to make sure that their loved ones are getting the best assisted living care. For my grandpa, I want to make sure there's a nice yard where he can get out and walk around.
    Celine |

  4. My grandma is getting older and it's looking like we are going to have to get some extra help for her soon. I want her to be happy and feel like she still has her freedom. I'm glad to see that there are so many good options out there.


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