What are the senior options?
Which one is the right choice?
In our past blog post “How to start the conversation” we discussed how start the care discussion with your elderly loved one on adding some additional care that might needed. Today’s post we are continuing to post more to help you through the whole process by assisting to find what the the next step should be.
As elders age, family members are frequently involved in providing support and assistance. This can provoke a wide variety of emotions including the feeling of being overwhelmed so families look towards getting help. Making the decision for an elderly loved one is never easy so when it does come to decision time it is always best to be well informed. Finding the right care options can seem overwhelming when dealing with financials and the different types of care available. While it can be difficult to determine which care option and what assistance is needed, it is helpful to look at some common problems that occur for seniors to see where help is needed. You must first determine the health condition of the individual before identifying the specific care needs.
The healthcare needs can be broken down into ADL’s (Activities of Daily Living) and medical care needs. Keep in mind of assistance with transportation and home modifications might be needed for a safer environment in addition. ADL’s is personal care which includes services such as dressing, bathing, eating, and toileting along with light housekeeping. Medical care is the medical needs of the individual that can be on an outpatient basis or a long-term care facility. Depending on the health hospice care may be needed. Check with licensing for in-home care agencies because some like us are not licensed for medical care.
When choosing a care provider, you need to make sure that in your research you are looking at licensed, insured, and qualified options. Know the pricing, employment screening, and possibly interview potential caregivers to find the right person for the job. Also take into consideration the arrangement chosen will accommodate for a senior’s current and future needs for as long as possible.
Assisted Living Facilities (ALF) offer housing in small private units and limited care designed for seniors who can no longer stay at home safely and require some assistance with daily activities (such as bathing, dressing, grooming, medications and meal preparation). However, they do not require the type of extensive care provided by a nursing home. The facilities do not usually provide nursing care, but check the licensing to be sure. The licensing will determine which level of care they are able to provide. Meals are provided in central dining areas with various opportunities to socialize. More services needed may be additional cost through the facility or through home health care service agency and keep in mind of transportation needs. ALF is going to be more restrictive than your independent living since they are more regulated.
Take a tour of the facilities and do the research to know what services are provided in the monthly fee and what would be additional cost along with their policy for allowing professionals to come in and provide care. As of last year, the median cost for ALF ran at about $4,000 per month. There are assisted living facilities that provide secure locked environment for individuals with cognitive impairment who wander, but are still able to live independently should you need them. It has also become popular to have assisted living within the same building or close by to a nursing home allowing a loved one to “Age in Place”. It allows them to simply moving over to the new location if the time comes that it is required rather than a completely different location.
Nursing Homes are mostly set up like a hospital so residents share rooms and have meals in central dining areas. The residents that are in these facilities is due to the need for 24 hour monitoring and availability for personnel. They provide more extensive medical care such as medication administration, wound care, and tube feeding besides the ADL’s. They may also provide physical, speech and occupational therapy and are staffed by medical professionals. Some nursing homes do provide short term care if recovering from surgery, illness, or injury.
Keep in mind due to COVID19 facilities and nursing homes are fairly locked down and are very limited on interactions and visitations.
Skilled Nursing Facilities (SNF) is similar to nursing homes. The care is for those that require more complex services. A SNF is needed since nursing homes do not usually provide these extensive services. Skilled nursing services involve care of tracheostomies or rehabilitative medical services like physical or speech therapy. Some dual care facilities do exist allowing individuals to transition from SNF to nursing homes or vice versa. These facilities will be your most restrictive option. Average cost for private room runs at about $8,500 per month.
Residential Care Homes are another form of long-term option for individuals who require care outside their home. The houses allow individuals to have the home like setting and are placed within communities that have between 2-8 residents living in them. Individuals usually have their own room and share living accommodations with the staff and other residents. These facilities offer 24/7 care with staff assisting with ADL’s and usually specialize in proving care to specific groups of people such as Alzheimer’s disease or Down’s syndrome.
Monthly fees include the room and board with 24 hours a day care for ADL’s however transportation and personal care items are usually additional expenses. When looking at this option, make sure residents have similar medical conditions to your loved one ensuring they will be comfortable and enjoy living with the others there.
Senior Independent Living Communities or retirement communities are for a large amount of seniors who can handle the activities of daily living on their own, but wish to enjoy a lifestyle with a community of their peers. The communities usually consist of private apartments or residential settings in a variety of sizes. They also offer numerous activities, events, and amenities to their residents. Different services such as housekeeping transportation, and dining are available upon request. The on-site staff provides minimal supervision permitting the unrestricted settings to allow seniors to maintain their independence.
In-Home Care or home health care is care that allows the elderly loved one the ability to stay in their home while receiving assistance with ADL’s without having to move or perhaps give up their pet. In-home care is there to assist with transportation, meal preparation, light housekeeping, and companionship. In-Home Care also provides multiple services whether it is personal, specialized, disabled, or post-surgical care.
Staying at home or “Aging in place” is the term used to describe this option. It’s certainly understandable that people would prefer to stay in the home that they’ve cared for, furnished and feel most comfortable. Not to mention for Dementia or Alzheimer clients it can make situations less challenging since they are in a familiar place. The main issue, though, is whether they can live there safely and securely, especially if living alone. The health of the elderly will also greatly affect the choice in care.
Most seniors do prefer to have the in-home care option because not only is it more affordable for the care needed, but being at home is the most comfortable and pleasant option. With a nursing home or assisted living facility, you do need to consider the care that will delivered to your loved one since the ratio for these options are usually 12 patients to 1 caregiver. The ratio does unfortunately mean that one-on-one care is very limited resulting in your loved one having to wait and not receive the care they deserve. It’s not a situation most prefer forcing a senior into an unfamiliar and possibly distressing environment and try to avoid if possible. However, if nursing and assisted living is the best option for your loved one some in-home care companies such as ours do assist in the facilities so they can receive that one to one ratio. Due to COVID-19, it will depend on the facility regulations if caregivers are permitted in or not and for how long.
While paying for in-home care can seem expensive, the truth is that its costs pale in comparison to other options such as an assisted living facility or nursing home care. In-home care also provides tremendous advantages, such as maintaining a sense of independence in the home seniors have come to know and love.
According to an AARP study, 90% of people age 65+ would prefer to stay in their own homes when they need additional support instead of going to a nursing home or assisted living facility. One of our clients referred to her brief stay at a nursing home as “just waiting there with the others to die”. Definitely not the right mindset to have.
If your loved one’s medical condition results in them being mentally incompetent or unable to safely care for themselves it may be best to seek legal advice for what options would be best.
If you and your loved one are not quite ready for facilities or not in much need for care at home just yet then there is another option that might be right. Respite care is for those taking care of loved ones for example a spouse or family member. Respite care is mostly short term and only a few hours a day when needed that allows the family caregiver time for themselves to run errands, attend appointments, or simply take a much needed break. Respite care can also be extended to more than just one day a week/month if needed and may also be provided not only in the home, but at a facility. Respite ensures that your loved one’s needs are met and their family caregiver is able to care for their own needs as well preventing stress and a burnout.
If all else is not the right option perhaps looking into having the loved one move into a family members home is for the best. They can be close to family and have assistance with their ADL’s if needed. Medicare may be able to help with some of the cost for your options that we have discussed above, but majority will be out of pocket. If you have a senior veteran be sure to see what can be done through the VA.
Whichever route you and your family choose, just be sure that you are have all the information and are making the choice that is right for your loved one. For assisted living/nursing home, take a look at the ones in your area and visit them in person, talk to the managers and the ones who will be assisting with your loved one, and read the reviews. For in-home care, talk to the owner/manager, read the reviews, and compare services. Find the option that works for the individual and the family so everyone can be happy.
Don’t forget we are always here for you and are able to create customized care plans that meet your specific needs. Contact us for information about our services or if you have any questions.
Best wishes,
Sweet In-Home Care