One of the most difficult challenges anyone can face is when lifetime roles reverse and adult children must begin taking care of their aged parents. The situation only is going to become more common in the coming years.
According to the U.S Census Bureau, 46.2 million Americans, or 14.5 percent of the population, were 65 or older on July 1, 2014, up from 44.7 million in July 2013. Caring for this aging population falls on the adult children, who often still are raising their own children.
Fortunately, people today have a far broader and deeper set of options for senior care beyond the stereotypical “old folks home.” Factors to consider when choosing a level of senior care include degree of independence desired (or possible), medical needs, social and recreational activities, and financial situation and resources. Adding to what can be a confusing and stressful decision is that some options are called many different things. Here’s an outline of the hierarchy of senior care options.
Home care (also known as home health care, in-home personal care or home aide) allows seniors to stay in their homes and remain independent while still receiving help with things they may not be able to manage on their own. This can include help with bathing, dressing, meal preparation, transportation, bill-paying and companionship. It can range from once a week to a few hours each day to a live-in aide.
Independent living communities (also called retirement communities or senior apartments) provide seniors who are fully independent in all their daily needs a place to live among their peers. The options can range from single family homes or condominiums to townhouses or duplexes to apartments or condominiums to mobile homes, either owned or rented by the residents.
The next level is assisted living (also called congregate housing). Residents have their own apartment but no care is provided beyond an emergency signaling system. The complex may include common sitting areas or living rooms, dining rooms and laundry rooms. Although no care is provided, services may include transportation, housekeeping, recreation programs and health screening.
Beyond assisted living is residential care. It also is called sheltered housing, board and care homes and personal care homes. This option is for seniors who need help with medical or personal care needs. These facilities are state-licensed, staffed 24 hours a day and must meet staffing requirements. Seniors at this level of care are reasonably mentally alert, don’t need help with getting dressed or using the bathroom (perhaps some assistance with personal care), can eat in a dining room and only behavioral supervision, if any. These facilities can range from providing studio apartments to one-bedroom apartments (with or without full kitchens) Beyond meals, they also usually provide housekeeping, laundry and social activities.
Continuous Care Communities
The next level of senior care is continuing care communities, also called multi-level care facilities, which provide independent living until assistance is necessary. This can be an attractive option for couples who require different levels of care. A variety of services usually are available, including hairdresser, library, organized recreational and social activities, exercise classes, transportation and healthcare.
Nursing homes (also called convalescent care or long-term care facilities), which provide either intermediate or skilled care, are the next level of senior care and probably are what most people have in mind when thinking of senior care. They provide care for seriously or infirm seniors. They include 24-hour supervision, skilled nursing care, rehabilitation services and social activities. A doctor’s recommendation or referral often is required for these facilities.
Beyond the nursing home is a level of care that is becoming more necessary, Alzheimer’s care (also known as memory care or dementia care). An estimated 5.2 million Americans suffer from Alzheimer’s, with another 200,000 estimated to have early-onset Alzheimer’s. Alzheimer’s care can be found in assisted living facilities and nursing homes as well as on its own. Seniors living in this situation typically have semi-private apartments, locked doors, gardens or walking areas and structured activities.
The final step for senior care is hospice. Hospice is a service that takes place wherever a person considers home. The services they provide are comfort oriented, where no additional life-prolonging or curative treatments are allowed. To be admitted to hospice, a doctor must have certified that a patient is likely to pass away in 6 months or less. Hospice is a benefit under Medicare or Medicaid, and the team provides supportive services to the patient and his or her family throughout the dying process.
Overall, selecting the right kind of senior care for a loved one can seem tricky. Try to identify where you’d like the care to take place (home or at a facility) and how much supervision and assistance your loved one needs. By answering those two questions, you’ll be closer to finding the right type of care.