Senior Living Options

Today, there are many options available to seniors. The terminology is often confusing and it is always best to ask questions. Here is some information to help you work you way through the maze.

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Summary of Services
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Independent Living is for people who want to and are able to live independently but do not want to maintain a home. Many people prefer to live in a community with others of the same age and with similar interests. An independent retirement community allows for a great deal of social activities and trips. Many independent living facilities also offer prepared meals and provide a wide range of amenities. 

Terms are most often month-to-month rental agreements. Independent residences are not regulated or licensed by any state or federal authority. Some units may have emergency call systems. Independent residences may state they have “home health” or “assisted living or personal care services” available; however, these facilities are not regulated or licensed by the state and there is no oversight of services provided.

Assisted living is regulated and licensed by the state.  Assisted living is usually private pay and some residences may be certified to accept payment from Medicaid if financial and functional eligibility requirements are met. There are also assisted living residences designed to be a secure environment for persons with dementia who wander. Terms are most often month-to-month rental agreements.

Assisted living residences offer a wide range of services and no two are alike. It is best to specifically ask for a list of services that are included in the monthly fee and if there are additional charges for any services. Assisted living residences are not allowed to provide what are called “skilled services.” This may include nursing, physical or occupational therapy. Assisted living residences are not allowed to have someone move-in who needs services and care beyond what is provided in that facility. Therefore, an assessment is completed on every potential resident of an assisted living residence.

Services are generally: 

• on-site 24 hour, 7 days/week personal care staff

• 3 meals per day

• personal care services (medication administration, assistance with activities of daily living, assistance with mobility, reminders and cuing, escort to and from meals, assistance with bathing)

• scheduled transportation

• weekly light housekeeping, laundry services, activities, social events, exercises, and protective oversight, all utilities plus basic cable, maintenance, and landscaping. 

Services such as home health nursing and therapy, or outpatient services, are available with a physician referral just as they are to anyone living in their home. Hospice also works closely with assisted living residences.

Skilled nursing facilities, also known as nursing homes or long term care facilities, are licensed and regulated by the state and federal governments. Medicare Part A and B will cover nursing home services if conditions of participation are met. There are also services available as private pay.  Medicaid payment is also accepted if financial and functional eligibility requirements are met. Physician referral is required. Services are generally very medical in nature and there is 24 hour nursing available for assessment and/or treatment. Services such as physical therapy and occupational therapy are available as part of Medicare Part A services. Services include all aspects of care, meals and monitoring of nutrition and specialized diets, activities, and restorative services.

Long Term Care insurance will pay for skilled nursing care and some policies will also cover some portions of assisted living; however, policies vary and generally will not cover more than 3-4 years maximum. Assisted living generally costs 1/3 more than retirement living. Nursing homes cost greater than 2 times more than assisted living.

Family Caregiver: 
Many times family members may choose to care for a loved one. Oftentimes this may prove to be a challenging option, in fact recent statistics show that senior care is taking its toll on American heads of family:

• 37% are worried about juggling care giving with other responsibilities.

• 25% about are worried about having enough time for nuclear family.

• 38% are worried about maintaining their own health.

• 34% of working women miss work due to caring for an aging parent.

• 24% of working men have missed work as a result of elder care.