When it comes to finding the right long-term care solution for an elderly loved one, the options can seem overwhelming and confusing. Should you consider a nursing home, in-home care, or assisted living? What’s the difference between these options and how do you determine the best fit for your loved one’s individual needs and preferences? If you’re trying to navigate these choices for an elderly loved one, it’s important to understand how senior care facilities work in order to make an informed decision. In this article, you’ll learn more about the various types of long-term care options available, plus we’ll deep dive into one suitable option for many seniors: assisted living.
What Are the Different Types of Long-Term Care?
Deciphering what the different types of assisted living care are — and what option may be best for your loved one — can be slightly complex. Learn what the differences are between in-home care, assisted living, and nursing homes to get a better understanding of what kind of care your loved one may need.
In-Home Care
In-home care services are typically for seniors who want to live independently in the comfort of their own homes with a little extra help. In-home care can include a range of services based on the individual’s needs. This type of care typically includes help with activities of daily living, including: meal prep, housekeeping, transportation, medication reminders, bathing, dressing, and more. In-home care services can also include more specialized care, such as physical therapy, occupational therapy, memory care, and more.
The main advantage of in-home care is that it allows seniors to receive care in a familiar and comfortable environment. Additionally, in-home care services can be customized to meet the individual needs of each senior, making it a flexible and adaptable option. However, there are a few drawbacks. It can be more expensive than other types of care. And it may not provide the same level of socialization and stimulation as assisted living or nursing homes. It is important for families to carefully consider the needs of their loved ones and weigh the pros and cons of in-home care before making a decision.
Nursing Home
Nursing home facilities provide 24-hour care and support for seniors with medical and daily living needs. The main difference between nursing homes and assisted living communities is that nursing homes tend to have a more medical setting. There are different levels of nursing home care that offer skilled nursing, rehabilitation, and memory care, and provide residents with meals, housekeeping, and personal care services. The main advantage of nursing homes is that they provide seniors with round-the-clock access to medical care and support, which can help folks with complex health conditions. Nursing homes also offer a secure environment that reduces the risk of falls, accidents, and other common senior safety issues.
Most long-term care options can be pricy and nursing homes are no exception. In addition, the quality of care can vary widely depending on the facility and the staff, so it is important to carefully research and evaluate their options before making a decision.
Assisted Living
Assisted living provides seniors with a combination of housing, personal care services, and health care. This type of care is designed for folks who need some help with activities of daily living (ADLs) but don’t require the 24-hour medical supervision of a nursing home.
Seniors in assisted living communities live independently within the community and have access to a range of services, including daily living assistance, therapy, medical services, and more. Services provided depend on the level of care each resident needs. Meals are typically provided and these types of communities often offer several social, recreational, and educational activities that help seniors feel connected with others in their community.
Assisted living can help seniors maintain their independence and autonomy while living in a secure and supportive community. However, they can be pricey and a difficult transition for seniors who may not want to leave their homes.
What Are Activities of Daily Living (ADLs)?
In assisted living communities, the level of care each resident receives depends on what activities of daily living (ADLs) they can perform on their own — and which ones they need help with. For those who are unfamiliar with this term, ADLs are a series of basic tasks that individuals perform on a daily basis to maintain their independence and well-being. They include activities such as:
- Bathing
- Dressing
- Eating
- Transferring (ability to move from one position to another, such as getting in and out of bed)
- Toileting
- Continence
Assisted living communities may also assess Instrumental Activities of Daily Living (IADLs) which are more complex tasks that are necessary for independent living. These can include:
- Housekeeping
- Meal preparation
- Medication management
- Transportation (i.e. the ability to arrange and use transportation, including driving, using public transportation, or arranging for a ride)
- Communication
By evaluating both ADLs and IADLs, assisted living communities can gain a better understanding of each senior’s individual needs and develop a personalized care plan that meets their unique needs.
What Are the Levels of Care in Assisted Living?
Assisted living communities offer varying levels of care to meet the different needs of seniors. The levels of care provided by an assisted living community can vary by community. However, here’s a high-level overview of the general levels of care.
Level 1: Low Level of Care
A “Level 1” assisted living resident needs very minimal assistance. They don’t show any signs of cognitive decline and can move around independently. They may need some help with some ADLs, but are otherwise active in social activities within the community. Services they may need at their assisted living community include:
- Support with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, etc.
- Medication management and reminders
- Housekeeping and laundry services
- Transportation to appointments or shopping
Level 2: Moderate Level of Care
“Level 2” residents need more than minimal assistance to safely go about their day. They have a growing list of ADL assistance and likely need medication management. Services that they may need in an assisted living community include:
- All services included in the low level of care
- Assistance with mobility and transferring
- Assistance with meal preparation and feeding
- Basic nursing care such as monitoring of vital signs and assistance with injections
Level 3: High Level of Care
Residents who are categorized as “Level 3” need help with most of their ADLs and are likely a fall risk. They may be experiencing cognitive decline and may not be able to participate in social and dining activities any longer. This type of resident may be moving toward memory care or a nursing home in the near future. Services they may need at an assisted living facility include:
- All services included in the low and moderate levels of care
- 24-hour skilled nursing care
- Specialized care for seniors with chronic health conditions such as dementia, Parkinson’s disease, or diabetes
- Physical therapy, occupational therapy, or speech therapy as needed
How Do You Know What Level of Assisted Living Your Loved One Needs?
Figuring out the appropriate level of care for your loved one is challenging no matter the circumstances. However, there are a few key factors that can help you guide the decision-making process. Here’s a list of questions that can help you assess the level of care your loved one needs.
- How many ADLs can they perform on their own?
- How is their memory?
- What are their social and emotional needs?
- Are they ready for a living transition?
Luckily, you don’t have to decide on your own what level of care your loved one needs. Healthcare professionals at the assisted living facility of your choice can help you analyze what would work best for your loved one.
What Is the Cost Difference Between Assisted Living Levels of Care?
The cost of assisted living care can vary widely depending the level of care required, the location, and the services offered by the community. Costs range from a national average of around $4,000 per month to two or three times that amount based on location, apartment size, community amenities, and services. In general families can expect to pay the following for each level of care at an assisted living community:
Level 1 (low level of care)
- Average monthly cost: $2,500 to $3,500
- Services typically included: Assistance with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, and toileting, medication management and reminders, housekeeping and laundry services, and transportation to appointments or shopping.
Level 2 (moderate level of care)
- Average monthly cost: $3,500 to $5,000
- Services typically included: All services included in the low level of care, assistance with mobility and transferring, assistance with meal preparation and feeding, basic nursing care such as monitoring of vital signs, and assistance with injections.
Level 3 (high level of care)
- Average monthly cost: $5,000 to $7,000 or more
- Services typically included: All services included in the low and moderate levels of care, 24-hour skilled nursing care, specialized care for seniors with chronic health conditions such as dementia, Parkinson’s disease, or diabetes, physical therapy, occupational therapy, or speech therapy as needed.
While some communities offer financial assistance or other cost-saving options for families who are unable to pay for the full cost of care, assisted living is primarily a private pay arrangement. Here are some common funding options to support the cost of assisted living:
- Life Settlement: the sale of a life insurance policy for a significant cash payout
- Reverse Mortgage: a type of loan that allows homeowners to borrow money against the equity in their home while deferring repayment of the loan until they move out or pass away.
- VA Aid & Attendance Benefits: financial assistance provided by the Department of Veterans Affairs to eligible veterans and their spouses who require help with activities of daily living
Senior Living Bridge Loans: short-term loans designed to help seniors pay for the cost of senior living while they wait for long-term financing options to become available
Talking to a loved one about long-term care options is never an easy conversation, but it’s an important one to have. By starting the conversation early and approaching it with empathy and understanding, you can work together to create a plan that meets your loved one’s needs while also giving you peace of mind. Remember to involve your loved one in the decision-making process, respect their wishes, and take advantage of resources available to you, such as financial planning tools and professional guidance. Retirement Genius is here to help seniors and families navigate the complex world of senior care. With the right approach and support, you can help your loved one navigate the process of aging and ensure they receive the care they need to live a happy, healthy life.
