Care Setting Options

Assisted Living

Assisted living facilities (ALFs) are long term care options that provide assistance to seniors with activities of daily living (ADLs) and personal care. For example, ALFs offer care with bathing, using the toilet, walking, medication management, and eating. ALFs are appropriate for seniors who are beginning to to face challenges associated with aging and they typically provide a variety of services and amenities to create a comfortable home environment. It may be time to transition to an ALF if a senior is beginning to have difficulty with basic tasks around the house, experiencing loneliness, had a recent fall or accident, or is experiencing weight loss. Some commonly offered services and amenities include gyms, scheduled transportation, staff-led outings and activities, prepared meals, laundry, and haircuts. The average monthly cost of an ALF is $4,051 per month, but costs vary depending on the quality of the facility, the location of the facility, and a handful of other factors. Facilities may use an all inclusive pay structure or use an itemized bill based on the services utilized. There are a variety of financial assistance options to pay for ALFs, including medicaid in some states, long-term care insurance plans, and VA benefits. When choosing an ALF, it is important to assess the frequency and quality of health assessments, the staff to resident ratio, the services and amenities, and the transparency and communication skills that the facility offers.

Memory care facilities are long-term care facilities that offer care for seniors suffering from dementia and support them with the challenges they may face with declining cognitive ability. If a loved one begins showing signs such as getting lost on familiar paths, losing objects more frequently, neglecting grooming, or decreasing cooperation with caregivers, it may be time to consider memory care. These facilities offer medical care to manage progressive cognitive decline as well as amenities and activities to maximize wellbeing. In turn, the senior relieves coordinated care between families and caregivers, behavior management through both pharmacological and non-pharmacological means, activities suited to their cognitive abilities, and a safe and supportive environment. Specific services provided include assistance with ADLs, meal preparation, cleaning and laundry services, scheduled transportation, and 24/7 access to nurses. These facilities also provide amenities for safety such as locked doors to control entry and exit, security camera monitoring, and medical alert systems. Moreover, many facilities offer leisure amenities such as gyms, game rooms, dining rooms, and a secure court-yard. Memory care facilities cost an average of $5,000 per month, but similar to ALFs, costs vary based on factors such as the quality of care and the location of the facility. Medicare and Medicaid do not cover memory care specifically, but Medicaid may cover some of the services often included in memory care. In addition, the VA offers the Aid and Attendance benefit that covers memory care services. When choosing a memory care facility, it is important to assess whether the facility offers appropriate care capabilities, the expertise and attentiveness of the staff, safety amenities, and the level of social engagement offered to residents. 

Memory Care

Independent Living

Independent living communities are communities that offer seniors a variety of services and amenities but do not offer personal care or assistance with ADLs that one may find in assisted living facilities or a nursing home. These communities allow residents to maintain independence while simplifying certain aspects of their lives and increasing social options. These communities are appropriate options for adults who do not require assistance with everyday activities but desire a community of peers. Independent living communities offer social opportunities, meal preparation options, housekeeping services, and staff available on call, which allows the residents to choose their level of privacy and independence. The average cost of independent living communities ranges from $1,000 to $3,500 per month, making them a more affordable option than assisted living and skilled nursing facilities. Medical insurance does not cover costs for these facilities, but some long-term care insurance, Medicaid, and VA benefits may offset some costs. 

Skilled Nursing Facilities (SNFs), also known as nursing homes, are residential care options for seniors who require constant medical care that would not be available at their home. SNFs offer both short-term and long-term care options, making them suitable for seniors recovering from an operation to seniors suffering from a chronic illness such as ALS. SNFs are an appropriate option for those who require constant medical attention, are immobile, are incapable of physically caring for themselves, are unable to manage medication schedules, or are otherwise incapable of managing their wellbeing. SNFs are federally required to provide a certain level of nursing, dental, pharmaceutical, and other medical services so that the resident is able to maintain their health, grooming, and personal hygiene. SNFs are an expensive option ranging on average from $3,000 to $10,000 a month, but there are a variety of financial aid options available such as Medicare, Medicaid, PACE, SHIP, VA benefits, and long-term care insurance. When choosing a SNF, make sure to consider whether it is government certified if relying on Medicare or Medicaid, the size of the facility, the star ratings, and the quality and variety of services provided by the facility. 

Skilled Nursing Facilities (Nursing Homes)

In-Home Care

In-home care uses home modifications, assistive technology, and aides to create a safe environment and provide the care and assistance that one needs while in their own home. In-home care provides some of the personal care and assistance with ADLs as one might receive in an assisted living facility, but it generally does not provide medical care available at a nursing home. In-home care may be appropriate for those who experience declining mobility, decreasing cognitive abilities, difficulty maintaining hygiene and one’s home, and overall increased challenges with everyday activities. There are various options within in-home care, such as companion care services that provide companionship and light assistance to seniors, personal care assistance which offers a larger degree of assistance with ADLs to seniors (but not at the level of assistance provided by an assisted living facility), and home health care which offers skilled nurses to provide health care to seniors. Companionship and personal care cost an average of $24 an hour whereas home health care costs an average of $25 an hour, with costs varying based on factors such as the degree of care required and location. Medicare and Medicaid typically do not cover in-home care, however some states offer Medicaid waivers to expand coverage and help decrease some costs. Moreover, some long-term care insurance and VA benefits cover some costs of in-home care. When hiring a caregiver, be sure to clearly outline the needs of the senior, provide a detailed description of the tasks that need completion, and find a caregiver who the senior and the family are comfortable with.