Levels of Care: Know Your Options for Senior Care

Levels of Care: Navigating Long-Term Care Options

While millions of Americans are balancing family, work, and caring for aging parents, many times it is just not possible for adult children to provide the level of care needed to maintain safety and quality of life for their aging loved one or for themselves. Many adult children work as professionals and simply do not have the time to devote to the care of a parent. Many adult children suffer the guilt of not being able to do it on their own, however, helping an aging parent weigh the options and find good care is an equally important role and contribution to the situation. When it comes to finding care for a loved one, there can be a steep learning curve. Understanding the amount of care and costs associated with each choice is crucial to finding the right fit for your situation.


Debunking Myths Around Senior Housing 

1. All old people are in nursing homes

2. Medicare will pay for all nursing home care.

3. Medicare will pay for home care.

4. Buying Long-Term Care Insurance will cover all care costs.


Choosing a Facility: Six Steps to Choosing the Right Facility

Step 1: Discuss changes in life

Step 2: Review the overall needs

Step 3: Educate yourself and collection information

Step 4: Get a current list of facilities in the area

Step 5: Schedule a visit with your top choices

Step 6: Come to a conclusion and decide


Levels of Care for Aging Adults 

1a. Retirement Communities

1b. CCRC Continuing Care Retirement Communities

2. Adult Family Homes

3. Assisted Living Facilities

4. Nursing Home Care

5. Specialized Unite/ Memory Care

6. Home Care or Home Health 

Let’s go through each of these options and briefly talk about the type of care providedthe pros, cons, and costs.


Retirement Communities 

Care Level: No Medical Care. Individuals enjoy fully equipped apartments or cottages. They may or may not offer meals, activities, transportation, socialization, or emergency call systems.

Pros: These places are full of active people with an independent lifestyle. They offer safety, security, privacy and there is no need maintenance on the home or its grounds.

Cons: No medical care is provided and they may have limited or no support. Residence must be healthy, completely independent.

Costs: Private Pay Only. Purchase Prices: $150k-$1 Million; Private Apartments: $1,200-$3,500

Subsidized Apartments: $300-$1,200


Continuing Care Retirement Communities

Care Level: Offers multiple levels of care, typically including retirement, assisted living, and skilled nursing on a single “campus”. May also offer memory care.

Pros:  Residents can remain in a familiar setting even as their care needs increase or change.

Cons: Requires a substantial entrance fee at the time of admission which is paid in addition to the month-to-month rent. They may require that residents are fully independent at the time of admission.

Costs: Private Pay Only. Entrance Fees Vary: $60,000- $1 Million; Monthly Fee Caries by terms of contract.


Adult Family Home 

Care Level: Care is provided by Certified Nursing Assistance or non-medically trained persons. They provide personal care, medication management, housekeeping chores.

Pros: Residents enjoy a small home-like atmosphere with a maximum of 6 persons per home. Many have Medicaid contracts.

Cons: Structured activities may be non-existent. Their ability to meet increasing care needs may be limited. Some Adult Family Homes are small and thus living space is small.

Costs: Costs vary widely based on the level of care needed and the type of room. Private Room: $3,500-$8,000/ Month. Semi Private Room: $3,500-$4,500/ month.


Assisted Living Facilities

Care Level: Nursing services are provided by an RN or LPN. They can help with personal care needs, medication management, offer meals housekeeping, activities, socialization, transportation, etc.

Pros: Looks like a retirement home with added personal care services. Residents usually get a private apartment. ALF’s offer a community of people to prevent isolation. Long- Term Care insurance may help with some costs.

Cons: They are rarely able to manage complex medical conditions. Most accept only private-pay or Long-Term Care  Insurance and some Medicaid.

Costs: Base Rate: Cost of the room ( Studio, 1 or 2 bedroom), Private Apt.: $3,500-$4,000

Semi-Private: $2,500-$4,000 Add on Care Services


Nursing Home Care

Care Level: Skilled nursing care is for complex medical needs. Rehabilitations services, such as Physical Therapy, Occupational Therapy, Speech, are available. It provides long-term care for a small number of individuals.

Pros: They can provide a high-level of care services. It can be a good place for rehabilitation. Long-term care insurance may cover some costs. They have better government regulation than in the past.

Cons: Nursing homes are more like a hospital setting. Medicare is limited in what it pays for. It can quickly deplete private financial resources.

Costs: Ranges from $8,000-$12,000 per month; Daily Rate: $266-$400 per day


Specialized Unites "Memory Care"

Care Level: These provide a high level of care for those who suffer from Alzheimer’s or other related dementias.

Pros: They have a high staff-to-resident ratio and staff are specially trained. This is a secure environment and offers care in a closely supervised setting with private or semi-private rooms.

Costs: Room rates plus service level; Private: $3,500-$8,000 per month; semi-private: $3,500-$4,500


Home Health/ Home Care

Care Level: All services can be brought into the home and are scalable. Care is usually provided on a one-to-one basis.

Pros: The client is able to be in his/her own home. Clients can maximize decision-making and independence. Care is scalable and can be used for just a few hours a week all the way to 24 hour live-in care. 

Cons: Medicare coverage is conditional and limited. It is the most expensive alternative for those who have very high needs.

Costs: Average costs through agency. Private caregivers are not recommended; Companion: $22/hr., CNA (Certified Nursing Assistant) $25-$27/hr.; LPN: $38/hr. RN: $48-55/hr. 



Published on July 19, 2013.