The power of foresight: Levels of care in senior living explained
“Hindsight is a wonderful thing.”
It’s a saying that makes little sense. Sure, it can be good to look back at past decisions and figure out what you would have done differently, but isn’t it better to just get something right the first time around?
There are times in life when foresight is a wonderful thing — the luxury of thinking ahead, weighing up the pros and cons, and making an informed decision.
This is especially true when it comes to finding the right level of care as we age. It’s common to assume every senior community is the same, but in reality there are many factors that can make a big difference to the experience of a senior citizen and their loved ones. From caregiver ratios to the medical care on offer, the devil is in the detail — and many families have needs that make a cookie-cutter, one-size-fits-all solution unsuitable for the future.
One of the main challenges when navigating the confusing world of senior living is knowing what different levels of care provide, and what they don’t. Understanding the complications that can arise is crucial. For example, many families don’t realize that a husband and wife can end up separated if they have different care needs. This article is designed to serve as something of a cheat sheet — explaining what each option typically offers, its limitations, and what distinguishes it from alternatives in the marketplace.
Weighing up the options
First, there’s independent living, where healthy aging takes center stage. In general, there is no care offered at this level and there are several models to choose from in this category. Age-restricted communities (55+) can enable eligible adults to buy or rent a property in a development complete with golf courses, gyms, high-quality dining and beauty salons. Housekeeping and garden work are often taken care of, but residents can continue to cook meals in their own kitchen if they wish or make use of dining services within the community. Many don’t realize that private duty care can often be brought into an apartment at an additional cost. This allows the resident to stay in their home for as long as they want without having to leave when care is needed.
Similarly, continuing care retirement communities (CCRCs) ensure homeowners can age in place and receive additional support within the community should they need it in the future. CCRCs typically require a high buy-in fee on top of the monthly costs, but offer the guarantee that all potential care needs are catered for.
The next level of care is assisted living. Depending on the community, residents can benefit from large social spaces, welcome overnight guests, have a parking space so they can drive at will, and most often bring their pets with them. The important thing to stress here is that the care is non-medical and there is typically only one caregiver per 15 residents. These communities encourage residents to be as independent and social as possible, but understand they may need assistance with activities of daily living (ADLs) such as grooming, bathing and eating. Staff are also there to ensure residents are keeping on top of their medication. Some communities do provide licensed nurses who can cater to higher care needs — assisting with things like insulin injections and wound care. This level of care eliminates the need for residents to cook for themselves and makes poor mobility much more manageable. Activities ranging from art classes to movie nights are either on site or situated close by, meaning social events, fun and interaction with like-minded people is always available.
Board and care homes offer a version of assisted living, but on a much more intimate scale, usually in a residential neighborhood, with a ratio of just three to four people for each caregiver. These universal workers do everything from cooking meals to cleaning — with shared and private rooms available. One interesting point about these residential care homes is that many cater to the hobbies and preferences of each resident — meaning even quirky pleasures such as folding clothes can be catered for.
Increasing attention is also being given to delivering the right care for those with Alzheimer’s or other dementia-related diseases. According to the Alzheimer’s Association, more than 5.8 million people are currently living with this disease in the U.S. — a figure that’s set to rise to 14 million by 2050. A lot of the time, the care falls to family and friends, and estimates suggest that 16 million Americans provide 18.5 billion hours of unpaid care every year. Memory care communities can help alleviate the pressure loved ones are under by providing purpose-built grounds with high ratios of specially trained caregivers — a place where residents have the freedom to walk around in meticulously designed spaces without their safety being at risk, and benefit from activities that keep their minds active. Long term, such an arrangement can be considerably more expensive than a less specialized community, and this is why it is important to understand where a loved one is on the spectrum of dementia. For those who are showing early signs of memory loss, people who don’t necessarily need to be in a secured environment, the memory care wings within assisted living communities can be more than sufficient. Some board and care homes specialize in this area, too.
Long-term care in a place that is unfamiliar isn’t always suitable for a person’s needs, but there are other ways that professionals can help. Short-term respite care can enable families to strike a balance between caring for their loved ones and fulfilling life’s other obligations. From a few days to a few weeks, this solution delivers flexibility when work commitments or other personal matters demand attention — and for families who are unsure whether assisted living would be a good fit, it can serve as a valuable test run. This option is also beneficial for recent hospital inpatients who need time to recuperate before they return home.
In-home care sees qualified and compassionate professionals coming in to help a few hours a day or around the clock. As care needs increase, it can become more affordable to move a loved one into an assisted living community or another senior living property.
And for those who cannot be cared for within their own home, but don’t need to stay in a hospital, a skilled nursing facility (SNF) can help. Here, they provide comprehensive medical care for those who are recovering after a recent hospital stay — perhaps providing speech therapy after a stroke, or exercise to build strength after illness. Longer-term communities have evolved to become more focused on residents — doing away with fixed schedules that treat everyone the same, and instead striving to make individuals feel comfortable. Unlike all of the other care types previously mentioned, it is rare for this type of care to be paid for privately. While Medicare can be used to cover the cost of short-term stays, Medicaid can cover the expense of a more permanent arrangement if a family qualifies.
Choosing care with care
No matter which type of care is best, due diligence is essential. One way to ensure you’re equipped with the most valid and up-to-date information is to rely on a local senior living expert. Often known as placement agents, these professionals know everything about communities within a certain region. They can provide you with a list of properties that meet your needs, set up visits, and even accompany you on these tours. These specialists can also provide precious insight on what to look out for, such as the appearance of other residents and how experienced the staff are.
With so many nuances to consider, thinking ahead and knowing the options on the table, as well as partnering with a local expert, can result in a smoother experience for everyone. When it comes to senior care, foresight really is a wonderful thing.
Arthur Bretschneider is the CEO and founder of Seniorly.com