What do the different categories of Senior Living Communities mean?
When many people think of long-term residential care, they think only of nursing homes. Nursing homes serve a specific area of need, but there are also other types of communities that are not considered nursing homes but that may very well meet your or your loved one's care needs. Generally, there are five basic categories of long-term care residential communities: nursing homes, Alzheimer's care facilities, assisted living communities, independent living communities, and continuing care retirement communities. In addition, Home health care services cover a broad range of services, including skilled nursing and non-skilled companionship provided in your home. The level of care and services, cost, and options for financing your or your loved one's residency varies greatly by category and even within each category.
With respect to the cost of care, communities generally charge a basic monthly fee for room, meals and often some personal care. You may have to pay extra for other services or special medical needs. The basic charge can vary widely from community to community and state to state, depending on what services are included, state requirements and the level of quality of the community. Communities can run the gamut from basic semi-private accommodations to very posh resort hotel type living. Some communities include services like housekeeping and social activities in their basic charge, and some charge extra for such services. You must visit each community you are considering and acquire a firm understanding of what services are offered and how they are paid for. The following descriptions attempt to provide an estimate of the low end of costs you can expect. Given the wide-range of quality and service offered at different communities, there is no average high end that can be stated. You will be able to find a community that provides all of the grandeur, services and amenities you could possibly want.
Select a community type from the list below for a brief explanation.
Nursing Homes
Assisted Living
Home Health Care Services
Alzheimer's Care Facilities
Continuing Care Retirement Communities (CCRC)
Independent Living
Nursing Homes
Nursing homes, which may also be skilled or non-skilled nursing communities, provide a long-term home and services for people who cannot be cared for at home or in the community, and are not likely to return to independent living. They provide care for individuals who need nursing care without being in a hospital. A doctor supervises this type of care and state boards of health regulate these communities. Nursing homes also generally offer short term and respite care for those who need rehabilitation care. Costs for long-term nursing home care generally run from $50,000 a year and up. A substantial portion of these costs are generally covered by Medicare, Medicaid and/or private insurance.
Assisted Living
These communities are also referred to from state to state as "residential care", "assistive living" or "personal care communities". "Assisted living" is a general term for living arrangements in which some services are available to residents who still live independently within the assisted living complex. Help is generally offered in day to day tasks with which a resident may have trouble such as taking medicine, bathing, dressing, using the bathroom, getting to appointments or preparing meals. A variety of services and amenities such as dining room service, group outings, and recreational and social programs are usually available. In most cases, assisted living residents pay a regular monthly rent, and then pay additional fees for the services they require or desire. Assisted living communities can be a good value if you only need help with a small number of tasks, such as cooking and laundry, or reminders to take medications. Costs begin at approximately $1,000 per month, and are sometimes covered by long-term care insurance.
Home Health Care Services
Home Health Care Providers offer assisted living services to you or your loved one at home. Depending upon the Provider, Home Health Care services may include, skilled nursing, physical, occupational and speech therapy, meal preparation, light housekeeping, medication reminders, shopping, errands and incidental transportation to religious services, social events and medical appointments. Home Health Care Providers help people live independently in their own homes, providing peace of mind for you or your loved ones.
Alzheimer's Care Facilities
This facility type specializes in the needs of those with Alzheimer's disease and similar dementia or memory loss ailments. They will have communities, programs and staff training specifically designed for the safety and security of one suffering from dementia-related ailments. For instance, programs will run around the clock, and the facility itself may be more secure than an assisted living facility so that residents may move safely about the facility without fear of wandering into dangerous situations. There may also be programs, such as animal or music therapies, specifically designed for the enjoyment of these residents. These communities may exist exclusively for the care of Alzheimer's patients, or may comprise a special unit of an assisted living facility or a nursing home. Costs are similar to those of nursing homes because of the high level of specialized care required.
Continuing Care Retirement Communities (CCRC)
CCRCs are housing communities that provide different levels of care, from independent living apartments to skilled nursing care in an affiliated nursing home, based on the residents' needs. Their goal is to allow a resident to maintain the maximum amount of independence as they age while meeting the housing, entertainment and medical needs of that person as they change over time. Residents move from one setting to another based on their needs, but continue to remain part of their CCRC community.
Almost all CCRCs offer independent living, assisted living and 24-hour skilled nursing communities. Some communities also include special Alzheimer's care units. Typically, a resident will be guaranteed access to more intensive care as required. One major advantage of a CCRC arises when a resident needs to move to higher level of care only temporarily to address an injury or other health problem. That resident can, for instance, move from independent or assisted living to skilled nursing communities to recover from a severe fall, and then move back again while maintaining continuity of their physical and social environment.
Most CCRCs provide a variety of services, which may be covered by monthly fees or be available at extra cost. Services offered may include housekeeping and maintenance, meals, recreation programs and communities, prescribed diet, transportation, utilities, and care during illness.
According to the Continuing Care Accreditation Commission, there are three basic types of contract that a resident enters into with a CCRC: extensive, modified, and fee-for-service. An extensive contract offers unlimited long-term nursing care for little or no substantial increase in your usual monthly payments. Entrance fees and monthly costs under extensive contracts are typically higher than those under modified or fee-for-service contracts. That entrance fee may be refundable over time, partially refundable or nonrefundable. You may acquire ownership of your residence within the community, or you may be provide housing on a rental basis.
A modified continuing care contract includes a specified amount of long-term nursing care beyond which you are responsible for payment. Once such specified amount of care is reached, the resident may continue to receive care, but most pay the facility's daily or monthly nursing rate.
A fee-for-service continuing care contract covers the cost of your housing, residential services, and amenities. You pay full daily rates for all long-term nursing care required. Entrance and monthly fees are lower under this type of contract because residents are responsible for all long-term nursing and health care costs.
There are many options available under the general term "CCRC". Your best course of action is to visit several communities and to decide which community offers the best combination of services, amenities and contract options for your or your loved one's particular needs and desires.
Independent Living
Independent living communities are senior-only housing communities that may be comprised of houses, townhouses or apartments. Many offer "resort hotel" living type arrangements. As with other community categories, a variety of recreational, educational and social activities are often offered. Housekeeping and restaurant style dining are common amenities which may be offered at an additional cost or included within the monthly rent. As such, rents can vary widely. The range of medical services offered varies depending on the facility. Independent living communities can be very similar in appearance to assisted living communities, the difference being that residents in independent living communities don't need assistance with everyday tasks. Costs generally begin around $1,000 per month and can sometimes be partially covered by Medicaid for low-income persons.