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What is the Difference Between Nursing Homes, Assisted Living, and Home Care?

 

How many of you have heard your parents say “I’m not going in a home!” What they are referring to is your grandparents nursing home. Like many things in life, senior care has evolved, and nursing homes are not the only option for our seniors.

Nursing Homes provides a higher level of medical care than Assisted Living Communities. There are two kinds of care: Skilled Nursing Facilities (SNF’s), and Intermediate Care Facilities (ICF’s), both supervised by Physicians and Nurse Practitioners.

A Skilled Nursing Facility is where patients are sent after surgery or after a serious illness for rehabilitation with physical, occupational, speech, or respiratory therapy. Other services provided at this level include: intravenous medications, nutritional management, and or wound care. These needs are very specific in nature and require the staff have the proper knowledge and medical equipment to meet the patient’s needs.

In the Intermediate Care Facility, you will find long-term patients that have complex needs such as getting in and out of bed, toileting, bathing, grooming, dressing and assistance with eating. Medications are ordered, reviewed, and administered by the staff.

The purpose of a Nursing Home is to meet both the patient’s emotional and physical needs. The financial burden can be overwhelming to both the patient and the family.  The average cost for care in a nursing home can range from $ 6000- $10,000 per month. This cost will include the cost of meals but medications are not included in this price.

An Assisted Living Community is made up of seniors that no longer want to stay at home, or aren’t able to because they’re no longer able to safely care for themselves or live independently. These residents do not require skilled nursing care.  The communities do have nurses that oversee medication administration and to evaluate any concerns the resident or the family may have regarding their care.  The nurse will be responsible for supervising all of the certified nursing assistants who will provide assistance with bathing, dressing, grooming, and eating.

An ALC can provide companionship, socialization and stimulation for its residents. This will help the residents transition out of living at home to  living in a community that will feel like home. The residents have a high level of autonomy as well as still having their privacy respected. The culture in an Assisted Living is to live with purpose. You will find that there are daily activities to keep the residents busy and  engaged, while still providing the assistance that they need.

ALC’s will provide 3 nutritious meals a day. Many communities offer a menu for the resident to order from. They will usually have a few specials which change daily, but also a few mainstays for you to eat if the specials don’t appeal to you. If you have a favorite recipe from home, bring it; many of the chefs at the communities will put it on the menu.

Other services that are provided include medication assistance, housekeeping and laundry, assistance with toileting, bathing, dressing and grooming. Transportation to activities is included. Assisted Living communities pride themselves on keeping the residents busy having fun. They will provide transportation to outings such as  stores, restaurants, doctor appointments, baseball games, and movies. The residents will live in apartment-style units ranging from shared rooms all the way up to 2 bedrooms/2 bath units. Some have kitchens and some have kitchenettes.  Staff is available to the residents day and night. Nursing services are provided either part-time or full-time.

Assisted Living Communities are private pay. They do not accept Medicaid. The average cost of assisted living ranges from $ 3000-$ 5000 a month plus care. Care pricing is usually either on a point or level system depending on the resident’s care needs or on an ala carte system.   A RN from the community will come to your loved one whether in the hospital, SNF, or at home and will do an assessment to determine what type of care is needed.  Do they need assistance with medication management, bathing, dressing,  grooming, or toileting? Are they incontinent? Can they transfer safely in and out of bed or the chair? All of these factors will determine the level of care for that resident. This will determine what the cost of the care will be.  This means that a resident who is moving into Independent Living and does not need assistance will not be charged that level of care cost. However, as this resident continues to age and decline the services are there if they should need it and they would start to pay for care at that time. When paying for Assisted Living there are benefits from the VA Aid and Attendance that may be available to help pay for your care.

The last option is Home Health Care which  allows people to bring in services to take care of them in the privacy and comfort of their own home. There are two types of care:  Medical and Non-Medical.

Many seniors do not need medical assistance but just need a little help around the home with bathing, dressing, grooming, going to the store, preparing meals, housekeeping, transportation, bill paying and medication reminders. Caregivers also provide support and companionship to their clients. The cost of your care is determined by how many hours and days you are requesting the services.  Some companies will require an upfront deposit while others will have minimal shift requirements. Non-Medical care is not typically covered by Medicare.  However, there are tax breaks for those who coordinate home care services for themselves or loved ones.  Eligible veterans and their spouses can apply for the VA Aid and Attendance benefits program which can increase the monthly pension to help cover the costs of the care.

There are many options for you or your loved one. Do your research, ask for references, or ask a senior advisor who specializes in the care of seniors for help and guidance with the process. This is their job and they have many resources to help you.

About the author
Ruthie Barkus

RN, BSN, CDP

CarePatrol of Mokena

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