When living at home is no longer an option for a senior, families often have to make the tough choice about where to move their elderly loved one so that they will be safe and cared for. Depending on the level of care needed, many seniors will end up moving to an assisted living community or nursing home.
Assisted living communities are best for adults who are still fairly independent, but need some assistance with the various activities of daily living, such as bathing and dressing. Nursing homes, on the other hand, provide a higher level of care (read the next section, for more). In addition to helping with daily living, assisted living communities typically offer meals, housekeeping, exercise programs, social services and more.
Assisted living is generally paid for out of pocket, and is often broken down into three payment tiers: all inclusive, where everything is bundled; level of care, where costs and services are grouped by tiers; and fee for service, where everything beyond room and board is charged a la carte.
When considering whether assisted living is suitable for your loved one, assess the following areas of their life. If you answer yes to several of these questions, assisted living may be a good option for your loved one.
Nursing homes are best for seniors who need a high level of care, as assistance is available 24 hours a day from skilled nurses and aides. Some residents come from assisted living communities while others may go directly from living at home to a nursing home. Unlike assisted living communities, nursing homes must comply with federal standards, which were enacted in 1987 under the Nursing Home Reform Act. Know that states may have their own additional regulations. Many nursing homes also cater to residents with memory care needs, such as dementia or Alzheimer’s.
Nursing homes also differ from assisted living communities in terms of how residents pay for them. It is sometimes possible to cover assisted living costs with Medicaid, but it varies by state. Paying for a nursing home with Medicaid, however, is fairly common; almost two-thirds of nursing home residents are Medicaid beneficiaries, according to the Centers for Medicare and Medicaid Services. Residents may start by paying out of pocket, but many spend down their savings and then are able to qualify for Medicaid.
Making the decision
Deciding to move to a nursing home is a personal decision, and coming to that conclusion looks different for different people. When trying to decide if it’s the best option for your family, consider both the needs of the senior and their caregivers. For some, the following might indicate a nursing home is needed:
Continuing care retirement communities, or CCRCs, are a less common but increasingly popular senior living option. CCRCs are unique in that they allow adults to change their level of care as their needs change, while staying in the same community. They also allow couples with differing care needs to continue to live close to one another while catering to both partner’s needs. Most CCRCs offer the full range of care all the way from independent living up to round-the-clock skilled nursing care.
In terms of payment, most CCRCs offer three levels of contracts, which residents sign upon joining. All contracts generally include an upfront fee as well as a recurring monthly fee. The three types of contracts, from most expensive to least expensive, are: