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. Beginning the search for care outside of your home can be an emotional and overwhelming experience. As the primary decision-maker, you’ll want to pinpoint:
Whether your aging relative needs a lot of help with basic daily tasks or simply needs a constructive, active environment, nursing homes, assisted living or continuing care retirement communities (CCRCs) can all be successful living and care arrangements.
A quick overview:
Learning about even more of the differences among all these options can help you decide what’s best for your loved one. And no matter which type of facility you’re considering, you might want to identify questions and priorities to keep in mind during your search.
While weighing the pros and cons of various facility types, you’ll want to pinpoint the costs of each type of facility. After all, the choice you make could significantly impact financial planning, budgeting and uncovering available benefits.
Although it’s ideal to research and prepare a game plan for funding long-term facility care ahead of an emergency, it’s not uncommon to find yourself gathering information on the financial piece of the puzzle while simultaneously searching for a nursing home, assisted living facility or continuing care retirement community (CCRCs).
A variety of factors — such as meeting certain financial and functional requirements (e.g. requiring help with activities of daily living like bathing or dressing) — go into whether or not an older adult will be able to use federal benefits (like Medicaid) to pay for long-term care. Though the federal government provides some funding, states run the program, which means eligibility requirements and what’s covered can vary considerably by location.
You might also explore:
Researching and understanding these options can help you determine what route is the best fit for your loved one’s financial picture.
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.
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.
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:
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.
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 partners' 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: