Understanding Levels of Senior Care: A Beginner's Guide

Understanding your options is one of the first and most important steps in navigating senior and elder care. There are several types of care available, and today we will focus on the five main forms of community-based care. While this is not an exhaustive list, it provides a strong foundation for getting started.

Each level of care offers different services, supports, and environments, and it is essential to understand the benefits and limitations of each option in order to make informed decisions that best meet your loved one’s needs.

Types of Senior Care

In-Home Care

In-home care is just as it sounds, care within the home! This type of care allows your loved one to stay within the home they have created with added supports. This level of care is often excellent for seniors who need minimal to moderate supports to maintain their ideal level of independence. In-home care largely is not covered by insurance as it is considered "non-medical" care.

Services Offered for "non-medical" in-home care:

• Activities of Daily Living assistance (bathing, dressing, toileting, ambulation)

• Meal preparation

• Companionship

• Light housekeeping

  
  

Pros:

• Your loved one can remain at home

• Personalized care-the caregiver is providing care to your loved one only

• Scheduling flexibility (often providers will ask for a 4 hour minimum per shift)

  
  

Cons:

• Costs can accumulate quickly as these fees are not covered by insurance

• You may need multiple caregivers to meet your loved one's needs and so may not see the same caregiver all the time

  
  

Assisted Living Facilities

Assisted living facilities provide a community setting where seniors can live and assistance with activities of daily living. These facilities can be larger and resemble apartment complexes or be within single-family dwellings in your local community! Each facility's services and amenities will vary greatly.

Services Offered:

• 24-hour supervision

• Assistance with activities of daily living (ambulation, toileting, dressing, bathing, transferring and feeding)

• Coordination of social activities and events

• Medication Administration

• Some Transportation services (each facility will vary on the availability of this service and fees associated with this)

• 2-3 meals provided per day

  
  

Pros:

• Social interaction can increase in an ALF

• Access to various activities

• Licensed professional staff available around the clock in the event of any emergency

• Many ALFs have in-agency medical providers who will visit your loved in the home, ensuring they receive their medical care in a timely and efficient way

  
  

Cons:

• Your loved one will have to leave their home

• Costs have a wide range and will likely be higher than in-home care

• Insurance will not pay for this level of care (unless you enroll in a specific waiver through Medicaid)

  
  

Nursing Homes

Nursing homes, also known as Long Term Care facilities, provide a higher level of medical care than Assisted Livings for seniors with significant health issues or disabilities. These facilities have licensed medical staff round the clock.

Services Offered:

• 24-hour medical care

• Medication Administration

• Rehabilitation services (physical, occupational, speech therapy)

• Specialized care for chronic conditions (wound care, IVs, ventilators, etc)

• Assistance with activities of daily living

• Social Activities

  
  

Pros:

• Access to medical professionals 24/7

• Comprehensive care for complex health needs

  
  

Cons:

• Less personal space and privacy (you often will share a room with one other person)

• Higher costs than Assisted Living or In-Home care

• Insurance will not cover the cost of your care unless you are enrolled in LTC Medicaid

  
  

Memory Care

Memory care facilities specialize in caring for individuals with cognitive diseases like dementia or Alzheimer’s disease. These facilities provide a secure environment and tailored programs to support cognitive function. Some facilities are locked to prevent wandering, while others are open.

Services Offered:

• Specialized memory care programs

• Secure living environments

• Medication Administration

• Assistance with activities of daily living

  
  

Pros:

• Trained staff in dementia care

• Structured activities to promote cognitive engagement

  
  

Cons:

• Highest costs due to specialized services

• Limited service providers

• Insurance will not cover the costs of this level of care

  
  

Adult Day Care

Adult day care centers offer a safe environment for seniors during the day, allowing caregivers to work or take a break. These centers provide social activities and support services.

Services Offered:

• Social activities and outings

• Meals and snacks

• Health monitoring

• Transportation services if you are within a certain mile radius from the center

  
  

Pros:

• Daytime care to alleviate some caregiving needs

• The cost is paid fully by Medicaid if you are a recipient

• Transportation is generally included to and from the center

• Opportunities for socialization

  
  

Cons:

• Day time services only

• May not be suitable for seniors with severe health issues

• Many facilities only accept Medicaid or private pay