I want to explore options when living at home no longer seems the best choice for my loved one.
INTRODUCTION TO THE TOPIC / IMPORTANT INFORMATION
This tool is intended to help you understand your and your loved one's needs and preferences as you consider available residential options and which might be the best option for you both.
Most older adults wish to remain in their own home as long as possible. Even when staying at home does not seem ideal, the thought of moving somewhere new, making new friends, finding new places to shop or worship, is emotionally difficult for everyone involved. The Situation Review will help you look at some of the benefits and/or challenges that your loved one may experience in living at home.
Read each statement in the Situation Review and click on the response that seems most true. After you have completed the Situation Review you will be able to print out a paper copy of your responses along with an Interpretation of Your Responses as well as relevant resources. Use the record of your responses and the Interpretation as you explore the resources that are available for your loved one at home in order to match the available resources to his or her needs.
Keep in mind:
- There are a number of residential settings providing care and services for an older adult who needs them
- It is important that you visit any residential setting you and your loved one are considering before you make a decision to make sure of the quality of care that is provided.
- Your our loved one has a right;to make his or her own decisions even if this means living in a less than ideal situation.
Below is an Overview of Residential Options for Older Adults describing the kinds of residential settings, other than a private home, that are available for older adults who need some support services.
Domiciliary Care (also known as Adult Foster Care)
In domiciliary care ( “dom care” for short), an individual or family provides a room in their own home for up to 3 adults who have physical disabilities, developmental disabilities and/or mental health concerns. In addition to attention, support and friendship, domiciliary care offers three meals a day, housekeeping, laundry, and personal hygiene services, medications reminders, and transportation to and from medical appointments and social service activities.
Personal Care Boarding Homes
Personal care boarding homes provide housing and services for adults who have physical or mental disabilities and are unable to live alone. Personal care boarding homes may offer more services than domiciliary care settings do and are appropriate for those who are less able to care for themselves independently. In additional to the services provided in domiciliary care, personal care boarding homes may offer help with bathing, dressing, toileting and incontinence, getting in and out bed or chairs, walking, social activities, and managing finances.
Assisted Living Facilities
Assisted living settings run from small (20 or fewer residents) to large (a hundred or more residents). In assisted living, residents have their own individual apartments or rooms with private baths. Although residents of assisted living facilities may need some assistance with everyday personal care, they want and are able to maintain some level of independence at the time they move into an assisted living setting. Assisted living facilities generally offer meals in a dining room for residents along with housekeeping services and transportation to shops or other local destinations. Additional services may be provided to residents needing them for an additional fee. Assisted living facilities should offer residents the opportunity to “age-in-place,” meaning that as their needs increase so too do the available services that they can purchase, thereby avoiding the need to move to a nursing home. The hitch is that Medicare and most health insurance policies do not cover the cost of assisted living, so expenses must be paid for privately.
Nursing homes offer 24-hour care and supervision for those with complex medical needs and/or significant chronic health conditions, including dementia. Nursing home residents most often do not have private bathrooms and may share a room with a roommate. Nursing homes are responsible for meeting all of a resident’s medical and personal care needs. Family members often continue to be involved in caring for their loved one living in a nursing home through their visits, continuing to include their loved one in family and social activities, going along to doctor’s appointments, providing favorite foods and buying clothing when needed. Nursing home costs may be paid from a resident’s own money unless the resident’s income, savings and property fall below a certain amount, in which case the costs of nursing home care may be paid through Medicaid. Some individuals have long term care insurance policies that may also help with the cost of care.
Continuing Care Retirement Communities Continuing care retirement communities (sometimes referred to as CCRCs) are privately built and owned residential communities that include homes for independent living (single homes, town houses and/or apartments), an assisted living setting and a skilled care facility that often can provide short-term rehabilitation care (for example after surgery or an accident or illness) and long term nursing home care. Generally CCRCs are limited to adults 55 years old or older. If you become a member of the community by paying the sometimes significant entrance fee or purchase price.
Senior housing refers to a setting that offers independent living apartments or cottages for people above a minimum age. The minimum age can vary from 50 to 62 years. A benefit of senior housing is being in a community with other older adults, which offers opportunities for socializing. There may be informal or formal social activities offered by the community. Some senior housing is subsidized by the federal government and is available for older adults who have moderate or low incomes. The rent in subsidized senior housing is usually no more than 30% of an individual's income. If you are considering senior housing for your loved one, check to see if the setting offers any support services for residents.
Nex, click on the "Click to Proceed' button at the upper right to move on to the Situation Review. When you have completed the Situation Review, you can print it out along with the Interpretation of Your Responses. You will also be presented with relevant resources to hellp you put in place the decision-making supports that your loved one may need. Use the print outs to help you determine what resources will be most valuable for you. Keep the paper print outs and go back to them to review your responses as your situation may change.