Finding the right care for your loved one

Millions of families today are facing a difficult reality: “mom cannot live safely in her home anymore, and I am unable to care for her myself. She needs more medical attention that I can give, but I do not want to place her in a nursing home. What do I do now?”

Many years ago, if you could not live alone in your home anymore, your only option was a nursing home. Today, there are several different care options for the older adult, all with varying levels of medical care, privacy, cost, and assistance. The following compares facility types, requirements, costs and the level of care received.

Independent Living
Individual residing in their own home, alone or with another individual(s), functionally and socially independent most of the time. In home assistance may be provided by third party service agencies, church, friends or family.

Congregate Housing
Person residing in their own apartment. Functionally and socially independent most of the time, chronically ill, socially isolated, frail are provided with 24-hour on-call assistance.

Assisted Living
Institutional setting or apartment style building. Independent apartment or private/semi-private room.

Long-term Care
Institutional setting

Continuing Care Retirement Center
Services designed to provide whatever level of support needed regardless of the individual’s needs.

Independent Living
House, duplex, condominium or apartment

Congregate Housing
Mid-rise or high-rise facility, cottages. HUD 202, HUD 236, independent housing project or group home.

Assisted Living
Wing of long-term care facility or congregate housing facility, or separate apartment building or house.

Long-term Care
Intermediate care or skilled nursing facility. Free standing institutional design.

Continuing Care Retirement Center
Combination of independent cottages/apartments, congregate, assisted living and long-term care on a campus.

Independent Living
None

Congregate Housing
24-hour monitoring for assistance, ore or more meals daily in common dining room, various planned activities and recreation areas, laundry room for use by residents. Federal rent subsidy a likely option.

Assisted Living
24-hour monitoring and low-level medical interventions on behalf of the individual. Monitor medications, assist with ADL’s as needed, all meals provided, laundry and house-keeping provided. Could include separate wing or accommodations specifically designed for dementia care.

Long-term Care

24-hour total care. Accommodations for dementia care.

Continuing Care Retirement Center
Range from minimal or no service to 24-hour total care. Single campus setting, Resident can move from one aspect of the campus to another depending on level of care desired or needed. Exceptionally nice amenities common throughout.

Independent Living
None

Congregate Housing
Federal and/or State regulations, especially if HUD property. Additional state regulations may apply.

Assisted Living
Varies greatly from state to state. General overview by a state agency (agency by state). Some legislation, standards and guidelines.

Long-term Care
State and Federal regulations apply. Medicare and Medicaid may be relevant to individual – additional regulations if so.

Continuing Care Retirement Center
State and Federal according to level of care.

Independent Living
Independence. Upkeep of home and property, property taxes, utilities, potential isolation.

Congregate Housing
Rent, utilities, taxes, some meals provided, sliding scale cost, activities, socializing with fellow residents. Loss of some privacy and independence.

Assisted Living
Level of care provided at a cost less than LTC, but generally expensive. Meals, medication monitoring, assistance adds to monthly cost. Loss of some privacy and independence. Limitations to the extent of care available.

Long-term Care
Highest level of care provided 24 hours daily by professional staff. High cost. Loss of some privacy and independence, some potential social stigma.

Continuing Care Retirement Center
Potentially the best living situations regardless of level of care needed. Loss of some privacy and independence. High initial and monthly cost based on level of care and type of residence. Can have financial complications.

J. Steven Fulks, Ph.D Barton College