What are the Levels of Care for the Elderly?

When seniors grow older, they require certain levels of care based on health and social needs. Your more active seniors may need minimal attention and low cost. Other seniors may require more acute care at a higher price.

The following are levels of care for the elderly to guide you as you determine which one is the best fit:

• In-home aide
• Adult daycare
• Adult daycare health center
• Independent living
• Active senior
• Senior apartment
• Senior co-op
• Retirement community
• Assisted living facility
• Respite care
• Memory care
• Residential care home
• Nursing home
• Hospital
• Hospice
• Continuing care retirement community

Not only is it important that your loved one receives the best consideration for their situation, but that their specific needs are met.

It can be hard to know where to start when assessing your elderly loved one. Two things to consider as you make these decisions are acuity of care and cost.

Low acuity and low cost

In-home aide

In-home aide empowers seniors to experience the comfort of their home while receiving support with activities of daily living from qualified home health care specialists. The cost of In-home care varies depending on the acuity of care required. The ability to pay for these services is a significant factor in determining in-home care for seniors (“Golden Placements, 2017”).

Seniors that require around the clock care are going to incur a much larger cost than a senior that only needs to be seen once or twice a week. The lower end of the cost spectrum is ideal for primary caregivers that merely require someone to check in occasionally. The average cost of this service is $20 per hour and up (“A Place for Mom, n.d.”).

This kind of care also benefits seniors that live by themselves but still need help with medications, meals, bathing, or a driver for errands.

Adult daycare

Adult daycare centers are programs designed to give care and camaraderie to the elderly who require assistance or guidance throughout the day. It also provides entertainment and social outlets to seniors on a day by day cost.

This program is ideal for family members that must either work or manage individual business throughout the day and need someone to administer a low level of supervision for their aging senior. This program can generate peace of mind for active family members or hardworking caregivers (“Thecaregiverfoundation.org n.d.”).

The purpose of these programs is to limit or postpone institutionalization by presenting an alternative type of care. In the process, these programs aim to raise self-esteem in the aging seniors and encourage them to remain social; therefore aiding cognitive health and slowing down their decline (“Thecaregiverfoundation.org, n.d.”).

Adult daycare health center

Adult daycare health centers offer more critical health and curative practices. Social services for individuals with severe medical problems at these types of facilities are provided. If someone is at risk of requiring home care by a healthcare professional, consider this option as they will focus on health as well as social needs (“Paying for Senior Care, n.d.”).

Some of the services you can expect to find may include but are not limited to education, meals, exercise, health screenings, medical care, physical therapy, socialization, recreation, transportation, medication, and counseling (“Thecaregiverfoundation.org, n.d.”).

You can expect these centers to stay open during working hours. You can find these centers in a wide range of locations including schools, hospitals, churches, and nursing facilities. Some even provide and schedule transportation for seniors.

Independent living

Independent living is the freest level of care for those in senior neighborhoods. These communities provide private apartments and living quarters for their residents. Most of these communities offer individualized meal plans to meet dietary needs.

They will still get access to amenities like housekeeping, social activities, transportation, and emergency services.

This type of care is best suited for individuals with little medical issues and require very little supervision. The cost for these communities is still moderate but less than an assisted living facility (“Senior Living, n.d.”).

Low acuity and moderate cost

Active senior

It is designed with an active and healthy senior in mind. Perfect for seniors who wish to live independently and stay active and engaged in their lives. Amenities may include golf, clubhouse, hiking trails, swimming, and tennis (“Retirement Living, n.d.”).

Senior apartment

Senior apartments are designed for convenience. They have fewer stairs, in-unit laundry, no yard work, or household repairs. It provides total freedom with access to other seniors with limited social activities (“Laureate Group, n.d.”)

Senior co-op

Senior co-ops are owned and controlled by resident seniors. It functions as a socially supportive and cooperative community. This kind of care provides full apartments or townhouses controlled by the residents. Senior residents even receive financial benefits from this kind of housing including the return of equity on resale (“Senior Co-op, n.d.”).

Retirement community

Retirement communities are residential or housing complexes designed for older adults who are capable of taking care of themselves. Homecare agencies are welcome in these communities. They have the option of owning or renting with access to organized social activities, valet services, and emergency response systems (“Senior Living, n.d.”).

Intermediate level of care and moderate cost

Assisted living facility

Sometimes, seniors are still capable of most of life’s duties. They may require minimal help throughout their day but have trouble completing all of their tasks. If your loved one falls under this umbrella, consider assisted living facilities.

Assisted living facilities are ordinarily for seniors who can live autonomously but need minimum support to live. The services come in the form of medical monitoring and light ADL (Assisted Daily Living). The idea is to provide long-term personal care for seniors who generally need help with ADL. Some of these activities are housekeeping, meal prep, light grooming, getting dressed, and help with medications (“Thecaregiverfoundation.org n.d.”).

Consider using third-party planners to ease the transition for your loved one. The goal is to make the option of assisted living an attractive option for your senior and in the process create less friction for the family (“Thecaregiverfoundation.org n.d.”).

Assisted living facilities are located in retirement communities, nursing homes, senior housing, or may operate as a standalone facility. Depending on the state, assisted living facilities run under different names. Some of the titles include residential care, congregate care, and personal care homes.

The cost of assisted living facilities is much higher than adult daycares. They tend to cost less than nursing homes.

The services provided change the cost you can expect to pay per year. The lower end of the spectrum can range to a little less than $10,000 a year, all the way up to $50,000 a year. On average, it would cost about $1,800 a month (“Thecaregiverfoundation.org n.d.”).

Respite care

Respite care is planned temporary emergency care provided to caregivers of a child or adult. Respite programs provide families with time-limited and planned short-term breaks.

Respite care gives primary caregivers a break. Caring for your loved one is difficult, and sometimes a break is needed. The duration of respite care can range from an afternoon to a couple of days, to weeks. Respite care happens at various locations, including but not limited to: at home, in a healthcare facility, or adult daycare centers (“Nia.Nih.gov., n.d.”).

Memory care

When caring for a senior with Alzheimer’s or Dementia it can present as challenging, demanding, and draining. Memory care facilities provide residents with 24-hour support with the purpose of ensuring safety and high quality of life. Due to safety concerns, resident living areas are safely enclosed to safeguard the resident. These precautions prevent them from wandering off. Often these facilities are a subset of an Assisted Living facility (“Golden placements, 2017”).

Residential care home

Group homes or more formally known residential care homes are senior communities for individuals living together in a private house with live-in caretakers. There will usually be a night and day shift for caretakers. These caretakers help with activities of daily living, medications, and more advanced nursing services.

This option is very similar to assisted living but with a greater sense of independence for seniors and more social interaction. Depending on the facility, it’s not uncommon to pay anywhere between $1,500 to $3,000 monthly (“Golden Placements, 2017”).

Acute care and high cost

Nursing home

When a loved one requires higher levels of care than an assisted living facility can provide, a nursing home may be the best option to ensure quality care. Nursing homes have a wide range of services that range from around the clock medical care, daily meal prep and feedings, total housekeeping and social activities appropriate for their medical condition (“Golden Placements, 2017”).

Nursing homes tend to be staffed by a full team of nurses, nurse aides, physicians, and other healthcare professionals.

Some example of acute care needs include:

• lack of vision
• loss of communication
• cognitive and memory issues
• altered mental status and behavior
• bowel and bladder issues
• assistance with daily feeding
• inability to ambulate
• bathing and grooming
• daily medication needs

These facilities also provide procedures that must be done by a licensed professional. Some of the services may be in-house rehabilitation by a skilled and licensed professional sometimes 24 hours a day. A doctor will order treatment for individuals if needed (“Thecaregiverfoundation.org n.d.”).

Some examples of procedures performed at these facilities are:

• tracheotomy care
• decubitus ulcers
• wound care
• catheter care
• intravenous medications
• oxygen therapy
• renal dialysis
• chemotherapy
• tube feedings
• complex medication control

There are some factors to consider when deciding if a nursing home is the correct level of care for your senior. If they are unable to care for themselves for extended periods of time, they may need nursing home care. If they are presenting as a danger to themselves due to an inability to perform multiple daily activities, they most likely are a candidate for a nursing home. States tend to require that they are unable to care for themselves in various categories (“Paying for Senior Care, n.d.”).

If your senior has multiple of the following issues, consider nursing home care (“Paying for Senior Care, n.d.”):

• Medical – require catheters, IV drips, ventilators
• Cognitive – memory issues such as dementia or Alzheimer’s
• Behavioral – uncontrollable actions or impulses
• Functional – unable to manage ADL

The cost of nursing home care is expensive and can range from $3,000 to $8,000 (“A Place for Mom, n.d.”).

Hospital

Severe illness and disease will require hospitalization. Inpatient hospitalization sometimes requires short or long-term care depending on the issue. Though the goal of hospitals is to treat acute illness and discharge a patient to a more suitable facility, sometimes their stay can be longer than one wishes. With the increase of time spent in a hospital, so too increases the cost of care (“Thecaregiverfoundation.org, n.d.”).

Hospice

Hospice care is for individuals who are terminally ill. Hospice care occurs at a facility or in-home. Hospice facilities tend to employ hospice nurses specifically. Hospice nurses are trained to give the end of life care to those in their final days. They provide comfort to patients and families in their remaining moments (“Thecaregiverfoundation.org, n.d.”).

It’s important to consider how we want to be treated during our last days. For the caregiver, it can be a considerable weight to shoulder as to whether someone is the right fit for hospice. Try to communicate with your loved one before it gets to this point so that you are well aware of their desires (“Thecaregiverfoundation.org n.d.”).

Consider a living will or advanced care directive before deciding on hospice care. Unfortunately, not everyone will be able to communicate their wishes appropriately; when this happens, treat the decision with the appropriate consideration it deserves (“Thecaregiverfoundation.org, n.d.”).

Continuing care retirement community

Continuing Care Retirement Communities (CCRC) are campus-like facilities. They are designed for seniors with diminishing health and those that want to remain in a single location. Continuing Care Retirement Communities attempt different levels of care. The range of care in CCRCs go from Independent living for seniors who do not require special assistance, to assisted living, skilled nursing, and rehabilitation (“Paying for Senior Care, n.d.”).

The rich tend to favor these types of communities as they provide alternative levels of care in the same place. It is considered the ultimate retirement plan for the wealthy. This framework, allows seniors to progress through all the levels of care. They get to engage in an active lifestyle as long as they are capable of until their health no longer allows it. They get to build lasting friendships in these communities as most residents will stay through the course of evolving care (“Senior Living, n.d.”).

Having all of these levels of care creates a degree of convenience for seniors who may experience changes in their health over time. There is a cost that matches the level of comfort with these facilities. They range from moderate to the most expensive of all options (“Senior Living, n.d.”).

Final word

The cost associated with different levels of senior care is one of the most important factors when deciding what the next step is. It is wise to get ahead of these choices and have uncomfortable conversations now. Everyone will eventually require extra care and help.

For the sake of your loved one, it is best not to take these considerations lightly as they not only come with a significant financial decision but also determine the quality of life your loved ones will experience over time. It’s ideal to allow your aging senior to enjoy a robust social life and safety, but always consider medical issues as a priority when making your decision.