Last week Mom was fine (or so it seemed), but today she is forgetting her medications and the boiling teakettle. It may be time to consider a move to a care facility, but how do we choose? There are more options available to day for senior care than there have ever been, but choosing the best option for your situation requires some basic research followed by facility visits and meetings with the staff.
Q: What choices do I have for senior living facilities?
A: Choices range from independent houses or duplexes on a retirement campus to highly skilled care in a licensed nursing home The best choice for you depends upon your individual needs, the choices available in the geographic area, financial status and personal preference. The Office on Aging in your county may have a list of senior care options in your area.
Q: Retirement communities advertise assisted living, congregate housing, licensed residential care and skilled care. What is the difference and how do I know what I need?
A: This can be very confusing. Generally speaking, independent living units are apartments or houses that are on a single campus, but are not licensed by the state to provide personal or nursing care. Residents of these units, can, however, contract to receive such care from outside providers such as home health agencies or, if appropriate, hospice care providers.
“Assisted living” is a term that has led to much confusion. Many assisted living facilities are licensed as residential care facilities, but some are not. If the facility houses at least 17 people and provides supervision and personal care services for more than three of those persons, it probably should be licensed. There are limits to how much care such a facility can offer, especially with respect to skilled nursing procedures. Someone seeking residence in such a facility should ask about the range of services available and the criteria used to determine when a resident can no longer be safely cared for in the facility. Many new assisted living communities are actually one or two bedroom apartments. Each of these apartments is licensed as a residential care unit. This arrangement permits residents to stay where they are and receive only those services they need as time passes (sometimes called “aging in place”).
Congregate housing typically is an apartment building or series of buildings that offer limited services such as one to two meals a day with other residents in a congregate dining setting. A congregate housing facility does not provide health or social services, although generally a service coordinator assists residents in getting such services (by providing for transportation, for example).
A nursing home offers a high level of skilled nursing care to meet the physical, mental, emotional and social needs of the residents. Skilled nursing facilities are highly regulated by state and federal law and the residents typically are seriously ill and need ongoing nursing attention.
Q: What is a continuing care retirement community?
A: A continuing care retirement community (CCRC) is generally a single campus that includes independent living, assisted living or residential care, and skilled nursing care under common ownership and control. Residents typically move into a CCRC at either the independent or assisted living level. Those who choose this option assure themselves of a place to live and appropriate care in a setting of their choice as their needs increase. CCRC contracts vary greatly, but most give campus residents preference, at least, for placement in the more intensive levels of care as needed. These communities also generally include on-site services such as health clinics, beauty shops, banks, transportation for shopping, pastoral counseling, psycho-social services and plenty of organized social activities.
Law You Can Use is a weekly consumer legal information column provided by the Ohio State Bar Association. This article was prepared by Martha Sweterlitsch, an attorney with the Columbus firm of Benesch Friedlander Coplan & Aronoff.