As your loved one ages, they may need more assistance around their home. And as time goes on, the level of assistance they need may reach a point where additional outside help makes sense. While the first option that may come to mind is a nursing home, it may not be the right choice for your loved one’s needs. A nursing home is a specific type of senior living offering a high level of care, rather than a catchall term for the various senior living options available. Read on to learn about your options for making sure your senior loved one gets the care they need.
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Nursing home care is for people who need more advanced health care or require round-the-clock assistance with activities of daily living (ADLs). This level of care is provided in a nursing home facility, rather than at someone’s independent residence.
Nursing home care includes:
However, while nursing homes provide intensive care that may be needed for some, these facilities often aren’t the best choice for seniors who need some assistance but still wish to remain independent. In these cases, there are many alternatives to nursing homes such as home care, assisted living, residential care, adult foster homes, senior apartments, independent living, Medicare PACE, and adult daycare.
Depending on the level of care your loved one needs, their financial situation, and whether they want to stay in their current home, there are a variety of senior living options to consider. Below, we’ll break down different care types that may be options.
Home care refers to care that takes place at your parent’s residence. Home care is a good option for a senior who wants to remain in their own home but has some daily care needs. It can also be a temporary option, such as transitional home care when recovering from a surgery or returning home from a hospital stay.
Home care consists of homemaker services and home health aides, either of which can be used alone or in combination.
In addition, a parent who has health concerns or rehabilitation needs may also require some level of home health care or skilled nursing care alongside home health aides or homemaker services.
Assisted living is a community-based care type. Typically, an assisted living community functions similarly to an apartment community, with the added bonus of on-site assistance and care. They usually also have added social elements, such as clubs or game nights.
Some features of assisted living include:
Similar to assisted living communities, residential care homes offer an independent lifestyle with the benefits of increased access to care. Typically, a senior will have a private room in a residential care home. Unlike an assisted living community, though, residential care homes tend to be smaller and more personal — though they may lack the larger sense of community.
Some features of a residential care home include:
Similar to residential care homes and assisted living communities, adult foster homes provide care to adults in a homelike setting. However, it’s important to note that this term has different meanings in different states and may often be used interchangeably with residential care homes.
For adult foster homes, in the states that differentiate them from residential care homes, they typically only have a few adults in them at a time, with most states capping this number at three to five individuals living in the home at any given time, meaning that more personalized one-on-one care can be provided. Adult foster homes can be a more individualized alternative to a nursing home, as they provide some similar benefits including 24/7 supervision.
Other services provided include:
Senior apartments and independent living communities offer a sense of independence for seniors who want an easier lifestyle with fewer home maintenance tasks but who may not need daily assistance. For seniors who want to retain this type of independence but do need some daily assistance, home care and home health services are ways to bring that assistance into a senior apartment or independent living residence.
Some features of senior apartments include:
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Medicare’s Program for All-Inclusive Care for the Elderly (PACE) is designed to help seniors receive their health care needs within their own community as an alternative to a nursing home. PACE may cover elements of care such as adult daycare, health care, home care, hospital stays, and transportation to PACE services.[01]
It’s important to note that PACE is not available in all states and has some restrictions for who can use the service:
Adult day care provides a space for seniors with assistance needs to have a safe, comfortable, and engaging space during the day. This is a way for family caregivers to ensure that their loved one is cared for while they are at work, or otherwise busy. It is often a more economical choice than hiring personal home care services for extended hours during the day.
Adult day care provides:
Ultimately, choosing the right care type depends on a variety of factors, including what your parent wants in terms of independence, the level of care they need, health concerns, the advice of their doctor, financial considerations, and more. In the chart below, we break down some of the financial and choice factors to help you and your parent plan for their care.
| Type of care | Median cost | How to pay | Who benefits most with this care type |
|---|---|---|---|
| Nursing home | • $9,034 a month for a private room • $7,908 a month for a semi-private room[02] | • Personal funds • Medicare, for short-term stays prescribed by a doctor • Medicaid • Long-term care insurance | • Seniors with more advanced health issues • Seniors who need 24/7 care or supervision |
| Home care | • $27 an hour for a home health aide • $26 an hour for homemaker services[02] | • Personal funds • Certain aspects may be covered by Medicare, Medicaid, or VA benefits | • A senior who wants to stay in their home • Someone who needs some assistance with daily activities or help around the house |
| Assisted living | $4,951 a month[03] | • Personal funds • Certain aspects of care may be covered by Medicare or VA benefits • Medicaid waivers are available in some states | • Seniors who wish to retain their independence • Seniors who need some daily assistance • Seniors who want to downsize their living quarters from a home to an apartment |
| Residential care homes and adult foster homes | $4,197 a month on average[03] | • Personal funds • Certain aspects may be covered by Medicare, Medicaid, or VA benefits, depending on your state of residence • Some types of private insurance, such as long-term care insurance | • Seniors who need more direct supervision and care • Seniors who want more personal care and independence than a nursing home may provide • Seniors who don’t need on-site medical care |
| Independent living communities | $3,170 a month on average[03] | Personal funds | • Seniors age 55+ who want to downsize their home • Seniors looking for a community of similarly aged people • Seniors who don’t need daily assistance or supervision • Seniors who need daily assistance and have hired home care |
| Medicare PACE | A monthly premium, unless if your parent is on Medicaid[01] | Personal funds to cover premium | • Seniors who need a nursing home level care but wish to stay at home • Seniors willing to have their care covered in multiple ways such as through a combo of home care and adult day care • Seniors who live in a state offering PACE |
Read related article:Skilled Nursing Facility vs. Rehab Center: How to Choose
While a nursing home may be the best option for your loved one, another option may be a better and more comfortable fit for their lifestyle if they don’t need intensive care or supervision.
After you discuss your parent’s desires with them, consider talking with a financial advisor about covering long-term care costs. Another resource is A Place for Mom’s Senior Living Advisors, who can help you plan next steps, recommend care near your parent, and answer questions you have along the way — all at no cost to your family.
Original article by Chloe Clark
What is a nursing home?
U.S. Centers for Medicare and Medicaid Services. PACE.
Genworth Financial. (2022). Cost of Care Survey.
A Place for Mom. (2022). A Place for Mom Proprietary Senior Living Price Index.
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