When you think of senior living, you might automatically think of a nursing home where your grandmother lived decades ago. However, today’s “nursing homes” are nothing like what you are likely picturing. Older adults have a wide variety of senior living solutions to choose from, each designed to enhance independence, cultivate wellness, and increase socialization.
There is a time and a place for nursing home care — which is now called skilled nursing care — but many older adults find that other solutions meet their needs better than the highly clinical environment you typically find in a skilled nursing facility. These nursing home alternatives each provide personalized care for different levels of need, and they come at different costs.
Here’s what you need to know about the most common nursing home alternatives, including financial assistance that may be available to cover the costs. The more you know about senior living solutions, the better you can make a decision that will meet your loved one’s needs, preferences, and budget.
Assisted living communities are often a wonderful option for seniors who prefer a balance of privacy and community. These vibrant and active communities feature many luxury amenities and services in addition to the peace of mind that comes with having friendly caregivers who are available to provide personalized assistance around the clock.
Residents in assisted living communities typically live in bright and spacious private apartments. They enjoy easy access to three meals per day in a social dining room setting with neighbors. Residents have entree options for each meal, and meals are prepared by chefs. Residents also enjoy lifestyle amenities that include events and programs held on-site, planned excursions to local spots, and scheduled transportation services.
Perhaps the biggest benefit for residents in assisted living is the personalized care provided by trained caregivers. These caregivers provide assistance with activities of daily living, such as dressing, bathing, and other personal care tasks. Caregivers are also there to assist in case of an emergency. Nursing staff members also provide assistance with medication management and are there to communicate with physicians as needed.
The cost and financial assistance for assisted living, including Veterans Aid & Attendance benefits, varies by state.
Assisted living offers around-the-clock caregivers as well as nursing supervision, but those with complex medical needs will likely need skilled nursing care. If you are unsure whether assisted living will provide your loved one enough support, it is best to speak with your loved one’s physician to get their recommendations.
The Alzheimer’s Association reports that up to 18 percent of adults over the age of 60 have some type of mild cognitive impairment (MCI). Though not always a harbinger of dementia, MCI does affect daily living and can quickly progress without the right intervention.
For older adults living with early cognitive decline, a specialized senior living environment that features meaningful socialization opportunities and daily cognitive work can make a huge difference in independence, health, and self-esteem. Arbor’s one-of-a-kind Bridges program was developed to provide the environment and programming seniors living with MCI need.
For seniors living with Alzheimer’s disease or other types of dementia, everyday tasks can be challenging. Memory care communities are designed to meet those daily challenges head-on. Typically operating under an assisted living license, memory care communities feature specially designed environments to enhance independence, health, and comfort.
Caregivers are specially trained on the dementia disease progression as well as in best practices for dementia care. Residents enjoy personalized interventions based on their current preferences and past histories, as well as medication management, nutritious meals, and events to increase socialization.
Costs for memory care vary by state, as does financial assistance.
Home care services are provided by agencies that specialize either in nonmedical tasks — such as personal care assistance, meal preparation, or light housekeeping duties — or in medical tasks such as therapy or wound care. Caregivers come into the adult’s home to perform these tasks on a schedule that suits the adult’s preferences and budget.
The more care and assistance the older adult requires, the more expensive home care services can be. However, it does provide the senior with the support they need to remain at home for as long as possible. Home care allows seniors to age in place and receive the assistance they need from the comfort of their own homes.
Medicare’s Program of All-Inclusive Care for the Elderly (PACE) provides services to qualified individuals who need skilled care but want to remain living in their community. To qualify, participants must be over the age of 55, live within a PACE organization service area, have state certification that they need skilled care, and require PACE services to remain at home safely. Medicare PACE enrollees are often required to use a PACE-preferred doctor, which may restrict the enrollee's ability to stick with a doctor they already know and trust.
PACE services are varied and can include adult day care, dental visits, meal services, recreational therapy, hospital care, and even prescription drug management.
Medicaid home and community-based services (HCBS) waivers provide a variety of care services and nonmedical support for Medicaid recipients. Applicants must be at least 65 years old or disabled, financially qualify for Medicaid, and require assistance with at least two activities of daily living, which include dressing, bathing, toileting, mobility, and eating.
Many times, older adults receive support from family members. Unfortunately, those family members are then at an increased risk for caregiver burnout, which can result in health complications. Taking a rest from the caregiving role can decrease that risk. Respite care is a service that allows the senior to get the support they need from trained caregivers while giving family members a break from caregiving.
Respite care can be provided by a home care agency. Seniors can also receive respite care by moving into senior living communities on a short-term basis.
Continuing Care Retirement Communities
Continuing care retirement communities (CCRCs) provide multiple senior living options all on one expansive campus. It is most common for residents to move into a CCRC while they are largely independent. Then, if needed, they can move to other levels of care throughout their time there.
It is important to note that CCRCs that are considered life plan communities often have contracts that include an entrance fee based on local real estate costs. Then, residents pay a monthly fee that allows them access to the amenities throughout campus.
Adult Foster Care
Adult foster care programs offer a family-oriented living experience in a private residence for 1-6 seniors. These residences provide assistance with medication management, toileting, personal care, and household chores. Some participants may receive financial support to offset the costs of the program thanks to Medicaid.
Adult Day Care
Some older adults thrive if they are able to have a structured day, complete with socialization and interaction with others. Adult day care services offer a place for seniors to socialize, stay safe, and receive some care while family caregivers are at work during the day.
This senior care option works well for situations in which family members don't want to leave the senior alone during the day or for seniors who want to regularly spend time with others.
Weighing Your Options
There are many alternatives to nursing homes that offer seniors the personalized care they need in the environment that suits them best. If you aren’t sure what type of senior living solution could be best for your situation, download our free guide, “Senior Living Demystified.” You’ll get the information you need to begin your senior living journey with confidence.