Assisted Living and Long-Term Care: A Primer
Long-term care isn’t a topic most of us want to think about. As a health care admissions director for Bethany Village continuing care retirement community, I educate people in the pros and cons of the services available for the aging. Many times, I find myself delivering this type of information during a crisis, which makes careful consideration of their options very difficult.
I’m hoping this article will serve as a primer on the scope of services available in assisted living, what type of issues require skilled nursing care and the costs associated with them. Knowing as much as possible before you, a loved one or a parent needs supportive services is always the best strategy.
In a broad sense, assisted living is a lifestyle that supports people’s independence and strives to make it possible for residents to live with people who are physically, socially and cognitively similar for as long as possible.
Tasks that may have required asking for help – such as driving to appointments, cleaning, doing laundry or preparing meals – are provided for you in assisted living.
There are two rules of thumb that require skilled nursing care rather than assisted living.
Many assisted living communities offer graduated levels of services and prices. Those include:
Some states, including Pennsylvania, offer another option for long-term care called a Personal Care Home. These are a good option for individuals who need assistance with activities of daily living (dressing or bathing), medication management or memory support. They offer many of the same services as assisted living centers and are less expensive. However, Personal Care centers do not have to meet the same staffing requirements, staff education or “opt out of services” requirements, just to name a few things.
When you look at providing residents with the ability to age in place over the long term, assisted living often begins to look like the better choice.
Here’s a hypothetical example that explains the difference. If you’re doing research into Personal Care and Assisted Living, it’s important to ask what specific health services they can legally provide and what level of staff member would administer those. Let’s say Mrs. Smith lives in a personal care center and is admitted to the hospital because she contracts an infection. After a few days, the hospital is ready to discharge her, but she needs IV antibiotics. A personal care home might not be able to take her back; she would need to go to a nursing home where an RN is on staff until her IV antibiotics regimen was complete. That’s a lot of added stress for Mrs. Smith and her family members.
Confronting age-related decline is difficult for the person experiencing them and their loved ones. Acknowledging that those issues may require moving to a new home is more challenging yet. Keep in mind that moving during the midst of a medical crisis is the greatest challenge of all.
I see people every day who are in desperate situations – a parent has been injured and is unable to return home, a person with memory issues has gotten into a car and ended up lost for several hours, a relative has been found wandering outside in 20-degree weather.
Have a plan in place. Research your local aging services and long-term care communities. It is important to do this before a crisis limits your choice for the best possible care. Finally, schedule a tour of several communities to be sure that the one chosen is a good fit. In addition to these basic guidelines, the Assisted Living Foundation of America has evaluation resources on their website.
Long-term care costs vary widely across the United States. Here’s a national comparison of monthly assisted living charges.
At Bethany Village, in Mechanicsburg, Pa., daily rates start at $221 for people who are not already residents of our continuing care retirement community. Residents pay less. The highest assisted living rate is typically for memory support, due to staffing needs and security issues. Some of our competitors’ rates are slightly lower, but we feel our services, staff levels and training justify the additional cost.
Skilled nursing is more expensive. Our daily rates start at $355. Especially when you are looking at memory support, long-term care costs adds up quickly.
Medicare does not cover skilled nursing unless it is following a hospital stay for rehabilitation. Medicare will cover up to 100 days as long as the resident is making progress in a therapy program. Medicaid will cover skilled nursing if you meet your state’s financial need guidelines.