Senior Living Options in a Nutshell: Cliff Notes on Senior Living Models

Ideally, people prefer to be able to "age in place”. To have the ability to go through the aging process while living in the comfort of your own house. A house you have created so many memories in and a house you are proud to call home. It’s easy to take this gift for granted. We all live in our homes, create lasting memories with those we love, and go to bed at night in our own bed with our own pillow feeling independent, safe, and comfortable.

Some people consider trading this home with a home inside an independent senior living community. Most of these individuals are between the age of 55 to 60 and above. Perks to moving into an independent senior living community is living among people of this age group. Other reasons would be to have access to amenities that you wouldn’t have in your home including a clubhouse, fitness center, access to scheduled activities, transportation to scheduled activities, and other services that are specific to each community.

For other people, there may come a time in their lives when they have to give up their current homes and their living situation. It’s a double whammy really. As we age, our ability to be independent slowly begins to be compromised. We begin relying on our loved ones to help maintain the house, help with daily chores, and for some people, rely on others to take care of themselves. At our most physically vulnerable and emotionally sensitive stage in our lives, we are expected to make a choice of leaving our most secure and proud possession, our home. Worst yet, you may not make the decision by yourself. You mostly get the advice you’re your loved ones. Those who care about your high fall risk and the risk of hurting yourself while in the kitchen when making a meal. Those who want to prevent you from having a drastic accident leading to the emergency room and being hospitalized then discharged to a rehabilitation center or nursing home. After the hospital and rehab center, you wish you made the move to a senior living model earlier.

This sounds grim and depressing. But, it doesn’t have to be.

I have been lucky enough to be a part of success stories of people who have been forced to transition from their current home into a place they call home. Some people have been blessed to have a lot of caring people in their lives to support them during this transition. Others have little or no support. I’ve seen success stories with both.

The process of leaving your home is challenging. But moving into another home and later realizing that you made a big mistake and count the days you have to live there. Obviously, it’s most ideal to only make this big move once. The next facility you chose to move in to will be a risk. But, with legwork and extensive research, this risk can be a calculated one. This is why I’m passionate about Senior Living Link. Use their resources and searchable facility platform to acquaint yourself with the facilities available for you.

Begin this transition with the end in mind. Research the different types of senior living models. What type of services do you need for your current state and your future state 5 or 10 years from now? This is one of the most important things to consider. I have seen a lot of people making a decision to move into a facility only to move out for another one less than a year because of physical decline due to disease progression. Nobody can predict his future health status and well-being. But, take a good inventory of your health status and be as honest and as truthful as you can be about the services you need today and in the near or far future. If you are aiming to only move once, this is key.

I’ve put together a small chart below on the common questions get when people compare the 4 models of senior living.

	Independent Living Community	Assisted Living Community	Residential Care Home	Nursing Home/Skilled Nursing
Typical Age Group	55 - 60 +	82 +	82 +	Varies
Environment	Indwelling’s in a Community	Apartment Type	Shared Home	Institutional Like
Has a memory care unit	No	Some	Some	Some
Allows Home Healthcare Visits (Hospice, Mental Health, Registered Nurse, Physical Therapy, Occupational Therapy)	Yes	Yes	Yes	No, provides it in-house
Assists with basic needs: dressing, bathing, grooming	No	Yes	Yes	Yes
Assist with continence	No	Yes	Yes	Yes
Assist with transfers and mobility	No	Yes	Yes	Yes
Assist with Medication Management	No	Yes	Yes	Yes
Assist with Medication Administration	No	Yes with restrictions	Yes	Yes
Provides Meal Preparation	No	Yes	Yes	Yes
Provides assistance with eating (pureed diet, hand feeding)	No	Yes with restrictions	Yes	Yes
Provides Scheduled Activities	Yes	Yes	Some	Yes
Has full-time nursing staff for hands-on resident care	No	No	Some	Yes
Housekeeping/Laundry	No	Yes at extra cost	Yes	Yes

Independent Living Simplified

In a very simplified nutshell, independent living communities are more suitable for people who do not require hands-on assistance living their daily lives. Quality of life is enhanced because of the amenities and activity services the community offers. Each is different from the other and some have specialties like having dedicated grounds for golfing, for instance.

Skilled Nursing and Rehabilitation Centers and Nursing Homes Simplified

Nursing homes, or skilled nursing facilities, are an institution feel setting. They look and operate like a hospital but the patients are less acute and more stable. Because they are like hospitals, these facilities have their own in-house doctors, specialists, registered nurses, physical therapists, occupational therapists, speech therapists, and social worker or discharge planner. They also have the ability to conduct laboratory work. Many people live in these types of facilities temporarily until they are through with their rehabilitation and are in a more stable physical and emotional state.

Independent, Assisted, and Residential Care Homes don’t provide this in-home. Rather, they rely on home healthcare services. These agencies provide a medical team suitable for the resident medical needs. The caveat is that the resident has to be considered “homebound.” To be homebound means having the inability to travel due to physical, mental or emotional inability. If a person doesn’t qualify to be homebound, then families or the facility will be responsible ensuring that the residents are taken to their medical service providers.

Assisted Living Versus Residential Care Homes

Most common questions are the differences between assisted living facilities and residential care homes. (Note that different states name residential care homes differently, so for simplicity, I will refer to them as residential care homes.) Assisted living facilities are an apartment like setting and have licensed practical nurses (LPNs) or certified nursing assistants (CNAs) on staff to help residents with their daily functions like getting dressed, organizing their medications, providing meals, continence care if needed, transfer and ambulation attention if needed, etc. They also have an in-house activities coordinator to ensure quality and scheduling of social activities.

Assisted living facilities are limited to assisting individuals. Once a person becomes dependent on daily living tasks, their care needs are outside the limitations and scope of what the assisted living facility is licensed by the State. This resident will be asked to find a more appropriate living environment to meet their care needs as dictated by the State.

I have seen many families offer compensation for not having to move out of the assisted living home of their loved ones by hiring in-home caregivers from a private agency. This sometimes becomes very costly and so I often see people seeking residential care homes after dissipation of funds. I’ve also witnessed families who seek immediate residential care homes because they themselves have tried to take care of their loved ones so they wouldn’t have to move them out of the assisted living facility. Obviously, this solution is less ideal as well because not only are you not being the daughter or son that you want to be to your parent, but you are also not being attentive to your quality of life as well.

Residential care homes were designed based on this demand. They fill the gap of the people who require more hands-on care and attention than what assisted living model can provide but are more stable and not in need of rehabilitation that nursing homes and skilled nursing model provide.

Residential Care Homes Simplified

Residential care homes are single dwelling homes licensed for a limited number of residents, the number depends on the state, to share the facility. Each resident will have either a private or shared bedroom and will have access to communal areas such as a living room, kitchen, dining area, and bathrooms. Residential care homes have licensed caregivers who are working on the floor taking care of the residents. States have different requirements, but in the state of Washington, the ratio at its full capacity is 2 caregivers to 6 residents. That’s a 1:3 ratio! Like assisted living facilities, outside health care teams are allowed to visit residents in this model. And, if a person needs to transit into hospice care, they will likely not have to move. Some residential care homes do not accept hospice and so the resident will have to move to one that does. And, in this model, caregivers can provide more hands-on assistance with feeding, continent care, and medication administration. Each State varies in the requirements of the functions the homes can provide. Some care homes have scheduled activities, some don’t.

Residential care homes also have the ability to provide staffing if a person requires 24/7 attention. While some care homes do not offer “awake staff”, staff member or members whose shift begins when the day shift ends and when the day shift begins. The awake staff can have a cup of tea with a person if they are unable to sleep at 3 am, for instance. If a person suffers from insomnia, requires help when using a bathroom during sleeping hours, a care home with an awake staff is essential.

Memory Care Simplified

The specialty care needs of memory care are available in all the models except independent living. Some assisted living facilities to have a special secure unit for memory care. Others only service people with memory care needs. This is true for residential care homes as well. Some operate homes with residents of various levels of cognitive decline including end-stage dementia, others specialize in only providing care to residents with end-stage cognitive functions.

When considering moving into a senior living model don’t limit yourself to one type. Everyone has a different story and each story needs to be compared to each senior living model. One model may not be a perfect fit, but you will make a decision as to which model fits the best now and in the near future. Once you have familiarized yourself with the model that best suits you, you are ready to use the Senior Living Link platform to search for facilities in the areas you desire.

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Senior Living Options in a Nutshell | Senior Living Link