Choosing the Right Level of Care
Everyone has a desire to age with dignity, but when aging at home is not an option, how do you know the best choice for you or your loved one?
Aging at home
Much is being written about aging in place and in some cases this may be the right choice.
Aging in place is an option that is best suited for seniors who are functional in all activities of daily living (this is often abbreviated as ADL) which includes eating, bathing, toileting, dressing, maintaining continence, and transferring (getting out of a bed or chair). So for those who require limited or no assistance in getting around their home, the prospect is good for sustained independent living. Home modifications can be a rather easy and often less-expensive solution, depending on their needs and whether they are living alone or as a couple.
There are risks to aging in place. Home modifications need to be done to address safety and help prevent falls, one of the top reasons the elderly are placed in nursing homes. Aging in place is not appropriate for someone that cannot leave their home on their own to attend social events. The elderly population runs the risk of decline due to loneliness, helplessness, or boredom. Human beings need companionship and an aging loved one should not be isolated in their home for extended periods of time, as this has shown to lead to rapid decline in health and well-being.
One option is to move yourself or a loved one to a senior independent community, designed to provide access to emergency medical care and social activities. These communities are not equipped to assist in activities of daily living.
Board & Care
A board & care community is a step below independent living and a step above assisted living. Services are often limited, but an aide is provided to monitor safety. Residents have their own apartments and bathrooms and include dining and activity services.
The next step in the continuum of care is assisted living. Assisted living is best suited for those that need some supervision but do not require 24-hour nursing care. Many people feel like the best solution to caring for their loved one’s needs is to move them to an assisted living facility. Assisted living facilities provide basic help with daily care. Residents have their own apartment, meals may or may not be included, and activities are generally limited. Residents receive weekly housekeeping and laundry services as well as med-management. Residents receive limited help with ADL’s.
Recently there has been an increase in assisted living facilities keeping residents longer than they should. Some residents require a higher level of care and won’t receive these services in an assisted living environment as they are not equipped to handle acute care services.
How do you know if assisted living is the right choice in care?
There are different care levels to assisted living. (Utah State Law)
Type I facility:
Shall accept and retain residents who meet the following criteria: are ambulatory or mobile and are capable of taking life saving action in an emergency without the assistance of another person; have stable health; require no assistance or only limited assistance in the activities of daily living (ADL); and do not require total assistance from staff or others with more than two ADLs. Level one aides are not required to be certified.
Type I facility:
May accept and retain residents who meet the following criteria:
Require total assistance from staff or others in more than two ADLs, provided that: the staffing level and coordinated supportive health and social services meet the needs of the resident; and the resident is capable of evacuating the facility with the limited assistance of one person.
Are physically disabled but able to direct their own care; or are cognitively impaired or physically disabled but able to evacuate from the facility with the limited assistance of one person. Level two aides must be certified.
Type I and Type II assisted living facilities shall not admit or retain a person who:
(a) manifests behavior that is suicidal, sexually or socially inappropriate, assaultive, or poses a danger to self or others;
(b) has active tuberculosis or other chronic communicable diseases that cannot be treated in the facility or on an outpatient basis; or may be transmitted to other residents or guests through the normal course of activities; or
(c) requires inpatient hospital, long-term nursing care or 24-hour continual nursing care that will last longer than 15 calendar days after the day on which the nursing care begins.
Nothing brings more fear to an elder than the term nursing home. Nursing homes are notorious for creating ridged institutional environments that strip the resident of their autonomy, privacy, dignity, and respect.
Nursing homes are appropriate for those that need 24-hour medical care due to disease, disability, or cognitive decline. Nursing home staff are licensed professionals and provide extensive ADL services, dining and nutrition services, medication and pain management, and extensive therapy services. Nursing homes provide extensive activities, wound care, IV treatments, and tube feeding. Nursing homes are tightly regulated through the state and federal government.
The key is whether you choose a traditional nursing home or a Culture Change community. Culture change homes provide excellent nursing and medical care, but keep the home relationship-centered. Residents enjoy an environment similar to an assisted living facility, but have access to all the care that a nursing home offers.
Memory Care Communities offer programs designed for those with cognitive disabilities such as dementia and Alzheimer’s. Specially trained staff offer access to activities designed to meet their needs and cognitive level, preserving their memory and physical stamina as long as possible. Memory Care Units can be provided at both the Assisted and Skilled Nursing Level.
Check out our culture change homes in care communities!