Senior Living and Care Definitions:

Independent Living Communities provide residents an independent living setting without the burden of home ownership. Typically, residency is established on a monthly rental basis. Residents live in fully equipped private apartments or cottages from studios to large two-bedroom units that may be rental-assisted or market-rate depending on the community. Amenities and hospitality services such as housekeeping, linen service, transportation and social and recreational activities may be included, provided for an additional charge, or may not be available at all. Independent Living communities do not provide assistance with activities of daily living or personal care.

Assisted Living Communities are State-regulated rental properties where 10 or more residents may reside (however this # may vary a bit between states). Care assistance is available, including: medication management, bathing, dressing, toileting and eating. Apartments must be fully self contained private living units with a lockable door, private bathroom, and kitchenette facilities. The fee schedule is regular monthly rent along with additional fees for specific services and amenities. Assisted living communities are best suited for individuals who want to remain as independent as possible and who are able to direct their own care.

Memory Care or Dementia Communities offer or provide care for residents with Alzheimer’s disease or other dementia in a home like environment. These senior living communities, must receive an endorsement and is governed by additional regulations that are specifically intended to support individuals with dementia, including: a secure building that alerts staff if a resident has exited, a secure outdoor area that provides outdoor freedom safely, interior finishes that are non-glare and well lit, and visual contrasts between floors, walls and doorways. Alzheimer’s units must also have programs, which include: gross motor, self care, social, craft, sensory enhancement and outdoor activities.

Adult Care Home or Family Care Home are private residences that provides a home-like setting, and serves 5 or less residents. The caregiver may perform several functions, such as personal care, housekeeping and activities and group meals. There are three levels of Adult Foster Care Home licenses. The classification system is based on level of care the Adult Foster Home may provide to residents who live in the home as well as the experience and training of the providers and their ability to assist residents with: personal hygiene, mobility, eating, dressing, toileting, and behavior management. Residents may require very light assistance or may be dependent with several care needs; it is best to ask individual locations for their specific policies and license.

Skilled Nursing Facility (SNF) – these are sometimes referred to as a Nursing Home is a State-licensed facility that provides a safe, therapeutic environment for individuals who require rehabilitative care. Skilled Nursing Facilities offer 24 hour skilled nursing care and medical services by licensed nurses and support professionals. This is the highest level of care that can be provided that is not a hospitalization. Additionally, nursing facilities offer residents planned social, recreational and spiritual activities. (The term Nursing Home is considered a bit outdated.) This is a higher level of care for senior living, compared to that of assisted living or independent living.

Home Care – focuses on activities of Daily living (ADLs) such as bathing, dressing, medication assistance, incontinence care, transferring and other support services. These services assist individuals to remain in their homes (wherever home may be) or assist families in caring for elders living with them. Services can include Companion Care, Emergency Response Systems, Errand & Shopping Services, Housekeeping, Medication Reminders, Personalized Visitation.

Home Health – offer medical services in a home setting, therapists, medical social workers and health aids. The medical services such as changing wound dressings, checking vital signs, cleaning catheters and providing tube feedings; services can be provided on a daily hourly, weekly or 24/7 regular schedule. These companies are typically licensed by the state. Some agencies are Medicare certified and may be reimbursed for some services. Some HHA’s also offer Companion Care, which provides non-medical in-home assistance; Medicare does not typically reimburse for these services.

Hospice Care (Palliative Care) – emphasizes comfort measures and counseling to provide social, spiritual and physical support to the dying patient and his or her family. The goals of hospice are to keep the patient as comfortable as possible by relieving pain and other symptoms; to prepare for a death that follows the wishes and needs of the patient. Hospice care, is typically offered in the last six months of life and covered under Medicare Part A . Care takes place in the home or a home-like setting such as a nursing home, board and care home, or assisted living community and serves patients of all ages.

Information By State

How do I pay for home care services?

Although paying for home care can be expensive, there are many options for seniors and their families. Learning more about Medicaid, Medicare, long-term care insurance, and various state programs can help older adults as they navigate the financial aspect of long-term care.

  • Medicaid: Funding for those with limited financial resources may receive assistance with some or all of their care expenses from Medicaid.
  • Medicare: Available to all adults 65 and older. However, Medicare is meant for acute health episodes, and not long-term care. Those that are homebound, need skilled services, and require intermittent help may be able to receive some home health care services under Medicare funding.
  • Long Term Care Insurance:  Each policy is different, with some covering only nursing home costs- but many current policies allow for homecare services.
  • State Programs: Older adults that do not qualify for larger government programs like Medicaid may qualify for more local state programs, because states have greater freedom in establishing requirements for their programs.
  • Private Pay: Many families choose to perform many of the home care services for a loved one themselves. Yet, some seniors require skilled services. For families that do not meet eligibility requirements of certain programs, out of pocket funding may be unavoidable.
  • Non profit support: There are many other non-profit organizations, volunteer groups, or faith based organizations that may also help. Check your local area agency on aging for more information.