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Elderly Care Options

Factors in the Eldercare Decision

Knowing that an elder requires care is one thing. Figuring out what sort of care arrangements can be made to address those care needs is another thing entirely.

What Types of Eldercare Are Available?

The many different types of eldercare available to families and are broken down into two major categories: family providing care and professionals providing care. There are six types of professional care; in-home licensed or unlicensed care, adult day programs, independent living facilities, assisted living facilities, a continuum of care facilities, and dementia facilities. Each care arrangement offers advantages and disadvantages and may be more or less appropriate depending on elders' needs and desires and the family's needs and constraints.

Adult Day Programs

Adult day programs offer elders supervision and care in a structured setting during daytime hours. More specifically, they offer elders the opportunity to participate in structured social and personal activities, receive basic medical and therapy services, or participate in educational programs. Adult day programs come in two varieties, which may or may not co-occur. Some programs emphasize social interaction and, separately, programs that exist to fulfill medical needs. Most all-day programs are community-based and generally available only during regular business hours, Monday through Friday. Enrolled elders may attend programs one or more days each week.

Family Provided and In-Home Care

Family-provided care can occur in two ways: Either elders at home with family members providing them with assistance or the elder move into a family member's home. In either situation, in-home professional health workers may still be needed to provide care during work hours or other times when responsible family members cannot be present.

There are three main categories of in-home workers: housekeepers and chore workers, homemakers, and health aides. Housekeeping and chore workers are hired to take care of basic household tasks, including getting the laundry done, dusting, cleaning, doing yard work, or running errands. Homemakers assist with more in-depth household management and may do tasks including meal preparation, personal care services (such as assisting with bathing or dressing), and making sure that medication gets taken at scheduled times. A homemaker may be employed directly by the elder or family or work for an agency.

Independent Living Facilities

Independent living facilities offer elders the opportunity to rent or purchase apartments or condominiums within a complex or campus, offering recreational and social activities and sometimes transportation services. Residents live independently while being part of a community of others in similar circumstances. The primary benefit of independent living facilities over conventional living situations is the recreational and social opportunities they offer residents and the assistance such social opportunities may provide in preventing social isolation and depression.

Assisted Living Facilities

Assisted living facilities are sometimes referred to as residential care, community-based retirement care, personal care, or adult foster care facilities. They offer residents comprehensive help with activities of daily living but also feature an essentially independent living arrangement. Elders generally will occupy their own unit or apartment within the facility from which they can come and go as necessary. They will also have access to personal care workers as necessary to assist with their care needs. Skilled nursing services are not available on-site, by and large, but basic health services may be offered. Recreational and social activities are also made available to residents.

Nursing Homes

Nursing homes provide care for elders requiring constant, "round the clock" care. Care is provided by licensed health professionals, including registered nurses (RNs), licensed practical nurses (LPNs), and nurses' aides. Elderly nursing home residents will reside in a room within the facility that may or may not be private. Housekeeping and linen services, meals, and care from the medical staff and a social worker are included. Elders may also be offered on-site social and recreational activities.

Continuum of Care Facilities

Continuum of care facilities offers elder residents the widest range of care options. Private independent living arrangements are the basic feature of such facilities, with services added in a la carte fashion to assist residents as necessary, from basic assistance with daily living activities through skilled nursing services usually only available from sub-acute nursing homes. Assistance with daily living activities, including cleaning and laundry services, meals served in a common area, grounds maintenance, and security services are offered, as are social and recreational programs. Available health services range from personal care to rehabilitation, hospice, or Alzheimer's services.

The wide range of services available in a continuum of care facility makes them particularly suited to elders with progressive conditions that will cause them to decline over time and require increasing care levels. The care facility continuum offers the most flexible combination of independent living and care as residents' care needs increase over time. By offering a full range of care in one place, these facilities lessen the number of times elderly residents must move as their care needs increase.

Dementia Care (Alzheimer's) Facilities

The final type of eldercare facility to discuss specializes in elders' care with Alzheimer's disease or other forms of dementia. This type of facility provides comprehensive assistance with daily living activities, has skilled nursing available on site, and may offer a moderate range of social and community activities. Depending on state regulations, they may also administer medication. Elders are usually offered a private or semi-private room, meals, and laundry and housekeeping services. Fees are generally paid through a combination of private and Medicaid funds.

Does Medicare Pay for Assisted Living?

Medicare is the federal health insurance program for people age 65 and over, some younger individuals with disabilities, and some individuals with end-stage renal disease. Like other health insurance plans, Medicare does not cover long-term care services. Therefore, Medicare does not pay for the cost of room and board or personal care in an assisted living facility.

Does Medicaid Pay for Assisted Living?

Often confused with Medicare, Medicaid is a joint federal and state program that helps people with low income and limited assets cover health care costs, including long-term care. According to the Centers for Medicare and Medicaid Services (CMS), "Each state sets its own guidelines regarding eligibility and services," but they must meet federal requirements.

Most states offer long-term care Medicaid beneficiaries some level of financial assistance with assisted living costs, either through regular Medicaid or Medicaid waivers. However, Medicaid does not cover the cost of basic room and board the way it does for residents of nursing homes.

Personal Funds

Most seniors use their income and retirement savings to pay for independent living. Other sources of funds include distributions from retirement accounts, income generated by investments, such as interest and dividends, and liquated assets.

Social Security Benefits and Pensions

Elders receiving Social Security retirement benefits and other types of pensions can use this income to help cover senior living expenses.

Using Long-Term Care Insurance to Cover Assisted Living Costs

Long-term care insurance (LTCI) is a policy that is purchased through a private insurance company to cover the costs of elder care, including assisted living. Like health insurance policies, the price of the premium varies greatly depending on factors like the insured's health status, age, and amount of coverage. In fact, the best time to buy an LTCI policy is between ages 40 and 50 when a person is still in fairly good health

Applying for VA Benefits to Pay for Assisted Living

The U.S. Department of Veterans Affairs (VA) offers pension funds to some eligible wartime veterans (and their surviving spouses) with low income and limited assets. The Aid and Attendance (A&A) benefit is an "increased" monthly pension that many veterans and their families do not know about it. This higher pension amount is awarded to eligible veterans and surviving spouses who require the assistance of another person to perform activities of daily living (ADLs), such as bathing, dressing, toileting, and feeding. Assisted living facilities provide these kinds of personal care services.

In 2020, an eligible veteran may receive up to $1,911 monthly, a surviving spouse with no dependents is eligible for up to $1,228 monthly, and a veteran with a non-veteran spouse is eligible for up to $2,266 monthly through the A&A pension program.

Using a Reverse Mortgage to Pay for Assisted Living

An older adult who owns their home outright or has only a small mortgage can convert some of the equity in their home into cash payments while still retaining ownership.

Relying on Annuity Income to Fund Long-Term Care Services

An annuity is a contract between a person and an insurance company that is designed to meet retirement and other long-range financial goals. There are a few different types of annuities, each with different features, pros, and cons. You may make a lump-sum payment or series of payments and, in return, the insurer agrees to make periodic payments to you.

Call us today to speak to one of our Senior Care Specialists at 786-391-1478.

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