Long-Term Care Services

As our population ages, increasing numbers of individuals will require long-term health care services. There are many styles and categories of care, and they often overlap. However, the major types are outlined below.

Independent Living is essentially a retirement apartment complex, but meals, transportation and medical assistance are often provided. There will be no need to get the roof fixed or the plumbing repaired. No one can be expected to check to see whether the elder is clothed and clean, whether he/she is ill, or who is coming and going at the apartment. However, there are many other residents nearby for social interaction, who may get to know the resident’s family and report concerns. Entertainment, laundry facilities and transportation are often available, and medications may be administered by the staff. Other arrangements will have to be made if the minimal rules of social behavior, hygiene or safety cannot be followed. The cost of this type of facility will vary greatly depending on the elegance of the apartments and common areas. Medication distribution, hair care, transportation and other supplemental services will cost extra.

Assisted Living facilities have become quite popular for those who need an increased level of attention somewhere between independent living and traditional nursing home care. The cost is less than the price of a nursing home, and is determined by the choice of care level from the 2 or 3 levels of individual attention offered. For example, the resident with one level of care may come to the medication station to receive the dosage ordered, but a higher level could involve delivery of the medication to the resident in his/her room and supervision while it is taken. Individual “apartments” may be locked, but these facilities usually offer limitations on entry and exit to discourage wandering outside for those who have diminished mental capacity. Nurses are on call rather than constantly on the premises, and there is usually a choice of 1-2 doctors if medical care is not continued with outside health care providers. Laundry and housecleaning are usually included in the basic cost. A move will be expected if the elder becomes combative, requires a two-person transfer from bed to chair, or is so ill as to require constant health monitoring.

Skilled Nursing care offers the highest level of medical and personal care, and it is the only choice for 24/7 supervision. short of having a dedicated caregiver live in the home or round-the-clock home care workers present. Even in a nursing home, falls are a great risk because the movements of the elder cannot be watched constantly. Personal care may not meet the expectations of the family because of staffing limitations, which is not a permissible excuse for these failures.

Attendant Care – this is a relatively new type of service which can supplement any of the above levels of care. An advocate who will come at different times and days, check on hygiene and other physical needs, monitor hearing aid batteries and provide outings and companionship can make up to some degree for the lack of privacy and other downsides of the more limited residential options. Daughters & Company® is an excellent example of this type of service. The website is www.daughtersonline.com.