Write a commentIf you were heading across country on a vacation, is it safe to say you would not walk out the door, get in your car and start driving without thinking much about it? Would you head out without having a plan, a map or a little idea of what is out there in the world before you?
Although spontaneity has its place and certainly can allow for some flexibility and even fun, this may not be the right approach to planning your future and ensuring your healthcare needs are met.
While no one can predict the future, educating yourself paired with a little planning can make the difference for you or a loved one as aging takes place and healthcare needs change. Continuing to thrive as you age means learning how to maintain your independence for as long as possible. This may mean modifying your own home, or it could mean moving to a housing facility with support options on site.
With such a broad array of housing options available to seniors and a laundry list of names and terminology that can make your head spin, the process can become very become daunting.
Aging in place is preferred by many adults as the years creep up on them. It has the advantage of being in a familiar place and you know your neighbors and the community. There is a wide range of home care services that can help you maintain your independence within the comfort of your own home. This may be a good option if:
• A close network of nearby friends and family is present
• Transportation is easily accessible
• Your neighborhood is safe
• The home can be modified to reflect changing needs
• Home and yard maintenance is not overwhelming
• Physical and medical needs do not require a high level of care
• You have a personality that will keep you within reach of social support
Aging in place is a less effective senior housing option once mobility is limited. Isolation, loneliness and depression along with safety will all contribute to need for additional options.
Independent Living refers to housing that is restricted to older adults, or may include younger adults with disabilities. Also sometimes referred to as retirement communities, retirement homes, senior housing, and senior apartments; here you will often find a tenant-landlord relationship where there is no responsibility on the owner/operator to provide supervision or care. Home maintenance and upkeep is provided to you and you will sometimes find recreational centers, or common areas for social opportunities. You may want to consider independent living if:
•You are independent in all activities of daily living but are feeling overwhelmed by the responsibilities of home ownership.
•You would like a place that does not require a great deal of maintenance and upkeep.
•You like the idea of socializing with peers and having activity options nearby.
This type of housing is usually not licensed or monitored by housing agencies. Payment options include; private resources, HUD subsidized housing or Section 8 certificates.
Independent Senior Housing with Services is an option that will often include apartments with one or more of the following supportive services: meals, housekeeping, transportation, socialization activities, laundry, and sometimes personal / home care services are available through a licensed home care agency at an additional fee. This may be the right choice if:
Needing minor assistance with activities of daily living now or anticipated in the near future.
• You would like a place that does not require maintenance and upkeep.
• You like the idea of socialization and staying connected to your community having access to transportation, services, and networks.
• You are having difficulty preparing meals, or getting to the grocery store.
Payment options include; private resources for rent however services provided by a licensed agency can be paid for by long term care policy (dependent on the policy terms).
Enriched Housing is a program that provides older adults with an apartment type setting, with a package of services that includes; meals, housekeeping, shopping, transportation, social activities, and some personal care services. Enriched housing may also include medication administration. This program is licensed and regulated by the department of health. Consider enriched housing if:
• You are home alone and are socially isolated.
• Meal preparation and good nutrition has become difficult or non-existent
• Taking care of household chores such as laundry, cleaning, and upkeep are becoming difficult or overwhelming.
• Mobility is good however assistance with personal care and/or ADL's is needed now or will be needed in the near future.
• Managing medications has become overwhelming.
Payment options for Enriched housing include; private resources and long term care policies (dependent on the policy terms).
Assisted Living is a term that until 2004 was used quite loosely by many housing facilities. Some Assisted Living facilities provide apartment-style living while others provide shared and private rooms. Today, an entity that uses the term "assisted living" must be licensed and regulated by the State and must provide for or arrange for the following:
• On-site monitoring 24/7
• Daily food service; three meals per day
• Personal care services and home care services including help with the activities of daily living (ADL's); dressing, grooming bathing, and eating
• Case Management
• Housekeeping / laundry
• Activities and recreational opportunities
• Medication assistance and supervision
It may be time to consider assisted living if:
• You simply need more personal care services than are feasible at home or in an independent living community.
• You do not need the 'round the clock' medical care and supervision of a nursing home.
• Having social opportunities are important to you and remaining and sustaining your independence in the areas that you are still able to do so is preferred.
• You have experienced a decline in mobility and need assistance or will need in the near future.
The Assisted Living model can serve individuals who might be medically eligible for a Nursing Home / Long Term Care setting, but due to the stability of their medical status can be served in this less restricted environment. Payment options include; private resources, long term care policies (dependent on the policy terms), Medicaid, and SSI (Supplemental Security Insurance).
Skilled Nursing Facility is the highest level of care for older adults outside of a hospital. It is in a nursing home where you will find 24-hour-a-day skilled nursing care and related services, or rehabilitative services for the injured or disabled. Skilled nursing care and medical professionals such as occupational or physical therapist are also available. Nursing home requires the completion of a Patient Review Instrument (PRI) prior to placement.
Nursing homes will often offer care ranging from post-hospitalization rehab for injuries like broken bones to sub-acute, skilled nursing and specialized dementia units. A long term nursing home placement most often occurs when a person needs either ongoing, daily physical assistance with activities such as eating, dressing, bathing, and toileting with at least one person or two person assisting, or daily ongoing skilled nursing care.
New York State's nursing homes are regulated by the State Health Department.
A nursing home may be a good choice if:
• Both medical and personal care needs have become too great to handle at home or in another facility. This may be due to a recent hospitalization, or a chronic illness which has gradually been worsening.
• You need a higher level of care temporarily after a hospitalization, but it's anticipated you will be able to return to home or another facility after a period of time.
Payment options include; private resources, long term care polices (dependent on the policy terms), Medicaid, SSI, and Medicare for short-term rehabilitative care.
Now that you know your choices, don't be shy, you have figured out the different places on your trip, now why not go out and explore! Next month, we will talk about "shopping your options" and what consumers should be asking and looking for when choosing a setting.
