Retirement
Seniors who live in CCRCs can select a service plan to suit their needs, abilities and preferences. Typical assisted-living services include recreational, social and educational activities; transportation; emergency help; housekeeping; meals; assistance with daily living; and personal assistance.

ASSISTED-LIVING FACILITIES
These housing options combine a level of independent living with some assistance for personal care. They provide care to residents who cannot live alone but do not need 24-hour nursing care. Assisted-living communities offer residents the privacy of their own bedroom, often with a small kitchen. Most offer meals in a community dining room, snacks, laundry services, housekeeping and assistance with personal needs, such as bathing, dressing or medication supervision. These facilities are not designed for people who need serious medical care, but there are some facilities for people with Alzheimer’s, dementia and memory loss.

The fact that assisted-living facilities are state regulated can offer family members peace of mind, but that does not mean less effort should be given for selecting the right one. When looking for an assisted-living facility, experts say it’s important to find one that offers a wide range of services while also having an ambiance that appeals to the resident. Collaboration between the potential assisted-living resident, family members, physicians and the facility manager will ensure that the balance between care and comfort is met. Next, determine all the available options, utilizing the same resources as for retirement communities.

Make an appointment to visit the managing director or director of the assisted-living facility. At that time, make sure the registered nurse is present at the meeting and make sure you obtain a disclosure statement that will tell you all the things the community can and will do for your loved one. Ask the cost of the facility and whether that is the total or if the facility offers levels of care, meaning the facility can add costs to everything it does for your loved one. Ask what the cost covers and how medications are given. Talk to residents and eat a meal there; food plays a big part in the residents’ lives.

Assisted-living residents can be young or old, affluent or low income, frail or disabled. A typical resident in an assisted-living facility is a widowed or single woman in her 80s. Residents may suffer from memory disorders or simply need help with mobility, incontinence or other challenges. Assisted living is appropriate for anyone who can no longer manage to live on their own but doesn’t require medical care.

Once a decision about a community has been made, review everything and ask questions if you do not understand. Ensure that everything is spelled out and clear. If you don’t feel good about the place, it’s probably not the best option. Pay close attention to what is going on and how you feel.

RESIDENTIAL-CARE HOMES (PERSONAL-CARE HOMES)
These group-living facilities, usually single-family homes, are designed to meet the needs of people who cannot live independently but do not need nursing homes. These homes provide some type of assistance with daily living activities, including eating, walking and bathing. Some homes provide skilled nursing, rehabilitative services or specialized care for illnesses, such as Alzheimer’s.

SKILLED NURSING FACILITIES
A skilled nursing facility is staffed by registered nurses (RNs) who help provide 24-hour care to people who can no longer care for themselves due to physical, emotional or mental conditions. A licensed physician supervises each patient’s care, and a nurse or other medical professional is almost always on the premises. Most nursing homes have two basic types of services: skilled medical care and custodial care.

Skilled medical care includes services of trained professionals that are needed for a limited period of time following an injury or illness. Skilled care also may be needed on a long-term basis if a resident requires injections, ventilation or other treatment.

Custodial or personal care includes assistance with the activities of daily living, such as bathing, dressing, eating, grooming, getting in and out of bed or walking around.

People who are able to recover from a disabling injury or illness may temporarily need the custodial care as they are getting back the strength and balance to be independent again. For people who are losing their ability to function independently due to chronic disease and increasing frailty, custodial care may be a long-term need.

In the most severe cases where a person is bed-bound, ongoing supervision by an RN is necessary along with the custodial care to ensure proper hydration and nutrition and to prevent skin breakdown. If a custodial-care resident becomes ill or injured, they may spend a period of time in skilled care and then return to custodial care. Whether a resident is under skilled or custodial care is important in terms of who provides the care and who pays for the services provided.

   
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