The Long-Term Care Spectrum

Different types of care facilities offer different levels of care, and your loved one may find that he or she needs to change care facilities several times as his or her condition changes.

Oftentimes, residents of care facilities are not able to stay in the same facility for the rest of their lives. Instead, a resident may move through what has been termed “the spectrum of long-term care” as his or her condition changes or as he or she requires more care.

This is especially important to remember if your loved one is considering a move to residential care. Before he or she signs any agreements, make sure you both understand how much care your loved one requires, and how much care the facility can provide. Think, too, about any anticipated future care needs. Carefully review any contracts or residents’ agreements. Be sure you understand the facility’s policies regarding moving out (including the refund of any deposits), as well as the circumstances under which your loved one could be forced to move (if he or she requires more care than the facility can provide, for example).

Generally, facilities at the beginning of the following list offer only basic residential services, such as housekeeping. In contrast, facilities at the end offer round-the-clock medical services and other specialized types of care. The normal progression of care facilities—from those allowing for the greatest independence of the resident to the least—includes:

  • In Home Services allow an individual to continue to live in his or her residence while receiving help with activities including meals, shopping, or nursing care. Depending on the circumstances, services provided range from minimal (e.g., housekeeping, shopping, or conversation) to extensive help with the care recipient’s activities of daily living (bathing, dressing, taking medication, etc.).
  • Independent Living Facilities or Retirement Communities allow individuals to live in their own house, apartment, or condominium, and often allow residents to purchase this residence. These environments often offer smaller services such as social activities, meals, or housekeeping for an additional fee.
  • Group Homes provide an independent living environment with only minimal services. These services are much like those offered in an independent living facility. Group Homes differ in that the individual usually co-owns or rents the home with a group of individuals who share the common areas of the living environment.
  • Congregate Care Facilities offer private living quarters with additional services, including transportation, housekeeping, or religious services. Like retirement communities, these residential communities offer the individual a chance to live around other seniors.
  • Assisted Living Facilities provide care for individuals who require help with more personal needs such as activities of daily living (e.g., bathing, grooming, toileting). They also offer less intensive services such as meals, housekeeping, or administration of medications.
  • Nursing Homes offer long-term care for residents who require 24-hour medical care under a doctor. The home also provides, room, meals, assistance with activities of daily living, and recreational activities for residents. Most residents in these homes have physical or mental impairments of such a nature that they can’t safely live alone.
  • Continuing Care Facilities cover the entire long-term care spectrum by themselves. They offer seniors a living arrangement that guarantees that care recipients will never have to move outside the community. In these communities, residents are encouraged to remain as independent as possible, but when they are no longer able to do so, they are moved to an attached facility that can accommodate their needs. Continuing care facilities are often expensive, and may charge a one-time fee based on the age, financial assets, income level, physical health, and mobility of the prospective resident.

In addition to the above facilities, there are some residential care settings that are not easily categorized. Be sure to look into the specific types of facilities available in your loved one’s area for more information.

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