Differences Among Types of Senior Care

We often refer to all long-term residential care for elders as “nursing homes.” But the differences can be significant, both in levels of care and levels of cost. If you are searching for the right place for your elderly parent or relative, it is important to know exactly what type of care will be provided. Your choices may be limited by the level of care your loved one requires, because not all residential care facilities offer all types of care.

Useful Definitions

Helpful definitions for researching types of care include:

  • Skilled (Nursing) Care vs. Custodial Care. Custodial care is considered non-skilled and usually involves help with activities of daily living (ADL), such as eating, bathing, dressing, toileting, and so on. Skilled nursing care is provided by a licensed or trained medical professional, often a registered nurse (RN), or a speech, occupational, or physical therapist.
  • Assisted Care vs. Memory Care. Memory care is intended only for those with dementia issues. It is not the same as assisted care, which provides personal care that is not focused on those with dementia. Assisted care is usually custodial.
  • Home Care vs. Home Health Care. Both of these types of care occur in the patient’s home. However, home care is custodial, while home health care requires medical training and is usually the same as skilled nursing care. Sometimes home health care workers also provide custodial care services.
  • Hospice Care vs. Palliative Care. Palliative care is meant to relieve pain and suffering without focusing on a cure. Hospice care, while it frequently includes palliative care, is meant for those considered to be in the last weeks or months of their lives.

Residential Care Options

When it comes to long-term care, four options exist besides at-home care. Each of these varieties of care can go by different names:

  • Independent Living Communities (ILC). ILCs consist of homes within a community that can offer recreation, transportation, and security services, but not any skilled care or custodial care services. They are for elders who can live on their own without daily care assistance. Some communities can be as luxurious as exclusive country clubs. ILCs can be called Senior Living Communities, Senior Housing, Senior Apartments, and Retirement Homes. Sometimes ILCs are called Retirement (Rental) Communities, but are not the same as Continuing Care Retirement Communities, described below. ILCs are usually the least expensive option.
  • Assisted Living Communities (ALC). An ALC usually consists of an apartment community and provides 24-hour custodial care assistance with the activities of daily living. However, they do not provide 24-hour medical assistance or skilled nursing care. If a person needs medical assistance, they often must leave the ALC. Such facilities can go by many different names, a few of which are Adult Foster Care, Adult Living Facilities, Sheltered Housing, and Group Homes.
  • Skilled Nursing Homes (SNH) or Skilled Nursing Facility (SNF). SNHs/SNFs are communities consisting of rooms or small apartments, shared or private, providing both 24-hour custodial care and skilled care by therapists and nurses. Doctors are often on call 24 hours a day. These facilities are intended to meet all needs: medical, personal care, and social. SNHs can also be called Nursing Homes, Skilled Nursing Facilities, Rest Homes, Convalescent Homes or Hospitals, and Nursing Home Care and Rehabilitation facilities.
  • Continuing Care Retirement Communities (CCRC). A CCRC usually offers the full gamut of care from independent living all the way to skilled nursing and hospice (end-of-life) care. They are intended to allow elders to live at the CCRC as their health declines, never needing to leave in order to obtain other services. They can be called Life Care Communities or Facilities, or Continuing Care Retirement Facilities. CCRCs are often the most expensive of the long-term care options.

If you are searching for a long-term care facility, be sure you know which type of place you are visiting, exactly which services will be available and at what cost, and what total costs are likely to be.

Keep in mind that just because a facility costs a lot of money this does not mean that it is free from elder abuse. When you are considering a long-term care facility for your loved one, always do your homework to minimize the chances of elder abuse, neglect, and harm. It is always a good idea to search the nursing home ratings on Medicare’s web site, as well as court records if you can, in order to determine whether the beautiful location you are considering is not so lovely to live in.