What Is Senior Care?
Senior care involves two main kinds of caregiving for people 55 and up: personal care and medical care.
- Personal care services help people accomplish "activities of daily living" or ADLs. Examples are bathing, getting dressed, preparing meals, and taking medications as prescribed.
- Medical care ranges from basic healthcare services to those requiring highly skilled workers. Examples are blood pressure monitoring, wound care, IV infusions and physical therapy.
A major subset of senior care is memory care, which can be combined with the above. Various memory therapies may help ease confusion, anxiety and other symptoms of Alzheimer's and similar diseases. For some patients memory care may also slow the rate of cognitive decline.
Where Is Senior Care Provided?
Senior care can be provided in-home, in assisted living centers and nursing homes, and in day care settings.
Usually in-home senior care is limited to companionship, personal care support and basic medical care. Often formal in-home care begins as respite for the person's partner or spouse; a home care worker lets the usual caregiver rest or take time to handle other responsibilities. As explained in our in-home care guide, respite care may be free or low-cost. More extensive personal care support might be covered by personal income, private insurance or Medicaid.
As needs increase in terms of the hours or medical expertise required, it might become more cost-effective for the senior to relocate. Still, it's possible for most hospital-level services to be provided in-home thanks to the development of portable medical equipment (e.g., compact dialysis machines) and other healthcare technologies. Medical expenses might be covered by private insurance, Medicare or the Veterans Administration.
Outside of a traditional home, what are the caregiving options? The next section looks at senior care in different kinds of senior-specific living communities.
Senior Care Choices in Different Settings
Apart from staying in their longtime homes, people ages 55+ have three major alternatives for housing: active adult communities, assisted living homes and nursing homes. Each senior living setting is generally associated with a different level of required care -- but it's important to know about overlap. The phenomenon of "continuing care" explains how, for instance, help with chronic medical conditions could be provided in a community of mostly healthy active seniors.
Here are overviews of different senior living settings as they relate to senior care choices.
Active Adult Communities
Active adult communities are also called independent living communities and retirement communities. As the terms "active adult" and "independent living" suggest, most residents aren't in need of senior care. Nonetheless there are several common ways to get personal care and/or medical care within active adult communities.
- Senior Care in Traditional Retirement Communities - Examples of traditional retirement communities are seniors-only apartment complexes and age-restricted condo communities. Generally people move to these settings when they're still independent. If the need for senior care arises, and they would rather not move away, then privately arranging for in-home care is the solution.
- Continuing Care Retirement Communities - Retirement communities with "continuing care" are set up for all levels of need: independent living, assisted living and skilled nurse care. Residents can move among the three setups.
Payment for continuing care retirement homes is made in advance at move-in to the retirement community. Each resident pays a large lump sum -- enough to cover potential long-term care needs, even if they're presently in good health. This high entrance fee brings the peace of mind that senior care costs are handled until the end of life. A high percentage of any unused funds are distributed to heirs.
- Continuing Care Assisted Living Homes - When an assisted living home offers continuing care, typically it has a separate residential area for people who need skilled nurse care. Many continuing care assisted living centers offer memory care in secured areas as well.
Approaches to memory care vary but some continuing care facilities have rooms specially designed for multi-sensory experiences that may be therapeutic for those with Alzheimer's disease, other kinds of progressive dementia and traumatic brain injury.
- Senior Cohousing - Cohousing combines private homeownership with communal neighborhood property and shared services. Management is by the neighbors themselves, not a private group or the government.
In specifically senior cohousing, the community is designed to support senior care as needed. Members of the community might start off as active independent adults, for instance, and years later collectively contract for services like daily transportation, meal preparation and home health care.
Assisted living homes, also called personal care homes, are for people in need of personal care support. Health aides and other staff help residents with activities of daily living (ADLs) such as bathing, dressing and transportation. Usually for Medicaid or private insurance to make payments, a person needs to require help with at least two ADLs.
If skilled medical service becomes a need, generally the resident relocates unless the facility is a continuing care assisted living center. (Continuing care adds nursing home services.) To avoid moving it may be possible to hire private medical caregivers.
Some assisted living homes also provide memory care for those with symptoms of Alzheimer's disease and other forms of dementia.
Nursing homes generally serve seniors who have chronic medical conditions that require skilled care. They also serve those with temporary needs for medical care after illness, injury or surgery. Some nursing homes offer memory care as well.
Nursing homes are typically the most expensive housing choices for senior care. This is because of the medical equipment and medical care provided in addition to personal care, room and board. Our guide to nursing home care explains payment options including long-term care insurance, VA funds, Medicare and more.