As we age we often come to need help with various things. Those we get to help us are our caregivers. These service providers can be as simple as a boy that mows our lawn or as complex as skilled nursing care, and everything in between. This is where we discuss some of your options and what to look for. To begin, lets look at some of the terminology within this area.
Levels of Care. The professions assisting the aging frequently use terms that refer to different intensities of care giving, frequently associated with differences in the place of one’s longer-term residence.
The first level of care is Home Care. Here the aging person continues to live in their home and obtains services to allow them to meet their needs while there. Differences in the intensity of care giving tend to be driven by the person’s needs, their affluence, and the services available in their community. The services utilized may be provided by family, friends, individuals hired locally, or professional services available in the community.
A somewhat more intensive level of care is Assisted Living. Typically in a non-home facility, these services vary widely in the intensity of care giving provided. Some provide very minimal care giving, such as house cleaning services and reminders to take medications, etc. Others provide more intensive care giving which may include providing meals, assistance with bathing or dressing, etc. Depending on the person and the services available at the facility, the care provided may be quite extensive. Assisted Living facilities often resemble apartments or condos. Like in an apartment, the building and grounds are maintained by the facility and the residents generally will have no such duties they need to perform. The Aging residents frequently develop strong friendships and may travel together on trips or outings.
The next most intensive level of care is care in a Nursing facility. Nurses, frequently LPNs (Licensed Practical Nurses) and their Aides, assist residents with toileting, bathing, dressing, grooming, medications and meals. This type of facility falls within the range of what most people would describe as a nursing home. It is not uncommon for residents to share a room with another resident. Nurses will come and go throughout the day providing medications, food and attending to the resident’s personal needs. The most common problem impelling one to enter a nursing home is incontinence.
The most intensive level of care is a Skilled Nursing facility. Typically medical services requiring respirators and IVs (Intravenous feeding and medications) and other medical procedures that require the skilled care of an RN (Registered Nurse) are only found in Skilled Nursing facilities. Typically residents of a Skilled Nursing facility will also include people that have nursing needs very similar to those at a simple Nursing Home. The distinction is drawn when a patient requires the more specialized care of an RN. Nursing homes that can provide this level of care are designated as Skilled Nursing facilities. This skilled level of care is not offered by simple Nursing Homes.
Hospital care is generally seen as short term. While it may be very intense care and provide extensive kinds of services, this level of care is not normally considered part of the standard Levels of Care, which are generally considered to be of a long-term nature.
While the above descriptions make it sound as if there are clear differences/divisions between these levels, in practice there is often quite a bit of overlap. With money one can provide almost all the services needed in one’s own home. Some skilled nursing services will frequently require a nursing facility.
The Commission on Aging
and Special Needs Citizens