San Francisco Chronicle - (Sunday)
Choosing the best level of care for your loved one
Senior living arrangements typically balance on two often intertwining factors: How much autonomy the older adult wants and how much care they require. Those questions must be answered whether the older person ages in place in their own home or if they will reside in one of the many levels of senior housing.
The most important consideration is if they are capable of independent living. If so, there are several options to accommodate that. They can live independently in their own home or in an older adult based community if they prefer. The baseline for independent living is “are they able to manage activities of daily living”? Also are they able to administer their medications and get to their medical appointments on their own?
Han Hwang, executive vice president at caring.com, said, “There’s really what we call senior care and senior living. Senior care is really care at home. Senior living is when you leave your traditional home to go into a community specifically geared towards seniors.”
If living in their own home, there are services which provide older adult with inhome caregivers. Medical caregivers are typically nurses, which are more expensive, while nonmedical aides often provide companionship and prepare meals. There are also meal delivery services, along with laundry and cleaning services.
Outside of the home are independent living communities specifically for older adults that provide various levels of these services. The most significant benefit is that they place the older adult in a social setting in proximity to others. These communities can be private neighborhoods for older adults (minimum age requirements are usually either 55 or 62 but can vary). They also can be in the form of retirement homes, senior housing or senior apartments.
Older adults who may need no or only limited care currently may prefer to live in a senior community. These are often called 55plus apartments for “active seniors.” These older adults can get themselves up in the morning and don’t need help bathing or taking their medications.
“‘Active seniors’ basically
» “There’s really what we call senior care and senior living. Senior care is really care at home. Senior living is when you leave your traditional home to go into a community specifically geared towards seniors.” Han Hwang, executive vice president at caring.com
describes a senior community like an apartment complex where you have an age restriction. It’s just like any normal apartment,” Hwang said. The benefits of living in the community are accessibility of social activities and the homogeneity of the community.
“You’re in a community of other seniors, but you’re taking care of yourself,” he said. “You’re completely independent. You drive. You prepare your own food. But you live in a community of folks who are of similar age, a similar stage in life.”
There are other independent living arrangements, which provide amenities such as food preparation and transportation for those who no longer drive. The apartment may or may not have full kitchen facilities depending on the dining options selected. It is still independent living as the older adults can take care of their basic needs such as getting up and going
to the bathroom.
Many independent living facilities include light care options. “If you need a medication reminder, they’ll call you to remind you to take your meds,” Hwang said. “If you need help with an insulin injection, they’ll help you with that. Things that you have to do that are nonmedical related activities.”
The next level is assisted living where the older adult needs more care.
“You may need somebody to help you get up in the morning, help you get dressed, help you go to the bathroom,” Hwang said.
Assisted living plans typically include food preparation, cleaning and laundry
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services, which can be tailored to the specific needs of the older adult. These services are typically provided in residential care homes, continuing care homes or continuing care communities.
Then there is memory care specifically designed for older adults who have dementia.
“A memory care community is focused on making sure you can have a better living because they try to do activities to kind of remind you of who you are,” Hwang said.
These programs provide secure environments and also
handle the activities of daily living for the clients.
“A lot of folks who suffer from dementia end up in some form of memory care,” he said.
Dan Bishop, who owns Right At Home of Burlingame, is a specialist in assessing home care needs.
“We basically provide services to elderly people who are trying to stay in their home and don’t want to move into an assisted living facility,” Bishop said. “People who want assistance with the activities of daily living, shopping, running errands and helping them get to their medical appointments and things of that nature.”
Bishop’s company mainly provides nonmedical home care.
“Personal care becomes more hands on if someone needs help with showering, bathing, toilet, things of that nature, we’re not licensed for home health. The home health is more skilled nursing. That’s when people need injections, things of that nature. Our caregivers are home care aides, they’re usually not nurses.”
While there are many companies who provide these services, they are not all the same.
“You want to ask if the agency is licensed and you want to ask them if they have all the proper insurance in place,” Bishop said.
Some agencies hire their caregivers as independent contractors rather than employees and a lot of times they’re not licensed with the state, and they don’t offer insurance. Because of that, they can offer lower rates.
“Certainly ask those important questions about if they’re licensed and if they have insurance,” Bishop said. “Because when you allow what is initially a complete stranger into an elderly, vulnerable person’s home, it’s a real big vote of confidence that you’re putting in that agency.”