When the time comes
You’ll know. Your mom or dad or grandparent can no longer live in their beloved house or apartment. They simply need more attention, all the time. Changing residences will be one of the toughest decisions you and they will have to make.
Get it right
Keep this in mind: The very first place your loved one moves to may not be their last care setting. We know decline in aging can come quickly. So, look at every change as a kind of stepping stone to the next. It will help you make better decisions as you go. And remember, too: This knowledge won’t save you from making mistakes along the way. But it will help guide you and begin discussions.
The levels you’ll encounter
Beginning at the ‘lower’ end of elder care settings, find Senior
Independent Living.
Simply… a place to live with other aging folks. As a rule, it will be almost indistinguishable from the apartment complex down the road. Hands-on care is not supported at this level. But some care is delivered: meals, transport, housekeeping, activities, etc. This is a great first option because seniors interact with one another, countering the loneliness of social isolation, with some support provided.
Also… if a senior needs temporary, limited support, it’s easy to provide in this setting. This care level costs more than apartment living only.
The next step upwards (more care) in elder living is called Assisted Living.
Just as its name implies, the residents in this type of setting get some care. The determination of how much care… and who pays for what… is where folks encounter problems. Assisted Living always includes meals, laundry, medication assistance and 24-hour supervision. This level of care costs more than Independent Living, of course. How much more will depend upon how much assistance is offered/utilized. (There are almost always ala carte costs associated with this level of care.)
The next step up in care is called a Skilled Nursing Facility (SNF).
Almost everyone calls this level of care a ‘nursing home’. (State health department rules are very strict about when a facility can call itself an SNF) At this level of care, all of a senior’s care needs are provided by SNF staff. There are well-defined rules about the number, caliber and duty hours of aides, nurses, therapists and doctors employed there. Because so much care is offered, usually around the clock, it is one of the more expensive settings. In Monroe County, NY expect to pay between $14,000 and $18,000 per month (as of 2-2022).
The last stepping stone… the highest level of care… is called Memory Care.
It’s best defined as an SNF-like setting, usually with locked ingress/egress
or a sophisticated ‘wander alarm’ system in place. This is because folks with certain types of dementia can be difficult to care for. They may even become combative. Your loved one won’t be able to wander off on their own… and you’ll probably have to be ‘buzzed in’ to enter. This is the most expensive out-of-home care option, always prescribed by physician’s orders. Be ready for a $16,000 to $19,000/month price tag.
As you embark on your decision-making journey…
1) Be cautious. Perhaps, hire a Geriatric Care Manager to assist in the decision-making. As you know, real life is complex and difficult because of our feelings for our loved one;
2) As you progress you’ll undoubtedly encounter an increasing amount of medical professional involvement. Take advantage of that and listen to what the pros are telling you;
3) Consider in-home care as an alternative. Older folks love it because they get to stay in the world they know. Depending upon the amount of care rendered in the home, in-home care can be more or less expensive than out-of-home care.
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