A new generation of seniors is approaching the age of retirement. The Baby Boomers, those born between 1946 and 1964, are now between 53 and 71 years of age and heading into retirement in droves (about 10,000/day).
Whether they choose to retire or remain employed, many Boomers are looking to downsize their homes. Some are looking at retirement communities, and the array of living options is dizzying: 55+ communities, Continuing Care Retirement Communities (CCRCs), personal care, assisted living, skilled nursing (aka nursing homes) – and a new community designation – life plan communities.
One of the most difficult decisions for seniors – and quite frequently for their adult children, who are often making such decisions for their elderly parents – is knowing when it’s time to move from one type of community to one that provides higher levels of care. The typical progression is from independent living to personal care to skilled nursing. (Personal care communities and assisted living communities offer very similar services and environments. In Berks County, there are 30 personal care communities and one assisted living community.)
One of the most difficult transitions for seniors is from personal care to skilled nursing. The differences between these two types of communities are substantial, so making an informed decision is critical. This primer is intended to provide guidance on the differences.
Personal care communitiesPersonal care communities are designed for seniors who are no longer able to live on their own safely but do not require the high level of care provided in a skilled nursing community. These communities provide personal care support services such as meals, help with medication management, bathing, dressing, toileting, personal hygiene, housekeeping, laundry and arranging transportation.
Personal care communities are not licensed by Medicare or Medicaid to give skilled care. Because they are considered nonmedical facilities, having a licensed nurse is not required by law, though some personal care communities, like Green Hills Manor at The Heritage, have both Licensed Practical Nurses (LPNs) and Certified Nursing Assistants (CNAs) and can provide for residents’ more basic health and medical needs. These communities’ focus is on providing a healthy social environment and preventing residents from becoming socially isolated. They typically feature well-appointed dining rooms and living-recreation spaces. Community activities are offered daily and usually include a range of social, recreational, spiritual, educational and cultural opportunities, including local excursions. Staff is available 24 hours per day for additional safety.
Many personal care communities now also offer short-term respite care – and many have separate units for Alzheimer’s residents.
Nursing homes – or skilled nursing
Nursing homes provide around-the-clock skilled nursing care for the frail elderly who require a high level of medical care and assistance. These communities offer 24-hour monitoring and medical assistance including dressing wounds, administering around-the-clock insulin, administering oxygen or other tasks that are defined by federal and state governments as “skilled nursing care.” Skilled nursing services are provided by licensed nurses. More and more nursing homes provide private rooms, though semi-private rooms are common in many homes. Meals are served in a central dining area unless the resident is too ill to participate. Like personal care communities, skilled nursing communities offer a variety of resident activities, though off-campus excursions may be limited.
Many nursing homes provide short-term rehabilitative stays for those recovering from an injury, illness or surgery. And, some skilled nursing communities also have a separate unit for Alzheimer’s residents.
Paying for long-term careAccording to a 2015 survey conducted by Genworth Financial, Inc., a leading Fortune 500 insurance holding company, the average cost of a one-bedroom unit in a Pennsylvania personal care residence or assisted living residence was $42,660. For nursing home care, the median annual cost was $113,150 – a substantial difference. So, it is important for the senior and/or their adult children to understand how the housing will be paid for.
Many people believe – wrongly – that Medicare, Social Security or Medicaid will pay for their long-term care needs. The Pennsylvania Health Care Association notes that, generally speaking, neither Medicaid nor Medicare covers the cost of personal care or assisted living.
As for nursing home care, Medicaid does cover care for the impoverished, and Medicare may cover some of the cost of care for those who require short-term rehabilitation. But, both Medicaid and Medicare require individuals to meet certain physical and medical standards. And, the amount Medicare covers depends on the length of stay. For more information on Medicaid’s and Medicare’s physical and medical standards and coverage, visit www.Medicaid.gov or www.Medicare.gov.
In the second and last part of this series, I’ll provide tips for adult children on how to talk with their elderly parents about moving to a senior living community.
