There are three major types of care to consider when you or a family member can no longer live alone. Here you will find a chart that helps you to understand the differences between Assisted Living, Memory Care and Adult Family home care.
Retirement Communities
These facilities typically provide studios, one and two-bedroom apartments. Most often they include assisted living services as a person’s need for care progresses. They are designed for adults 60+ who currently do not require assistance with their activities of daily living (ADL), such as showers and hygiene, dressing, grooming, eating, mobility, toileting and medication assistance. Entertainment and activities are provided daily along with transportation to shopping and doctor appointments and they have on site assistance 24/7 to call for help when you have an emergency. Monthly rent includes laundry facilities, utilities, cable, usually Wi-Fi internet, 1-3 meals per day in their dining room and limited parking. Your telephone is not included. These facilities are unlicensed by the Department of Social and Health Services (DSHS) and do not accept Medicaid. When care with ADLs are needed you may choose to privately hire a part-time caregiver or it may be wise, and less expensive, to begin licensed assisted living services.
In-Home Care
When nursing care or chore services are needed and the resident is committed to staying in their own home, contracted services can be arranged on an hourly or around the clock basis. Services may prevent or delay a move to a care facility, but an assessment is first recommended to determine what services and how much care will be needed to get an accurate picture of the costs associated with that level of care, since they frequently can exceed that of assisted living communities.
Assisted Living Communities
These private apartment-style facilities are licensed by the Department of Social and Health Services (DSHS) to care for seven or more residents 60+. They are similar to retirement communities and typically provide studio, 1 and 2 bedroom apartments, a variety of social activities, transportation to shopping, medical appointments. But the difference is that they are required to provide three meals a day in a dining room and are trained and licensed to help with activities of daily living (ADL) including showers and hygiene, dressing, grooming, eating, mobility, toileting and medication assistance. When an emergency occurs, their caregivers and nursing staff can provide hands on care and will also call an ambulance when necessary. Assisted Living communities provide varying degrees of nursing services and will coordinate with your medical professionals to meet your needs. However, most cannot provide 2-person transfers and some cannot accept diabetics unless they can self-inject insulin as necessary. They also cannot accept residents with dementia who are easily lost, or are in danger of wandering unaccompanied outside. Some assisted living communities will accept Medicaid payment after a resident has paid privately for a minimum of 2-4 years.
Secure Memory Care Communities
These licensed facilities have locked front doors to provide a secure caring environment to those with all forms of dementia, not just Alzheimer’s. They may stand alone or they may be a separate wing to an Assisted Living Community and they will usually have a few private, but mostly shared rooms and dining rooms for all meals and snacks. Some rooms are fully furnished and others require you to bring their own furniture. Their staff have been trained to provide specialized care to residents with varying degrees of decline in areas of intellectual functioning, use of language and numbers; awareness of what is going on around him or her; judgment; and the ability to reason, solve problems, and think abstractly. They include assistance with all activities of daily living (ADLs), specialized activities and sometimes occasional outings, depending on a resident’s abilities.
Adult Family Homes
These are privately owned residential homes licensed by the Department of Social and Health Services (DSHS) to provide 24-hour high levels of care for usually six (6) and sometimes up to eight (8) non-related residents. Depending on their specialized training, they most often serve the elderly and those with dementia, however, they may also be trained to care for those with mental illness and/or developmental disabilities. Caregiver to resident ratios are high and services include supervision and help with all activities of daily living, medications, personal care, all meals and snacks, sometimes furniture, laundry, and social services. Their specialized training includes delegated nursing services for insulin injections, eye drops, catheters, etc. and can usually handle two-person transfers, Hoyer lifts and the use of other medical equipment so that end of life care may be provided to all residents. Some adult family homes are private pay only and others accept Medicaid payment.