So, it has been my experience that independence is rarely lost overnight, but rather a bit at a time. This is not an esoteric political statement. It is about the elderly gradually losing their independence because as their physical or mental abilities begin to decline, they require more assistance. It can be painfully emotional, but also require an overwhelming amount of decision making in response. Those of us in the industry take for granted that these levels exist, but if you are only responsible for one person who is going through this for the first time, it can be like learning a whole new language.
Below are some basic guidelines about senior living options to help you consider what environment would best suit your loved one and possibly plan for the future based on medical conditions and other factors.
Independent Living: This is usually an apartment with a kitchenette or a small cottage where someone lives on their own but has access to help with certain services that were not available at home such as meals or transportation to appointments, sometimes even housekeeping services and a daily check in for safety.
Assisted Living: Often referred to as an “ALF”, this is typically a community that provides all meals, medication management, assistance with “activities of daily living” (ADLs), such as bathing and dressing, but tries to maintain the least restrictive and most home-like environment possible. Staff is on hand to help, but there may not be a nurse available, depending on the size and licensing of the facility. Depending on state regulations and individual facility licensing, one facility may be able to provide more or less mental health or nursing care than another.
Skilled Nursing: Often called “SNF” (pronounced "sniff"), this is the placement that comes to mind when we think of traditional “nursing home”. SNFs typically has a nurse on staff around the clock and the patient or resident requires care that involves specific nursing skills or constant monitoring. Sometimes it is actually a rehabilitation facility, but due to the higher level of medical care needed, it is “skilled nursing” not just “assisted living”. This may be required for a short term recovery after surgery or hospitalization, or it may be long term due to a degenerative muscular disease that limits transfer and mobility that makes someone unable to qualify as “appropriate” for assisted living facility care.
Memory Care: This can be either a dedicated facility or a separate section of an Assisted Living Facility that is “locked”, meaning that residents are unable to leave without a staff or family member due to their high level of confusion and tendency to compromise their own safety. Ideally, the space, activities, meals and staff training are all specifically designed to help residents with Alzheimer’s and dementia function optimally and to provide care in ways that decrease their agitation and other symptoms as a person’s memory declines. Not everyone who has memory issues needs memory care.