The terminology in long-term care seems to be changed regularly while the care provided remains basically the same. How does one navigate the offerings when the terms used are unclear?
We believe the categories can be boiled down to 4 basic types of offerings:
1. Independent Living
The model is a bit outdated because when these congregate settings were developed, it was assumed that seniors wanted to live with other seniors. Today’s seniors prefer the vibrancy found in multi-generational living.
Besides not being isolated, the past models of independent living have been providing more services, essentially making them assisted living facilities. What began as a social model is thus being transformed into a medical model of care.
The question here is, can you (or your loved one) live without the daily intervention of another person? If not, independent living is probably not the best choice.
2. Assisted Living
Due to the lines being blurred in different models of care, this category is sometimes encompassed in Senior Living. In addition, assisted living facilities have admitted residents who traditionally were served in nursing facilities, but without providing additional caregivers or nurses to meet the health care needs of the residents.
This has caused debate among assisted living providers as to whether they are providing hospitality, the social model assisted living was established to provide or whether they have morphed into being a medical model previously provided by nursing facilities.
This leaves assisted living facilities with a moral dilemma. While they need to market to those with medical needs in order to survive as a business, they cannot ethically hold themselves out as a health care company due to the limited medical services provided.
There are two questions to ask when looking into this model of care.
First, if the senior’s needs are more social and housekeeping oriented than medically necessary, assisted living may be a proper option.
But the second question that should be asked of an individual facility is, “Are the other seniors living here like me (or like my loved one), or are they here for medical reasons?”
If the mix of residents in the facility is tilted toward those with obvious health care issues, a fairly healthy senior may not be comfortable with this option.
3. Nursing Facilities
There has never been any doubt in the industry that nursing facilities were created to institutionalize those with health care needs, much like the purpose of a hospital. Rehabilitation services are now provided in many of these settings for short-term needs.
The confusion in this model of care comes from two sources.
First, the industry recognized (embarrassingly) that nursing care was not focused on the residents’ personal needs, but rather was provided based on the facilities’ convenience.
From this came a movement called “culture change,” where “person-centered care” was prescribed to providers as the mandatory way to treat human beings. A nursing facility boasting “person-centered care” is merely a nursing facility that is attempting to conform to what is expected by the public.
Second, nursing facilities built in the 1960’s were designed with long hallways and centralized dining, social and administrative areas. Not much has changed in this design, but the term used repeatedly is “home-like.” Large institutional buildings are marketed as home-like, but are nothing like the homes their residents previously occupied.
The purpose for being in a skilled nursing facility for long-term care is simple. One resides here when medical needs cannot be met in any other model of care.
4. Memory Care
With the growing understanding of Alzheimer’s, other dementias, Parkinson’s disease and other conditions causing cognitive impairment, “memory care” has become a term of art.
Unfortunately, this service is provided in varied settings, from a nursing facility with a locked hallway, to an assisted living facility with a secure front door, to smaller homes.
The question here is whether the provider can provide the environment, safety, health care and personal approach that your confused loved one needs. That is, does the provider really understand the cognitive and physical deficits that are brought on by Alzheimer’s, other forms of dementia, Parkinson’s and strokes?
Where does ComfortCare fall precisely in this smorgasbord of confusing options?
We believe our model is very simple to understand.
1. Our residents have cognitive impairment caused by Alzheimer’s, dementia, Parkinson’s, strokes or other causes. Smaller environments, real homes with a high ratio of caregivers to residents, are best for those with confusion caused by a medical condition in the brain that is not likely to improve. All of our caregivers are trained in memory care techniques. Memory care is our specialty.
2. While we provide a high level of psycho-social comfort to our residents, we are a medical model. Dementia and other cognitive diseases will result in the need for substantial health care in the final years of life. A high quality of life during all stages of memory loss is our goal. We are a premium provider of care.
3. Our homes are in residential neighborhoods and allow for freedom of movement in the house and yard, but secure the resident from wandering away from home or into dangerous situations. We engage our residents regularly in personalized, tailored activities appropriate for our low stimulation environment. Our homes are designed for those who are not appropriate for independent or assisted living due to memory impairment.
4. Any stand-alone assisted living, independent living or senior living provider with an unsecured building cannot provide the safety, proper engagement, psycho-social comfort and level of care required by our residents.
While there is overlap in this industry, asking the right questions is the path to finding a place that is appropriate for you or your loved one. The questions above are a good place to start.