Residential Care Options for Your Loved One
Knowing the options for each kind of facility will help as you consider your loved one’s needs.
Once you have decided your loved one is at a point in their disease’s progression that they can no longer live on their own, you need to choose a facility to provide what is called “residential” care. There are several types of facilities that provide room and board. These also have a wide range of how they organize their communities, the level of support your loved one will receive, and their overall costs.
Knowing the options for each kind of facility will help as you consider your loved one’s needs. These types of facilities include:
Independent living:
These facilities have small, easy-to-maintain private apartments or homes within a community of seniors. The main services typically include congregate dining options, recreation and social activities, and local transportation. No personal care or medical care is available in most senior independent living communities.
COST: These facilities are typically not covered by insurance, and so require private payment. Costs vary widely.
Continuing care retirement communities:
These communities provide different levels of care (independent, assisted living, possibly memory care, and nursing home/long-term care) based on an individual’s needs. A resident can move through the different levels of care within the community if his or her needs change.
COST: These communities generally charge a typical monthly fee, in addition to requiring a “buy-in” to the community to ensure the availability of space in the various levels of care when/if needed.
Assisted living:
These residences, known as “Assisted Living Facilities” or ALFs, generally provide small, easy-to-maintain private apartments within a multi-unit building. Services include 24-hour staff, personal and supportive services, recreational activities, meals, housekeeping, laundry, and transportation. Definitions of assisted living and the specific regulations differ from state to state. Residents may choose which services they receive from the residence, such as house cleaning, laundry, help with personal care, or medication reminders.
COST: These facilities are private pay, or may be covered by some long-term care insurance policies. Florida Medicaid won’t finance assisted living facilities directly. However, there are several programs that will reimburse an individual for some personal care services that are received in an assisted living facility.
In Florida, all licensed facilities are regulated by Florida’s Agency for Healthcare Administration (AHCA). Facilities must meet certain standards to maintain their license and are subject to periodic audits to ensure compliance with legal regulations.
To be accepted into a Florida ALF, your loved one must:
• Have good mobility and able to walk with minimal assistance.
• Be able to participate in social and leisure activities.
• Be able to perform most “Activities for Daily Living” (ADLs) with minimal assistance.
To be accepted into a Florida ALF, individuals must NOT:
• Require the use of restraints.
• Represent a danger to themselves or others.
• Need 24-hour nursing care.
• Need assistance with all ADLs.
• Be bedridden (at the time of admission)
Memory Care:
A specific type of assisted living for individuals with Alzheimer’s disease or other forms of dementia is called “memory care.” Individuals in need of support for personal care needs as well as supervision or support for personal safety. Memory Care (MC) units are designed with these needs in mind and typically offer higher levels of staff for more personal care support, along with being a secured or locked unit to prevent an individual from wandering off.
COST: These are private pay, or may be covered by some long-term care insurance policies.
Florida Medicaid won’t finance assisted living facilities directly. However, there are several programs that will reimburse an individual for some personal care services that are received in an assisted living facility.
Assisted Living / Memory Care with an Extended Congregate Care (ECC) license.
Some facilities choose to obtain licensing that allows them to provide the highest level of assistance for individuals needing significant assistance with personal care and those with dementia-related conditions. Having an ECC allows facilities the option to let a resident fully “age in place” and remain in the facility rather than be relocated when their condition worsens.
Board and Care Homes (In Florida = Adult Family Care Home)
In this type of assisted living or memory care, residents are provided a full-time, family-type living arrangement in a private home. Care is provided by the person who owns or rents the home and includes room, board, and personal care on a 24-hour basis. Homes can care for no more than five disabled adults or frail elders who are not relatives. These homes are subject to state licensing and operational regulations.
COSTS: These are private pay or may be covered by some long-term care insurance policies.
Florida Medicaid won’t finance assisted living facilities directly. However, there are several programs that will reimburse the beneficiary for personal care services received in an assisted living facility.
Nursing homes or “skilled nursing facilities.”
These facilities provide a full range of care needs, including both acute care and long-term care.
Acute care rehabilitation is short-term care offered for people with injuries, illnesses, or post-operative care needs who will eventually be able to recover in an environment outside a hospital. Long-term care refers to care that is not “medical care” but personal or so-called “custodial” care, including room, board, and 24/7 support for all personal care needs and safety is provided to individuals who require longer or permanent stays.
COSTS: In some situations, nursing home-eligible residents may be reimbursed under Florida’s Long-Term Care Waiver program.
