 | Lynn Spragg is a Licensed Practical Nurse with 13 years long term care experience, she has been the Operator/Director of Vintage Place Assisted Living for 4 years. |
Senior Living
2010-10-01 11:22:00
Differences in types of residences
Question: What is the difference between senior housing, assisted living, nursing facilities and skilled nursing facilities?
Answer: There are some very basic differences in senior housing, assisted living, nursing facilities and skilled nursing facilities, mostly centered on levels of care. Determining which one is the right choice depends greatly on the ability of the senior, and which one best meets their medical needs.
Senior Housing is housing situations with an age restriction requirement. In Senior housing, residents must be 55 to 62 or older, depending on the community. Senior housing can be independent houses, townhouses, condos, duplexes or apartments, or any other configuration you can think of in housing. The only real division in senior housing is that some of them are also income restricted. In an income restricted complex, (usually built with a government subsidy) only those who receive less than a certain income each year, are allowed to live there. The income restrictions usually allow differing amounts for individuals or couples and are adjusted up each year to allow for inflation. Usually the qualification is judged only on “income” and not assets. For instance, a couple could be millionaires in the value of their stocks, but if the income they received each year was under the limit, they could live in “income-restricted” housing. There are several examples in the Greater Wichita Area of “income-restricted” housing.
Assisted Living Facilities (ALF’s) is another form of senior housing, but is designed for those who are not able to care for themselves, and perhaps need differing levels of oversight. Those admitted to “assisted living”, or “residential care” may need something as simple as help taking their medications to stay well or other more advanced levels of care. However, to be able to live in residential care, one must be able to perform most of their own activities of daily living, defined as eating, dressing, toileting and walking. In assisted living, bathing help is available. Residents in “assisted living” often still have their own cars and can come and go as they please. Others have chosen assisted living when they were no longer able to drive and/or wanted the convenience of someone taking care of housekeeping and meal preparation for them. Residential care also allows for couples to share their accommodations if they choose. In some cases, a spouse, who is unable to help their partner as much as needed will choose residential care so they can continue life together in a much less stressful environment, where the chores are taken care of for them, and they can sit back and enjoy life. In an assisted living environment, the majority of the “help staff” usually are certified medication aides who are trained in the dispensing of medications and have previously qualified as certified nursing aides. Due to their training, they are able to watch for health indicators and to alert the licensed nurse when she comes in. They also are able to summon assistance when needs are beyond their training. Sometimes only a door separates the residential care complex from the skilled nursing facility which has licensed nurses on duty, and available for immediate care, 24 hours a day.
Nursing Facilities and Skilled Nursing Facilities or nursing homes as they are more commonly called are definitely a step up in care over assisted living. Once a person no longer meets the State mandated criteria for assisted living, they are no longer allowed to live there. An assisted living provider can be seriously penalized for allowing persons who no longer meet state guidelines to continue living in an assisted living facility. Once a person no longer meets assisted living guidelines according to their “care assessment” they are appropriate for care in a nursing home. The “care assessment” is a state test, performed by persons specifically trained in that test, to determine the level of care they need and whether they are qualified for nursing home care. One of the qualifiers is whether the person is capable of performing for themselves their normal “Activities of Daily Living” (ADL’s) as mentioned earlier when we were discussing the qualifications for Residential Care. Nursing home care is much more intense and can vary from helping one with two or three ADL’s to total care. Elderly persons with dementia, who are unable to manage their lives are appropriate for a nursing home, even though they might be perfectly capable of performing all their own ADL’s. They receive the level of care they need, however intense it may be.
Skilled Nursing Facilities (SNF) commonly referred to as “sniffs” differ from Nursing Facilities (NF) “niffs”. A SNF has the staffing and expertise, as well as regulatory certification to provide the higher level of care required by Medicare. A person who has undergone the requisite three-day stay in an acute care hospital and is released needing “skilled nursing” can only receive Medicare benefits from a SNF. Sometimes the ‘skilled nursing” is a form of physical, occupational or speech therapy. It may also include constant monitoring by licensed nurses, or special care that can only be provided by an adequate licensed staff. Nursing facilities, (NF) have licensed nursing staff, and in some cases meet the requirements of Medicare, but have just not been certified. Other times, they are located in more rural areas where adequate licensed staff is difficult to hire and they provide care for those who need a less intense regimen. It is not unusual for a certified Skilled Nursing Facility, to receive a resident from another nursing home which is a NF after that resident has been hospitalized. They provide the Medicare required services, before transferring them back to their original nursing facility when they are appropriately improved. “Rehab to Home” is a favorite expression for those who have completed their hospitalization and need more care, and usually therapies, before being released back home.
