No Clue About Senior Living? A Guide to Find the Right Level of Care

Helping your aging loved ones find the right senior living option isn’t exactly exciting, but it is super important.

So, you're probably coming closer to a place where your parents are starting to need a little extra help. Or maybe you're stepping up to the plate for grandma and grandpa. Either way, the idea of finding the best senior living option is about as appealing as a root canal.

Let’s face it: Senior living facilities and options can be a total maze. With all the jargon, the costs, and the fear of making the wrong decision, it’s enough to make us want to give up and binge Netflix instead. We’re here to cut through the BS and give you the straight talk about finding the best possible care for your loved one.

We’ll break down everything from understanding different levels of care to navigating the financial jungle. By the end of this guide, you’ll feel a little better about what to do next.

Understanding Senior Living Levels of Care: It's Not One-Size-Fits-All

Okay, so your mom or dad needs or even sweet grandma needs some level of senior care. Great. Now, let's figure out what kind. It's like ordering food – you wouldn’t order a steak if you’re vegetarian, right? Same goes for senior living.

Independent Living: Still Got Mojo?

Think of independent living as adulting, but with fewer responsibilities. It's like living in an apartment complex designed for people the same age. They get their own place, maybe a little smaller than a house or a condo, but with perks like dining options, social activities, and maybe even a pool or a gym. But they get this without all of the upkeep of a home!

It's perfect if your parents are still pretty independent but want to downsize or live somewhere with a built-in community.

Assisted Living: A Little Help Goes a Long Way

Assisted living is like having a safety net. It's for folks who need a little extra help with daily stuff like bathing, dressing, or even taking meds. Think of it as a step up from independent living, but not quite a nursing home. There are people around 24/7 to lend a hand, but there are typically social activities too.

Skilled Nursing Facilities: Round-the-Clock Care

This is what most people think of when they hear "nursing home." It's for folks who need medical care. We're talking about people recovering from surgery, managing chronic illnesses, or needing help with things like feeding tubes. It's a higher level of care, and it comes with a higher price tag.

Memory Care: Special Care for Special Needs

If your loved one is dealing with a specific and diagnosed memory illness such as Alzheimer's or dementia, memory care is a specialized option. It's a secure environment designed to help people with memory loss feel safe and supported. There are trained staff members on hand to assist with daily living and provide stimulating activities.

Continuing Care Retirement Communities (CCRCs): Planning for the Future

CCRCs are like all-in-one retirement packages. You start in independent living, and as your needs change, you can move to assisted living or skilled nursing within the same community. It's a way to future-proof your senior living plans.

So there you have it. A quick rundown of your options. Remember, this is just a starting point. Every situation is different, and the best choice will depend on your loved one's needs and your family's circumstances. For more information on each option, follow the links for in-depth information.

The Cost of Senior Living: It Ain't Cheap

Let's talk about money. Because let's face it, senior living ain't cheap. The price tag depends on a bunch of stuff, like where you live, the level of care, and what kind of amenities your senior parents want.

Senior-reviewing-finances-with-son_FB_iStock-1168448223_2021-01_1200x630.jpg

Independent Living: A Pricey Lifestyle

Independent living can be pretty pricey. You're basically paying for a fancy apartment with some extra perks. There's usually a monthly fee that covers rent, utilities, and maybe meals. Some places also have an

upfront entrance fee. Think of it as a deposit, but way bigger. For independent living facilities, you and/or your parents are paying out of pocket.

Assisted Living: More Bang for Your Buck (Kinda)

Assisted living is a step up from independent living, so it costs more. You're paying for extra help with daily living stuff, like bathing and dressing. The price tag covers your room, meals, and care. It can vary a lot depending on where you live and how much help you need.

When it comes to assisted living and payment options, the waters get a bit murkier than independent living facilities. Generally speaking, Medicare doesn’t cover assisted living costs. Think of Medicare as covering costs for hospital stays, doctor visits, and some home health care.

However, Medicaid can cover some costs. While Medicaid doesn’t typically cover room and board within assisted living facilities, some states have Medicaid waiver programs that can help cover costs for people with low income and assets. These may include services such as eating, grooming, bathing, medication management, and more. Because Medicaid is issued by each state, you need to find out what kinds of waivers your state offers and exactly what they cover.

Skilled Nursing Care Facilities: The Big Bucks

Skilled nursing facilities are the most expensive option. You're paying for around-the-clock medical care, which comes with a hefty price tag. There are different levels of care, and the cost goes up the more help you need. Plus, you've got to factor in rehab costs if they need physical therapy. In terms of payment methods, skilled nursing facilities accept a mix of options.

Medicare and Skilled Nursing Care Facilities

Medicare covers a portion of skilled nursing care, but there are conditions. You usually need to have been hospitalized for at least three days before entering a skilled nursing facility. Coverage is limited to a certain number of days and often requires skilled nursing care or therapy. Below is a breakdown of all the conditions that must be met:

Have Part A and have days left in your benefit period to use
Have a qualifying inpatient hospital stay
Enter the skilled nursing facility(SNF) within a short time of leaving the hospital(generally 30 days)
The doctor or other health care provider has decided that the individual needs daily skilled care, such as IV fluids, medications, or physical therapy. The individual MUST get the care from, or under the supervision of, skilled nursing or therapy staff
These skilled services are received in a Medicare-certified skilled nursing facility(SNF)
The individual needs skilled services for one of the following:
- An ongoing condition that was also treated during your qualifying inpatient hospital stay (even if it wasn’t the reason you were admitted to the hospital)
- A new condition that started while getting SNF care for the ongoing condition
Skilled nursing care or therapy is needed to improve or maintain the current condition, or to prevent or delay it from getting worse

For more detailed information about Medicare coverage for skilled nursing facility care, please visit the official Medicare website.

Medicaid and Skilled Nursing Care Facilities

Medicaid eligibility is based on overall income and assets. If your parent qualifies for Medicaid, it can help cover the cost of skilled nursing care. Medicaid coverage of nursing facility services is available only for services provided in a nursing home licensed and certified by the state survey agency as a Medicaid Nursing Facility(NF).

The need for nursing facility services is defined by states, all of whom have established NF level of care criteria and are required to be provided by the state programs for individuals age 21 or older who need them. Nursing facility services for individuals under age 21 is a separate Medicaid service, which is an optional service for states to provide.

Because the Medicaid plans are specific to each state, you and your parents will need to consult your state’s specific federal requirements and local requirements for coverage.

More information can be found at the official Medicaid website.

Private Insurance and Skilled Nursing Care Facilities

Some private health insurance plans may cover a portion of skilled nursing care facilities, but this is often limited to short-term stays and specified services. Long-term care in skilled nursing care facilities is typically not covered by private insurance. Review the insurance policy and consult with the insurance provider to better understand the extent of coverage.

Long-term Care Insurance and Skilled Nursing Care Facilities

This is specifically designed to cover the costs of long-term care services, including skilled nursing care. This type of insurance helps protect assets from being depleted by high care costs. Be sure to read through these policies carefully as they can vary greatly in the following:

Daily benefit amount: This is the amount the policy will pay per day for care
Benefit period: This is the total length of time the policy will pay benefits
Elimination period: This is the waiting period before benefits start
Service options: Some policies might cover a wider range of care services, including home health care and assisted living

Basically, make sure you read the fine print so you and/or your parents can choose a policy that meets the potential care needs and budget.

Memory Care: Specialized Spending

Memory care is designed for people with Alzheimer's or dementia, and it comes with a higher price tag. You're paying for specialized care, a secure environment, and activities that are tailored to their needs. The cost can vary depending on the level of care and where you live.

Private Pay and Memory Care

This is the most common way to pay for memory care. It involves using your own funds, savings, or investments to cover the costs.

Medicaid and Memory Care

Medicaid generally pays 100% of the costs of a nursing home stay, including any memory care services provided. However, it does not cover the cost of room and board in assisted living or dedicated memory care facilities. Medicaid may pay for some memory care services provided in these settings for eligible patients if the facility is Medicaid-approved. There are two ways in which Medicaid will cover memory care costs.

Institutional Medicaid: Medicaid actually covers the whole cost of nursing home care for people with Alzheimer's or dementia. That includes everything from room and board to medical care and even the special programs they need. But, there's a catch: the nursing home has to be certified to take Medicaid patients.
Home and Community-Based Services (HCBS): The other Medicaid program that lets people get help at home or in places like assisted living. It's called a waiver. Think of it as a special permit to get services like nursing care, help with bathing and dressing, and even some programs for folks with Alzheimer's. But here's the kicker: you gotta qualify, and there's usually a waiting list. It doesn't cover rent or food, just the extra help.

Medicare and Memory Care

Generally, Medicare doesn't cover the costs of long-term care, including memory care. It might cover some specific medical services, but not the overall cost of care.

Long-Term Care Insurance and Memory Care

Much the same with skilled nursing care facilities, if you have a comprehensive long-term care insurance policy, it might cover some memory care expenses. However, coverage varies greatly between policies. See above for more information.

Continuing Care Retirement Communities (CCRCs): Plan for the Future, Pay Upfront

CCRCs typically involve a higher upfront investment compared to other senior living options. Costs can vary widely based on location, amenities, and the specific CCRC. There are two primary components to CCRC costs:

Entrance fee: This is a one-time payment that secures your residency and often provides access to different levels of care. Entrance fees can range from modest to substantial.
Monthly fee: This covers housing, meals, utilities, and basic services. It may increase as your care needs grow.

Medicare and CCRCs

Medicare may cover short-term skilled nursing care within a CCRC, but keep in mind that care doesn’t include room and board, but only the skilled nursing care. It also doesn’t cover the costs of long-term care or assisted living expenses.

Medicaid and CCRCs

Medicaid eligibility varies by state and income, but it generally won’t cover the entrance fee or monthly fees for CCRC living. However, some states offer Medicaid waivers that may assist with specific services within a CCRC. Keep in mind that if you plan to use Medicaid, planning is essential. While not a direct payment option, Medicaid planning can help protect assets for potential future Medical eligibility if long-term care becomes necessary.

Long-Term Care Insurance and CCRCs

This can be a valuable asset in covering the costs of higher levels of care within a CCRC. These higher levels of care can include assisted living or skilled nursing care needs. Be sure to dig in and review all of the policies and everything they cover.

Private Pay and CCRCs

Unfortunately, most residents in CCRCs rely primarily on private pay. CCRC contracts can be difficult to navigate and the coverage from all of the possible insurances make the path even more difficult. The recommendation is to seek legal and financial advice. There are many resources that are free. But understand that you need to commit yourself to the time it takes to do this research. However, it pays to do it. Because in the long-run, it will cost hundreds of thousands of dollars for Continuing Care Retirement Communities if you don’t do the research and plan accordingly.

If you are one of the many that find yourselves in a situation where a parent needs right now care from a CCRC, immediately seek assistance from experts on Medicaid, long-term care insurance, an attorney, and a financial planner.

Evaluating Senior Living Quality

Independent Living

Okay, let's dive into finding the right place for your parents. First off, you need to make a list of places to check out. Think about where you want them to be – close to you, near a hospital, or somewhere with stuff to do. There are websites and places that can help you find options.

Once you have your list, it's time to dig in. Look at where the place is, what they offer, and if they have extra care if they need it. Can you visit easily? How's the place run? And what do other people say about it? Location matters.

Is it close to where your folks like to hang out? Can they get around easily? Is transportation offered or do they offer somewhere for your parents to park their cars? Think about doctors, shopping, and stuff like that. Amenities are important too. A pool, gym, or even a library can make a big difference.

Some places might have extra help if your folks need it down the line. Maybe they offer medication management or help with getting dressed. It's good to know what's available. And don't forget about visiting hours. Can you see 'em whenever you want?

Figuring out how to move in can be a pain, so find out what's involved. Waitlists, paperwork, the whole nine yards. There are websites and reviews out there, but nothing beats talking to people who actually live there or even looking for real reviews.

Word-of-mouth is gold. Talk to friends, family, or even doctors. They might know of a place that's perfect for your parents.

Evaluating Assisted Living Quality

Okay, so your senior parents might need a little extra help. Assisted living could be the way to go. It's like a step up from independent living, with more support. Let's figure out what to look for.

First off, you need to find some places. Start searching online, ask around, and see what's out there. Location matters, just like with independent living. Is it close to you or other family and friends? Are there things to do

nearby? Do they offer activities?

Assisted living is all about help, so look at what they offer. Do they help with bathing, dressing, or taking meds? What about meals? Some places have really good food. And if your folks need physical therapy or something, do they offer that?

Visiting hours are important. You wanna be able to visit whenever it works for you. So, make sure you know what the policies are for visitation. Lastly, find out how the move-in process works. Most often, this is also dependent upon insurance or if your senior parent is currently under a physician’s care or hospitalized. Find out about waitlists and get a firm grasp of timelines. Generally speaking, most assisted living facilities will require a lot of paperwork. So, make sure you know everything they need and go prepared.

Online reviews and ratings can be helpful, but it’s always best to see the place for yourself. Talk to other families, maybe even chat with people who live there. Get a feel for the place to determine which one is best for your parents.