Being prepared for senior care for you or a your loved one is easier if you know about the types of care options available in your county and have someone to personally show you where to find the “good” providers. By the way, we don’t call it a “nursing home” anymore, in fact in California there are four general types of care facilities for seniors who need to get their care outside of the home: Skilled Nursing Facilities, Assisted Living Communities, Board & Care Homes and also Adult Day Care Centers. Here’s when each are most appropriate…
Assisted Living communities are great for patients that enjoy socialization opportunities and engaging in organized activities but are no longer safe living independently. They look like a cross between a hotel and an apartment building. There’s a front lobby with someone at the front desk, restaurant style dining, and the residents have a choice between a studio, 1-bedroom or 2 bedroom apartments. There are many areas in the building that are common such as the dining room, library, a game room, a movie room and are for anyone to enjoy and are really an extension of your apartment. Assisted living communities are for patients that currently or will soon need help with either bathing, dressing, toileting, walking, medication reminders, or general supervision. They also have special wings for dementia care patients that need a locked and highly supervised environment. There is a broad range of levels of luxury and pricing, in fact in Southern California there is something for really every budget. A good thing to know is that Veterans are eligible for a special benefit up to $2,200/ month to help cover the costs!
Adult Day Care centers are great for patients who are living in their home or the home of a family member but need somewhere to go during the day for supervision, socialization or activities. There are two general models: medical model and the social model. The medical model program has intensive nursing and rehabilitative services for patients with multiple chronic conditions that require monitoring. The social model provides opportunities for socialization and recreation with limited health care and rehabilitative services. These centers provide transportation to pick the patient up in the morning and return home whenever needed. An average cost is about $90 per day, which means that if a loved one stayed there for 8 hours during the day that’s only $11,25 an hour which is much less expensive than an in-home caregiver. In many cases, Medi-Cal can be used to pay for the costs!
Board & Care homes are great for patients that need to always be within earshot of a caregiver. An example would be someone who is a high fall risk or a “wander” risk. These homes are well suited for patients who currently need help with bathing, dressing, toileting, walking, medication reminders or supervisions for dementia. These are houses that have been converted to care homes and there may even be some in your own neighborhood but you wouldn’t know it as there are no signs out front. They have a maximum of 6 patients and have 2 caregivers on staff at all times (that’s a really good caregiver ratio of 1 caregiver for 3 patients!)
The average cost for a decent home is about $4,500/month for a private room and $3,200 for a shared room (that includes all care, food and supplies.) Of course, there are some very upscale homes where the pricing can be significantly higher. Veteran’s benefits can also be used to help pay for these homes as well. For patients who need to always be near a caregiver but still want the socialization and activities of a Assisted living facility, a good solution is to have the patient to live in a Board & Care but attend an Adult Day Care center during the day and have Medi-Cal pay for it!
Skilled Nursing Facilities are appropriate for short-term rehab patients as well as long-term bed care patients that need 24 hour nursing staff. An example would be someone with a serious pressure wound (bed sore) or needs a feeding tube or ventilator. They are also appropriate for bed care patients that have run out of money and need Medi-Cal Benefits to pay for their care. These facilities have more of an institutional feel like a hospital and residents share a room with at least one other person. Medi-Cal is much more generous than most people realize when it comes to helping patients in a skilled nursing facility. In fact with the right planning and assistance almost anyone can qualify.
