Five Alternatives to Nursing Homes

alternatives to nursing homes

For many people, the idea of ending up in a nursing home is not a positive one. Some may be worried about the cost of long-term care, which can be considerable. Others may be reluctant to give up their independence or a beloved home. And still others may be concerned about mistreatment in a nursing home. Whatever the reason, seniors may prefer alternatives to nursing homes to help them on a daily basis.

The reality is that many people will not be able to live completely independently in their own homes as they age. Family members are then faced with a dilemma: is it better to let Mom or Dad stay in their home, even if doing so involves some risk to their physical safety, or force them into a facility, where they may be better cared for, but less happy?

It’s a difficult decision for everyone involved, especially when an aging parent feels more confident about living alone than their child feels about letting them do so. Fortunately, there is a middle ground between living alone and going into a nursing home, and multiple options in between.

Assisted Living

Assisted living typically involves a group residence with fewer than 100 seniors. Dwelling units are typically small private apartments, although in some settings apartments may be shared. There are usually on-site group dining and social activities. Residents can get the level of care they need, from minimal assistance such as medication reminders, to help with bathing, personal care, cleaning, and more. For residents with Alzheimer’s or other dementia, “memory care” sections may be available, offering a higher level of supervision and support for residents with memory issues.

Assisted living is typically less costly and less restrictive than a nursing home. However, some older people who would do well in assisted living have ended up in a nursing home because Medicaid would cover the cost of the latter, but not the former.

In-Home Care

For older adults whose objection to a nursing home is rooted in a desire to stay in their own home, in-home care might be a better option. Depending on the level of care needed, this can be a cost-effective option that allows a senior to get the support they need in the comfort of home. Some seniors can live with a family member who provides care.

While it may be possible to have a live-in non-family caregiver, most seniors living alone have a caregiver who visits at least once a week, or more often if needed. The caregiver may help with household tasks such as cleaning and preparing meals, offer basic medical assistance like managing medications, and assist with activities of daily living. For additional support when a caregiver is not present, technology designed to help seniors can give family members peace of mind.

Medicare PACE (Program of All-Inclusive Care for the Elderly)

PACE is a program available to some Medicare recipients to help them receive assistance to stay in their home or the home of a family member.

PACE is a program available to some Medicare recipients to help them receive assistance to stay in their home or the home of a family member.

The program provides medical care and some personal care assistance, but also relies on family members to provide care, so PACE programs might be better suited to families in which the older person already lives with a family member but could benefit from additional support.

PACE services are available only from a limited range of providers, and availability is greater in some states and counties than others. The Michigan PACE network is fairly robust compared to most states’ offerings.

Adult Foster Care

For adults who need more care than they can get living alone but who cannot live with a family member, an adult foster care program may be a good solution. In an adult foster care setting, a small number of older adults (fewer than six) live together in a family-like setting in a private residence. In adult foster care, seniors can get help with activities of daily living, household chores, and medications. However, fewer social options are generally available compared to an assisted living environment. Adult foster care providers are not medical professionals, however; seniors who need moderate to extensive medical support on a daily basis may be better served in another setting.

Continuing Care Retirement Communities

For seniors who are currently able to live more or less independently, but worry about increasing care needs as they age, continuing care retirement communities can be an ideal option. Initially, the senior will live in an “independent living” option in their own apartment, often with access to amenities like housekeeping services, transportation, restaurant-like dining, and social activities. If the senior becomes unable to continue living independently, they can transition into an assisted living facility operated by the community for added support, and ultimately to a nursing home if needed.

One advantage of continuing care is that once the senior is in the community, getting a higher level of care when needed becomes fairly seamless. The disadvantage is that this type of residence is often more costly than other options.

If your older family member can no longer live at home alone unassisted, it is time to begin discussing alternatives to nursing homes and elder transitions planning. For help initiating this discussion, or to learn more about alternatives to nursing homes in Michigan, please contact our law office to schedule a consultation.

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