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Senior Living Arizona
Trailer
Bonus
Episode 4
Season 1
Memory Care vs. Nursing Home vs. Skilled Nursing
In our earlier podcasts, we went over the difference between Independent Living and Assisted Living as well as the difference between Assisted Living and Memory Care. We also elaborated on what virtues and qualities to look for in those communities from the feeling you get when you walk in the door to the meal offerings, amenities, services, activities, and of course the financial aspects of these retirement options that are essential in a quality community and also vital to aging successfully.
Today’s show will take us one step further. We’re going to discover the differences between Memory Care, Nursing Homes, and Skilled Nursing Facilities. If you’re someone considering what your options are as you age or you’re a family member seeking to understand those same options for someone you love, we hope this information will help to guide you on your journey.
A recurring theme we often refer to in our podcasts is the language used when referring to retirement housing including “old folks home” and “nursing home” and when referring to an actual property calling it a “facility”. These terms can cause confusion with the various types of services available today. We encourage a more accurate term for the modern age of senior housing calling these Independent, Assisted and Memory Care properties, “Communities”. Now when it comes to Nursing Homes, and Skilled Nursing services we do refer to these operations as facilities because they have a primary purpose that revolves around the medical care being offered to their residents. Let’s dive deeper.
In our last episode, we covered some of the history of how senior communities offering support services evolved out of necessity from the early 1900s to today. Retirement housing for seniors in the US has come a long, long way since then thanks to laws and regulations put into place to enhance the quality and care of the progressive needs of our elders. The fact that our current population is living well into their 80s and beyond certainly dictates the need for retirement housing but what happens when aging includes poor health or progressive disease? What are the options if someone faces a sudden health crisis that leaves them unable to live their lives without assistance or medical care on a recurring or constant basis? Now, this is where we get into today’s subject.
Memory Care services are often present near or within any Independent Living or Assisted Living community and are specifically designed to address dementia and Alzheimer’s conditions by offering services that pertain to the daily needs of medication management, assistance with activities of daily living such as meals, bathing, dressing, and toileting etcetera.
Quality Memory Care also has activities to stimulate one’s physical and mental health. Activities and therapies that relieve dementia symptoms should be relaxing and brief. Most notably, routine is super important in Memory Care. Specialized services are focused on scheduling and structure because folks with debilitating dementia issues function better with routine. Otherwise, they are easily frustrated by change so the activities offered in other senior environments can be far from fun or entertaining for those with memory issues.
You’ll also find that dementia-specific building designs will often include hallways that run in a circular route so that those who wander never encounter a dead end, which leads to fear and anxiety for a resident. Amenities that contribute to a soothing and calming atmosphere are vital such as stations that let residents actively do or recreate daily activities from their younger years which can range from office duties to child caregiving. Even the atmosphere of dining is relevant for the memory care resident. Intimate dining like what we experience at home is an environment to be cultivated in a Memory Care community. Cafeteria-style dining would overstimulate and even disorient a person dealing with dementia. Something that many of us may not anticipate, is that it’s important in Memory Care that the ability to engage all of the senses from smelling food cooking to hearing music playing and seeing nature and most especially VIEWS outside with natural lighting from the outdoors. Even textile impulses are important along with consistency in patterns and objects. Let’s say a person in the throes of dementia picks up something that looks like it’s made of wood but then they realize it's made of a different material. This can be quite alarming for the individual. For the rest of us, this might sound so basic or even silly but for the loved one experiencing memory loss, these elements that cater to the ease and grace of their daily activities are very important for their peace of mind.
Quality Memory Care will also offer an air-conditioned environment reducing or eliminating areas with hot or cold drafts to make the sensations of space conducive to the soothing element that is so critical for these folks. And finally, when it comes to Memory Care, well-established security measures put in place to keep residents safe from harming themselves or others are crucial for obvious reasons. This is why safe indoor and outdoor spaces for active wandering are vital as well as invaluable in a quality community for you or your loved one.
Now, of course, financial responsibilities play a huge role in what kind of community or facility is right for the senior who is facing dementia or already in the throes of it. Often times it is easier to find a spot in a nursing home more so than in an actual Memory Care unit within an Assisted Living Community due to the red tape that can often accompany memory care decisions. Generally speaking, it is easier to qualify for nursing home care as long as one’s assets are under a limited amount, which varies from state to state. There can also be a limited number of beds in a facility if Medicaid or Medicare is in play and then you’ll end up dealing with a long waiting period to get in depending on the place.
This leads us to the subject of Nursing Homes and what they offer in terms of services that are similar to those in a Memory Care setting. A nursing home can be a good choice for you or your loved one dealing with memory loss but it is important to note everything we’ve mentioned so far. Many nursing homes are NOT designed for memory care and can be unsafe for dementia residents as they get stressed easily and can wander away without proper services in place to address their needs specifically. And many times it’s the financial piece that comes into play. Government assistance is available with programs such as Medicaid that can really help people in need as long as they meet the right criteria for coverage so they can get into a nursing home that DOES cover memory care residents. Otherwise, for the best Memory Care options, it is truly most beneficial to have long-term care insurance and if available to you or your loved one, other private pay options rather than a nursing home. There are many elder care specialists and advocates that will walk you through the process so you don’t have to feel overwhelmed by this information. You’re not alone and that is important to remember. There are resources available to help you figure it out.
What matters most when it comes to making the right choice of where you or a loved one belongs is to make the decision during the early stages of dementia while there is still the capacity to make informed decisions about a healthy and safe home for the expected, advanced, stages of memory loss.
So, when it comes to Nursing Homes, they are for people who cannot live at home because of medical needs (which is the same as for Memory Care residents) but as I mentioned a moment ago, Nursing Homes don’t require the specialization of their activities and environment to be as structured as with Memory Care. Nursing homes have very limited medical care but it includes medication management and dispensing and residents can access medical services at other locations when necessary. Nursing Homes will also offer assistance with mobility when a resident has difficulty getting around and will assist with bathing, eating, and dressing on a daily basis. Generally, a nursing home will offer a room to share or sometimes a single room per resident that includes housekeeping as well. You can also count on entertainment, activities, and meals to be included. Basically, a Nursing Home is where people usually go when they require high levels of assistance with non-medical tasks of everyday living and have access to skills of more advanced practitioners such as RNs, Occupational Therapists, and medical equipment available on site to assist their physical needs such as oxygen or dialysis machines.
One of the challenges with the language around these types of communities and facilities is that Nursing Homes will often be referred to as Skilled Nursing Facilities, which can actually be misleading. A Skilled Nursing Facility, or SNF, is actually a place for people to go who require medical care, for instance, like after experiencing a stroke. The SNF is there to provide around-the-clock SKILLED CARE for those who need assistance with day-to-day living and daily processes. The around-the-clock services cover stroke recovery, rehabilitation after an illness or a medical procedure like an operation, wound care, serious memory issues, and terminal illnesses. SNFs are also generally for short-term needs and patients go home to Assisted Living Communities or Nursing Homes once they’ve recovered. It is important to know that there are those people who have chronic or terminal conditions that may require a long-term stay in a Skilled Nursing Facility. In addition, if the person is at an SNF short term up to 20 days, Medicare usually largely or entirely pays for the cost.
We’d like to take this information one step further for you today when it comes to Skilled Nursing. You can actually get this service in your own home as well. Whether it is a physical, speech, or occupational therapist or a registered nurse, these professionals and the like can assist seniors with wound care, blood draws and injections, catheters, line dressing changes, IVs such as those used for chemotherapy, Mediports, and standard health monitoring. Isn’t that great to know….especially these days since we’ve collectively been through a pandemic and so many are in fear about going anywhere near a rehab or hospital? The services that are offered can vary depending on the agency and location of these agencies. The way it works is like this if a person requires intermittent or frequent care they are usually expected to go out to receive those services. But, if the individual is housebound with severe mobility issues then insurance and government programs are more likely to cover the costs. Thank goodness! Then if someone is unable to leave their home, whether in a private home, Independent, or Assisted Living, they can still take advantage of these services. And then, as for the activities of daily living such as bathing, cleaning, and cooking, an individual can always hire their own caregiver or a nurse’s aide that can cover those other duties.
So just to recap and summarize what we’ve covered today whether an individual needs Memory Care, a Nursing Home or Skilled Nursing there are common denominators such as housekeeping, assistance with daily activities such as dressing, bathing, mobility assistance, and then the activities and services that cater to the level of need of the resident. Memory Care and Nursing Homes offer very limited levels of medical care but do cover medication management and both are usually long-term living situations. Memory Care is best when it is private pay or utilizes long-term-care insurance. Nursing Homes do have programs such as Medicaid to help finance their services provided that the individual in need meets certain criteria and only some offer Memory Care units but it’s not common. And then we have Skilled Nursing Facilities that vary in their offerings of medical care and offer the same amenities as Memory Care and Nursing Homes but are more for a temporary stay to assist in the recovery of surgical procedures or stroke for example. Each of these services share nuances but do vary so it’s critical to know what level of care you or your loved one may need in the future.
Hopefully this information today was helpful in understanding those nuances and will assist you on the journey of finding the right choice for you or your loved one. Aren’t we so blessed to have these options today?
Thank you so much for tuning in with us today. This is your host, Linda Damita, wishing you longevity, laughter, love and the ultimate wealth of health.