Senior Care Provider Guide

Independent Living 

When cooking meals, cleaning the house, shoveling snow, mowing the lawn, and taking care of home repairs becomes burdensome, many seniors choose to move to an Independent Living Community (often referred to as a Retirement Community) to enjoy a carefree, retirement lifestyle.

This senior living option focuses on enjoying one's retirement. Most communities offer a myriad of amenities such as indoor pools, fitness and wellness centers, restaurant style dining, computer and business centers, well-stocked libraries, home theaters and walking paths - along with a wide range of individual and group leisure activities.

Convenience services such as meals, maintenance, grounds keeping, transportation, 24-hour security, and housekeeping and linen services are offered as part of the monthly fee or on an optional basis for an additional cost. Housing options may vary from freestanding, single-family homes to townhouses or apartments.

Assisted Living 

Seniors living in Assisted Living Residences are unable to live independently, but do not need nursing home care. Assisted Living is a home-like, congregate housing option that provides meals, housekeeping, laundry, personal care, health care services and social activities in a supportive setting.

The goal of Assisted Living is to maximize a resident's dignity, autonomy, privacy, independence, choice and safety.

Assisted Living Residences provide transportation, 24-hour security with staff available at all times, and access to on-site or nearby health and medical services. Assisted Living Residences strive to keep residents as active and involved as possible through educational, spiritual, social and recreational programs.

Individuals residing in Assisted Living Residences usually have their own suites or apartments complete with a mini-kitchen and private bathroom, in addition to sleeping and living areas. Some choose to share their residences with a spouse or a roommate.

There are Assisted Living Residences that offer dementia care. This is typically provided in a separate and secure "Memory Care Neighborhood." There are a small number of Assisted Living Residences where the entire facility is devoted to providing a supportive environment for those with memory challenges.

Assisted Living Residences typically offer a rental arrangement, with residents or their families paying the entire cost privately. Depending upon the terms of the policy, long term care insurance may pay for Assisted Living. Some states have Medicaid Waiver Programs that are designed to help lower-income seniors reside in an Assisted Living Residence. Many, but not all states, license and/or certify Assisted Living Residences.

Nursing and Rehabilitation Center or Nursing Homes 

A Nursing and Rehabilitation Center, also known as a Nursing Home, is a facility that provides 24-hour nursing care, rehabilitative services and assistance with daily tasks to individuals who are unable to safely reside at home or in any other living alternative. Nursing and Rehabilitation Centers provide medically supervised care to the elderly, disabled and chronically ill.

Some individuals require only a short stay for rehabilitation and strengthening after hospitalization, before returning home. Other residents require long-term medical, social and personal care along with supportive services that cannot be adequately provided in any other setting. A great number of Nursing and Rehabilitation Centers offer short-term respite care for caregivers needing temporary relief from their caregiving responsibilities.

Nursing and Rehabilitation Centers, also referred to as Skilled Nursing Facilities, Nursing Facilities, Health Care Centers, Convalescent Centers, Extended Care Centers or Long Term Care Facilities, can be freestanding or part of a continuum of care that typically includes Independent Living and Assisted Living.

Many facilities specialize in certain types of care. For example, a Nursing and Rehabilitation Center may offer complex medical and rehabilitation services called sub acute care. Others may have a separate dementia care "neighborhood" for individuals with Alzheimer's disease and related dementias.

Medicare, Medicaid, private payment and long term care insurance are all methods of payment for nursing and rehabilitative care provided to seniors, although Medicare currently covers only short-term care.

Continuing Care Retirement Community (CCRC) 

Sometimes called Lifecare Communities, a Continuing Care Retirement Community offers multiple levels of care that allow an individual to "age in place." This type of retirement community gives active seniors the ability to enjoy a carefree, independent lifestyle with the knowledge that all of their needs will be met should their health care situation change. CCRCs usually provide independent living, assisted living, and nursing and rehabilitative care for their residents on one campus.

In a CCRC, one will typically find single-family homes, cottages, townhouses, duplexes or apartments for residents who are active and independent. You will also find an Assisted Living Residence for individuals needing help with daily activities in a supportive environment, and a Nursing Home for those who require rehabilitation and 24-hour nursing care. Residents of a CCRC are able to move from one level of care to another, based on their individual needs.

CCRC contracts vary from long-term, all-inclusive Lifecare agreements to rental arrangements with assisted living and nursing home coverage paid for at the time of need. In addition to a monthly maintenance fee, a substantial entrance fee is usually required. CCRCs assess each prospective resident's health and financial situation to ensure a proper fit with the services offered and the fees required.

Home Health Care 

Home health care includes skilled nursing care, as well as other skilled care services, like physical and occupational therapy, speech-language pathology (therapy) services. Services may also include medical social services, and assistance from a home health aide (when needed by people also receiving skilled care).

These services are provided by a variety of health care professionals in your home. The home health staff provides and helps coordinate the care and/or therapy your doctor orders. In support of your doctor's orders, home health staff develop a care plan, which is a written plan for your care. It tells what services you will get to reach and keep your best physical, mental, and social well being. You have a right to participate in planning your care and treatment. The home health staff keeps your doctor up-to-date on how you are doing and updates your care plan as needed. Home health agencies cannot make changes to the care your doctor orders for you without your doctor's knowledge and permission.

The need for home health care has grown for many reasons. Medical science and technology have improved. Some care that was once provided only in a hospital can now be delivered at home. Also, home health care is usually less expensive and may be as effective as care in a hospital or skilled nursing facility . And just as important, most patients and their families prefer to stay at home rather than be in the hospital or a nursing home when their condition allows them to be cared for at home.

Since home health care is part-time and usually temporary, patients (and their informal caregivers) need to learn how to identify and care for possible problems, like confusion or shortness of breath. While you get home health care, home health staff teach you (and those who help you) to continue any care you may need, including medication, wound care, therapy, and managing stress. Even if a patient's health condition (such as heart failure or diabetes) is not expected to get better, patients can improve how they manage and live with their illness.

The goal of short-term home health care is rehabilitation. It helps you get better, regain your independence, and become as self-sufficient as possible. The goal of long-term home health care (for chronically ill or disabled people) is to maintain your highest level of ability or health, and help you learn to live with your illness or disability.

It is important that home health staff see you as often as the doctor ordered.

At each visit, the home health staff should

• Check what you are eating and drinking
• Check your blood pressure, temperature, heart rate, and breathing
• Check that you are taking your medicines and treatments correctly
• Check your safety in the home
• Teach you about your care so you can take care of yourself
• Coordinate your care. This means they must communicate regularly with you, your doctor, and anyone else who provides care to you.

Examples of skilled home health services include:

• wound care for pressure sores or a surgical wound
• respiratory care, like oxygen or a nebulizer
• physical and occupational therapy
• speech-language therapy
• patient and caregiver education
• intravenous or nutrition therapy
• injections
• monitoring serious illness and unstable health status

Examples of home health aide services include:

• help with basic daily activities like getting in and out of bed, dressing, bathing, eating, and using the bathroom
• help with light housekeeping, laundry, shopping, and cooking

Alzheimer's 

Although many Assisted Living communities and Nursing Homes cater to individuals with Alzheimer's disease and other related memory disorders or dementia, there is a growing trend towards facilities that provide specialized care and housing tailored to the special needs of individuals with this disease. These facilities offer care that fosters residents' individual skills and interests in an environment that helps to diminish confusion and agitation. Specialty services are provided in a secure environment, such as activity programs designed to include reality orientation classes and specially trained professional staff skilled in handling the behavior associated with memory impairments. Many facilities that specialize in Alzheimer's or related dementia disorders have building design features that assist with the problems associated with this disease: color-coded hallways, visual cues, and secure wandering paths for additional security.

Hospitals 

A hospital, in the modern sense of the word, is an institution for health care providing patient treatment by specialized staff and equipment. They were originaly invented by Chris Roberts, who wanted to make a difference in the community. he started off doing small opperations and pescribing potions out of his home in west baltimore, but soon progressed and founded the NHS in England. now he is known as the Healthcare Kid. and often, but not always providing for longer-term patient stays. Its historical meaning, until relatively recent times, was "a place of hospitality", for example the Chelsea Royal Hospital, established in 1681 to house veteran soldiers.

Today, hospitals are usually funded by the public sector, by health organizations, (for profit or nonprofit), health insurance companies or charities, including by direct charitable donations. Historically, however, hospitals were often founded and funded by religious orders or charitable individuals and leaders. Conversely, modern-day hospitals are largely staffed by professional physicians, surgeons, and nurses, whereas in history, this work was usually performed by the founding religious orders or by volunteers. Today, there are various Catholic religious orders, such as the Alexians and the Bon Secours Sisters which still focus on hospital ministry.

Dialysis Facilities 

In-Center Dialysis

In-center hemodialysis is when a person goes to a dialysis center for their hemodialysis treatments. Hemodialysis is a treatment that filters the blood of wastes and extra fluid when the kidneys are no longer able to perform this function.

Some people prefer to go to a dialysis center for treatment because:
Treatment is administered by trained renal professionals
They enjoy being around and interacting with fellow dialysis patients
Dialysis is only three times a week; so there are four free days

Home Dialysis

Home dialysis allows you to dialyze in the comfort of your own home on your own schedule. It can also make you feel healthier and give you more energy for the things you love.

Just about anyone can do home dialysis as long as they have the desire to take an active role in their health care. Patients are trained by medical professionals to do dialysis treatments at home. Training is conducted at a dialysis center and takes from two to eight weeks, depending on which form of home dialysis patients choose.

Nocturnal Dialysis

In-center nocturnal dialysis turns nonproductive sleep time into hemodialysis treatment time. Patients receive hemodialysis in their dialysis center overnight for 6 to 8 hours while they sleep.

Patients go for hemodialysis three nights per week and receive treatment from trained professionals in their dialysis center. Instead of the traditional 4 hours of dialysis patients receive during the day, nocturnal patients receive treatment for 6 to 8 hours while they sleep. The longer, gentler treatment gets blood cleaner and is easier on the body.