What's higher than assisted living? Understanding skilled nursing and other options

According to the National Institute on Aging, millions of older adults reside in a long-term care facility, with many requiring higher levels of care beyond standard residential assistance. For families navigating this decision, understanding what's higher than assisted living? is a crucial first step toward finding the right fit for their loved one's evolving needs.

Quick Summary

Higher levels of senior care include skilled nursing facilities for round-the-clock medical care, memory care units for specialized cognitive support, and Continuing Care Retirement Communities that provide a seamless transition between care levels as needs change.

Key Points

• Skilled Nursing Facilities: Offer the highest level of medical care, providing 24/7 access to licensed nurses and intensive rehabilitation services for complex health needs.

• Memory Care: Provides a specialized, secure environment with dementia-trained staff to support individuals with cognitive impairments, such as Alzheimer's, that standard assisted living cannot fully address.

• Continuing Care Retirement Communities (CCRCs): Unique campuses offering a full spectrum of care, allowing seniors to move seamlessly between independent living, assisted living, and skilled nursing as their needs change.

• Higher Medical Needs: The need for constant medical supervision, advanced medical procedures (IVs, wound care), or intensive rehabilitation dictates moving to a skilled nursing facility.

• Cognitive Impairment: A diagnosis of dementia or increasing symptoms like wandering and confusion are clear indicators that a specialized memory care unit may be more appropriate and safer.

• Assessing for Higher Care: The decision requires a professional medical assessment, a careful review of financial resources, and open communication with the senior to ensure their needs and preferences are met.

Skilled Nursing Facilities: The Highest Level of Medical Care

When a senior requires intensive, round-the-clock medical supervision, a skilled nursing facility (SNF) is the next step. SNFs, often called nursing homes, provide a clinical environment with licensed medical staff available 24/7, focusing on medical services rather than just residential assistance.

Services offered in a skilled nursing facility

• 24/7 Nursing Care: Licensed nurses administer medication, manage complex conditions, and perform procedures.
• Rehabilitation Services: On-site physical, occupational, and speech therapy are available for recovery.
• Complex Medical Needs: Facilities handle chronic conditions, post-operative recovery, and advanced medical care.

Memory Care Units: Specialized Cognitive Support

For seniors with Alzheimer's or other memory conditions, a dedicated memory care unit offers specialized care. These units provide a tailored and secure environment.

What to expect in memory care

• Increased Security: Features like secured entrances prevent wandering.
• Specialized Staff Training: Caregivers are trained in dementia care and managing behavioral challenges.
• Structured Environment: Routines are planned to reduce confusion and anxiety.

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

A Continuing Care Retirement Community (CCRC) provides a tiered approach with various care options on one campus. Residents can 'age in place,' moving between independent living, assisted living, and skilled nursing as needs change, avoiding future relocations.

The CCRC advantage

• Convenience: Residents move within the same community as needs evolve.
• Security: Higher levels of care are guaranteed.
• Community: Fosters a strong sense of community and social connections.

Choosing the Right Fit: Comparison Table

Choosing requires assessing a senior's current and future needs. This table compares the key differences.

Feature	Assisted Living	Skilled Nursing Facility	Memory Care	Continuing Care Retirement Community
Primary Purpose	Assistance with daily tasks (ADLs) and socialization.	24/7 medical supervision and complex medical care.	Specialized care for cognitive impairments in a secure environment.	A full continuum of care on one campus.
Environment	Residential, apartment-style.	Clinical, hospital-like setting.	Specialized, secure, and structured environment.	Campus with multiple housing types and care levels.
Staffing	Non-medical staff, limited nursing hours.	Licensed medical professionals (RNs, LPNs, therapists) 24/7.	Specialized, dementia-trained caregivers.	Varies by care level, with access to skilled medical staff.
Ideal Resident	Needs help with some ADLs, degree of independence.	Requires complex medical care, rehabilitation, or constant monitoring.	Diagnosed with Alzheimer's or other forms of dementia.	Wants long-term plan to age in place with access to higher care.
Cost	Less than skilled nursing, more than independent living.	Typically the most expensive.	Higher than standard assisted living due to specialization and security.	High initial entry fee plus monthly fees varying by care level.

Making the Decision for Higher Care

Determining the right level of care is challenging. Assess the senior's health, future needs, finances, and preferences. While assisted living offers support, declining health or cognitive impairment may require a higher level of care. Consult a healthcare provider and tour facilities to find the best fit.

Choosing higher care is a proactive way to ensure a senior's needs are met with dignity. The goal is an environment promoting well-being and security as abilities evolve.

For more information, visit resources like the National Institute on Aging, offering guidance on senior care decisions.

Frequently Asked Questions

What is the primary difference between assisted living and skilled nursing?

The main difference is the level of medical care provided. Assisted living focuses on personal care assistance and a residential lifestyle, while skilled nursing facilities provide 24/7 comprehensive medical care from licensed professionals.

When is a move from assisted living to skilled nursing typically necessary?

A move becomes necessary when a senior develops complex medical needs that require continuous medical supervision, such as managing chronic illnesses, recovering from a major surgery, or needing advanced therapies.

Is memory care considered higher than assisted living?

Yes, memory care is a higher and more specialized form of care designed specifically for individuals with cognitive impairments like dementia. It provides a secure, structured environment and highly trained staff that go beyond the services of standard assisted living.

What are the financial differences between assisted living and a higher level of care?

Skilled nursing and memory care are generally more expensive than assisted living due to the increased level of medical staffing, specialized training, and security measures. Costs can also vary by location and room type.

What is a Continuing Care Retirement Community (CCRC)?

A CCRC is a campus that offers multiple levels of care in one location, including independent living, assisted living, and skilled nursing. It provides a seamless transition for residents as their care needs increase.

How do I know which level of care is right for my loved one?

You should start with a comprehensive assessment of your loved one's current health and future needs. Consulting their primary care physician and touring different facilities to observe the environment and staff-to-resident ratios is also highly recommended.

Can I return to assisted living after a stay in a skilled nursing facility?

Yes, it is possible. Many skilled nursing stays are short-term and intended for rehabilitation after an illness or surgery, with the goal of returning the patient to a lower level of care, like assisted living or their home.