Choosing the right care for yourself or a loved one can be complicated.  Often times we realize that more care is needed but we don’t know where to start.  Nursing homes, assisted living, and memory care options differ in the care provided.  The choice between these options depends on the level of care needed, the individual’s physical and cognitive health, and where their well-being and safety will be best supported.  In this blog, we will explore these options and break down the details so you can understand your care options.

 1.  Nursing Home (Skilled Nursing Facility or SNF)

Care Level

In this setting, medical care is provided 24/7 and there is usually a licensed nurse on duty at all times.  Skilled nursing care and assistance with activities of daily living (ADLs) are both included.  Skilled nursing care includes IV treatment, feeding tubes, wound care or another type of care that requires a higher level of skill set.

Focus

Patients typically have chronic conditions, significant mobility limitations, or serious health issues that require intensive support.  Nursing homes usually focus on rehabilitation and health care.  This setting would be considered a step down from a hospital.  

Environment

Rooms may be private or semi-private and it feels a bit more like a hospital rather than a home setting.  This allows for a focus on medical care.

Who Is this For?

This is for those with complex care needs or serious medical conditions that cannot be managed in an assisted living or memory care facility.  People with advanced dementia who also have medical needs will also fit these criteria.

Cost

Nursing home are often the most expensive options due to the level of care provided.  Average cost in Maryland is $10,000 – $13,000 per month.  Medicare will usually pay for long term care; however, there may be a limited number of days that are covered.  Medicaid will cover this cost for eligible low-income individuals, but the eligibility and services covered may vary.  Long term care insurance may cover the costs depending on the coverage listed in the policy.  Other payment options include paying privately for the care.

2.  Assisted Living (AL)

Care Level

In this setting, care is provided 24/7 but it may be provided by a caregiver or certified nursing assistant.  It’s usually required that a licensed nurse provide supervision, but they do not need to be on site 24/7.  Assisted living is designed for people who require help with their ADLs, but intense medical care is not required.  This is not one on one care.  Staff to resident ratios vary for each facility.  

Focus

Residents are encouraged to remain as independent as possible with support in the areas they need it.  There is an emphasis on lifestyle enhancement and socialization rather than medical care.  Residents are encouraged to participate in community activities and often develop new friendships in this setting.

Environment

Rooms may be private or semi-private and apartment options may also be available.  This environment is more like a home and the community typically offers amenities such as dining, exercise, activities and transportation.

Who Is This For?

This is for older adults who need assistance with ADLs and where supervision will create a safer environment than living independently.  This is also an appropriate option when the primary family caregiver is no longer to care for their loved one at home.  People in the early stages of dementia may thrive in this environment because a structured routine and socialization can be beneficial.

Cost

Most assisted living care is paid for privately.  Average cost in Maryland is $4,500 – $7,000 per month.  This type of care is generally not covered by Medicare.  Medicaid may offer limited support, especially through a Medicaid waiver program.  Long term care insurance may cover the costs depending on the coverage listed in the policy.  Veteran’s or their spouses could qualify for financial assistance through the Aid and Attendance program.

3.  Memory Care (MC)

Care Level

In this setting, those living with dementia and other cognitive impairments will receive care 24/7, usually by a caregiver or certified nursing assistant.  Similar to an assisted living facility, a licensed nurse is typically responsible for providing supervision.  The care provided here is more specialized dementia care and will also include assistance with ADLs.  This is not one on one care.  Staff to resident ratios vary for each facility.  

Focus

Resident care will focus on structure, cognitive stimulation, and a calm environment.  Staff are trained to handle challenging behaviors such as agitation, confusion and aggression.  Some memory care facilities will have a neurologist or psychiatrist who visits regularly to manage these behaviors.

Environment

Rooms may be private or semi-private and the facility is secure to prevent wandering or elopement.  The resident may wear a device that alerts staff if the resident is wandering out of the safe environment.  They often include dementia-friendly environments using wayfinding techniques and color schemes to reduce confusion and enhance comfort.

Who Is This For?

This is for those living with moderate to advanced dementia who require a more controlled environment to maintain safety and structure tailored to their cognitive impairment.  Someone may enter into memory care directly from living independently, or they may transfer from assisted living to memory care when care needs increase.

Cost

Memory care services are typically paid for privately.  Average cost in Maryland is $6,000 – $10,000 per month.  This type of care is generally not covered by Medicare.  Similar to assisted living, long term care insurance, Medicaid and Veteran’s assistance may be available if certain qualifications are met.

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Each option offers unique support tailored to specific needs so it’s best to understand your care options.  Finding the right fit can greatly improve your or your loved one’s quality of life.  If you are navigating this decision and need guidance, I’m here to help.  As a dementia care consultant, I work closely with clients and families to assess individual needs and recommend the best care options to ensure comfort, well-being and safety at every stage.  Please contact me for a free consultation.