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Long-Term Care

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The Four Primary Kinds of Care Providers

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When your loved one can no longer care for herself, it's time to find help. But what kind of care environment is best?

The good news is you have options, more than you think. Making the transition to a new care environment or modifying a current one, like a home isn't as difficult as you might think.  In general, there are four common care environments: Home Health CareAssisted Living FacilitiesNursing Homes, and Adult Daycare CentersContinuing Care Retirement Communities usually provide several care environments within a multi-building campus.

Home Health Care

Receiving care in the home is perhaps the most flexible of all options. Caregivers who come into the home can provide services that range from stand-by oversight for a few hours a week to round-the-clock care. When you engage a home health care agency, they will supply caregivers with the appropriate skills during the time that you request. Before you plan for services with a home care agency, you should get an assessment of your loved one's care needs. Sometimes the agency can arrange this assessment, and it should be performed by a registered nurse.

Generally, most agencies want visits to last for at least 3-4 hours, and some have weekly minimums as well. If you request a caregiver in the home 24-hours a day, the agency will usually split the time into two 12-hour shifts. Unique state labor laws also factor into staffing for full-time caregiving. Some agencies will provide "live-in" caregivers, but there are requirements as to where and when they are allowed to sleep and how much free time they have.

An alternative to working with a home health care agency is to hire an independent caregiver directly. Because they work for themselves, you pay them directly. 

Home health caregivers can range in skill level from untrained companions, to homemakers, to skilled nurses. Many have completed programs to be Certified Nursing Assistants or Certified Home Health Aides, meaning they are trained to handle health issues such as mobility, nutrition, toileting, hygiene and behavior. These certifications may not mean that they are able to provide nursing care such as medication administration, injections or wound care. 

Cost: The annual cost of home care varies greatly with the number of hours per day that are needed. With the national median rate at $19/hour for a licensed home health aide, 40 hours of care a week would cost $43,472 per year*. The cost of independent care providers is generally lower than those employed by an agency. 

Assisted Living Facilities

There is no standard model for assisted living residences. They vary in size, appearance and types of services they provide. Assisted living facilities are a popular choice because they tend to have a variety of social programs and offer a community setting where residents can live relatively active lives. On a visit you might find an exercise room, a pool, hair salons, and a community garden. Residents can take part in group sessions and social activities throughout the day and some type of religious worship service during the week.


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