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Choosing a Long-term Care Setting: Facility Types - Review the Choices

  

Adult Day Care Services

Adult day care can provide respite care as well as ongoing services. Services are provided in a variety of centers around the state. Social, recreational and health services are provided in a protective setting to individuals who cannot be left alone because of health care needs, confusion or disability. These programs provide meals and care services in a community setting during the day when a caregiver needs time off or must work.

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Adult Foster Homes

Adult foster homes offer personal and health care to individuals in private residences. Care and supervision are provided to maintain a safe and secure setting. Adult foster homes are licensed, inspected and monitored by the Department of Human Services, Seniors and People with Disabilities and Area Agency on Aging offices. People often choose adult foster care because it is more affordable than other care facilities and care is provided in a homelike setting. These homes provide care for no more than five individuals.

All adult foster home providers and primary caregivers must:
  • Pass a criminal record check
  • Complete a basic training course and pass an exam
  • Be physically and mentally able to provide care
  • Provide care in a home that meets structural and safety requirements

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Alzheimer's Care Units

Some facilities specialize in providing care only to persons with Alzheimer's Disease or other forms of dementia. A facility that specializes in the care for people with memory impairment must receive an endorsement and is governed by additional regulations that are specifically intended to support individuals with dementia.

Structural requirements in an Alzheimer's-endorsed setting

  • A secure building that alerts staff if a resident has exited
  • A secure outdoor area that provides outdoor freedom safely
  • Interior finishes that are non-glare and well lit
  • Visual contrasts between floors, walls and doorways

Program Requirements

In addition to providing the services required in our other licensed settings, Alzheimer's units must also have programs, which include:

  • Gross motor activities
  • Self care activities
  • Social activities
  • Crafts
  • Sensory enhancement activities
  • Outdoor activities

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Assisted Living Facilities

Assisted living facilities provide housing and supportive services for six or more residents. These facilities are fully wheelchair accessible. Residents of assisted living facilities have private apartments, ranging from a studio to one or two bedrooms. Each apartment unit has a kitchenette and private bathroom with a wheelchair accessible shower. Assisted living facilities are licensed and regulated by the Department of Human Services, Seniors and People with Disabilities.

Assisted living facilities are best suited for individuals who want to remain as independent as possible and who are able to direct their own care.

Assisted living facilities are not required to have licensed registered nurses on staff 24-hours-a-day.

Duties and qualifications of direct caregivers will vary among facilities. Staff to resident ratio will typically be lower than what is required for nursing homes. Caregivers are not required to be certified, although training prior to providing services to residents is mandatory.

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Continuing Care Retirement Communities

Continuing Care Retirement Communities are generally made up of independent living residences, assisted living / residential care facilities and nursing facilities. These communities require an entrance fee along with monthly and/or other periodic charges. They are required to register with the state and disclose specific information about the services they provide and their finances. Only a nursing facility, residential care or assisted living facility located on the campus must be licensed by the State. Otherwise Continuing Care Retirement Communities are not regulated.

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Nursing Facilities

Nursing facilities are licensed by the Department of Human Services, Seniors and People with Disabilities and are required to meet both federal and state regulations.

Services offered in nursing facilities

  • Nursing care on a 24-hour basis
  • On-site physical rehabilitation
  • Recuperation after hospitalization for serious illness or surgery
  • Restorative services
  • End-of-life care
Nursing facilities are most appropriate for people who need 24-hour medical oversight and a protective/structured setting. Residents may have medical and behavioral needs that cannot be met in other care settings. Most residents must share their room. Space is limited, but residents are allowed to bring personal items to encourage a more home-like atmosphere.

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Residential Care Facilities

Residential care facilities provide housing and supportive services for six or more people who don't need 24 hour nursing care. Residential care facilities offer shared and private rooms. These facilities are not required to provide private bathrooms or kitchenettes. Many residential care facilities specialize in caring for individuals with Alzheimer's or dementia. These settings are licensed and regulated by the Department of Human Services.

When considering any long-term care setting, request copies of the residents' rights, the admission contract, and price list to read closely. Residential Care facilities are not required to have licensed nurses on staff for a specific number of hours per week. The nurse typically does not provide hands-on personal nursing care.

Duties and qualifications of direct caregivers will vary among facilities. Staff to resident ratio will typically be lower than what is required for nursing homes. Caregivers are not required to be certified, although training prior to providing services to residents is mandatory.

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Respite Care

Respite care gives families and other caregivers temporary relief from providing care for frail adults. Companionship, light assistance, recreational activities and security are provided in the resident's home, out of home in a group setting, or overnight in a residential setting. Respite care allows for a healthier and better quality of life for both the caregiver and care receiver.

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Retirement Homes/ Complexes/ Communities

Retirement complexes are for people who desire to and are able to live independently but do not want to maintain a home. Many people prefer to live in a community with others of the same age and with similar interests.

The Department of Human Services, Seniors and People with Disabilities does not regulate or license retirement communities.


See other "Choosing a Long-term Care Setting" sections: