Good Words on Senior Living
#1 An Essential Vocabulary
When starting to think about retirement living options, the first thing many people ask is “What's up with all the acronyms? What do they all stand for?“
Excellent questions. Let's dive right in!
Retirement Community (RC): A retirement community is a residential community or housing complex designed for older adults who are generally able to care for themselves.
Retirement communities may offer different "levels-of-care", including Independent Living, Assisted Living, Memory Care, Nursing Care, Rehabilitative Care (short term or long-term), and Hospice Care.
Retirement communities strive to balance both assistance with daily activities, and health care (if licensed), with welcoming residential settings that include activities, meal plans, and a variety of social opportunities.
Continuing Care Retirement Community (CCRC): A CCRC offers a “continuum of care”, or several levels of care on the same campus. Most CCRCs promise that you will never have to move out or leave the campus to receive any health care, other than critical or emergency hospital care. Residents are assured that all current and future healthcare needs are met in one community.
In the U.S. today, there are nearly 2,100 CCRCs. About 80% are not-for-profit, while 20% are for-profit.
CCRCs are somewhat costly, requiring a significant deposit (often funded by the sale of one's primary home) and monthly fees that can rise as your care needs increase.
Independent Living Community (ILC): Often called “free-standing IL” or “rental IL”, ILCs are often rental communities, requiring a low or no deposit. When an ILC only offers rental residences (usually apartments), they generally do not offer on-site health care or assisted living services.
Independent living residents must be able to live safely, without round-the-clock care. Most ILCs offer restaurant-style meal plans. Many ILCs welcome their residents to hire “at home care” to assist with certain needs, but again, not round-the-clock care.
Independent Living in a CCRC means just that. You live with your spouse, or alone, in your choice of an on-campus home, cottage, or apartment. Although you may not require assistance with daily activities (assisted living), you have the assurance of knowing help is there, when and if it's needed. Independent residents reap the benefits of the unlimited social, cultural, physical ,and spiritual amenities on the campus of a CCRC.
Assisted Living Communities (ALCs) can be free-standing, offered alongside Memory Care residences, or one of the sub-communities in a CCRC. Free-standing ALC's generally require a deposit or a community fee, plus a monthly fee.
The monthly fee is based on the amount of care a resident requires with "Activities of Daily Living". Generally, residents of ALCs must not be bed-bound, have mid- to late-stage dementia, or require around-the-clock care. ALCs strive to help residents maintain as much independence as possible.
Activities of Daily Living: ADLs are generally considered to be: bathing/grooming, dressing/undressing, eating/meal prep, safe restroom use/continence, walking (with or without assistance), and safe and functional transferring.
Memory Care (MC) communities provide a secure, physically safe, and emotionally and socially supportive environment to residents with dementia or Alzheimer's Disease.
Memory Care communities can be free-standing, offered alongside an ALC, or as a sub-community inside a CCRC. Memory Care offers very low resident-to-caregiver ratios. The mental, physical, and social well-being of each resident is of paramount importance in Memory Care communities.
Skilled Nursing Communities (SNCs or SNFs) provide both short and long-term rehabilitation and medical care. Some stand-alone skilled nursing communities are affiliated with large hospital networks.
Most CCRCs have a Skilled Nursing component as part of their continuum of care. When possible, the medical and nursing staff inside a SNC aim to discharge residents back home or to a retirement community that meets their needs. High daily costs of SNCs has changed this industry from a mostly long-term setting, to a mostly short-term setting.
Rehabilitation Care is offered most often in three settings. As a free-standing community, as a component inside a Skilled Nursing community, or as a separate offering inside a CCRC. Most general hospitals today do not provide long-term physical, or occupational rehabilitation on-site. As a result, free-standing rehab facilities are more common. Rehab staff in a CCRC include licensed nurses, doctors, and physical, occupational, and speech therapists.
In-Home Care offers hourly, half-day, or overnight assisted care in one's own home. Licensed nursing care can also be provided in one's own home, but it is more costly than "Companion Care" or "Assisted Care". In-Home Care can include assistance with Activities of Daily Living, as well as medication reminders, cooking and/or meal delivery, light housekeeping, and transportation services for shopping and errands. Retirement communities that do not offer Assisted Living may welcome residents to hire In-Home Care as needed.