The Definitive Guide to Senior Care
A how-to guide to types of care, costs and insurance, and making the care transition as smooth as possible.
You know your loved one has an uphill battle ahead. It could be Alzheimer’s moving beyond the occasional memory slip or misplaced keys, or maybe it’s chronic back pain that’s turned their simple tasks into your daily chores. Whatever the case, they’re going to need help. But what kind of help, how much, and what will that mean for your family and your finances? This guide looks at all types and aspects of senior care, from identifying the kind of care you need to breaking down the financial options to make it all happen. Senior care may seem like a big scary step for you and your loved one, but it doesn’t have to be.
Quiz: What Care Do You (or Your Loved One) Need?
Not sure which care option makes sense for you or your loved one? Take our quiz to find your top matches, and then get details on those matches in the senior care profiles below.
Question 1 / 10
Senior Care Match Results
- Senior Co-op
- Independent Living
- Continuous Care Retirement Community
About this quiz
Your senior care matches are based on questions, answers, and values drafted in conjunction with senior care specialists and actual senior citizens. All senior care matches are for informational purposes only, and do not, in any way, represent concrete recommendations for care. If you have any further questions about the quiz, or about this page in general, please reach out to us via our Contact Us page.
Profiling Types of Senior Care
Many people need the services of a caregiver as they age, but how much care a person needs can vary tremendously. For some, an occasional in-home visit is plenty. For others, round-the-clock care might be a requirement. Some need care only for themselves; others need care for a couple aging together. Given the wide ranges of elderly experiences, there are numerous senior care options available, all with their own list of services and corresponding price tags. Here are the 12 most common options, ordered by level of care needed.
Senior Co-ops
Usually reserved for those 55 or older, the co-op allows residents to buy into a community that provides them with independence and social interaction, but they don’t have to worry about maintenance of the apartment, expenses of typical home ownership, or even most chores that accompany ownership, such as taking out the trash or paying the bills. These co-ops are designed to allow residents to have a voice in the way the co-op is run, and also free them up to enjoy their golden years without worry about losing their independence.
WHO THEY’RE FOR
Best for those who are in good health but want to make life much easier through avoiding typical chores and maintenance.
HOW TO CHOOSE
A co-op works by holding the master mortgage for the building; the residents buy into the co-op and pay for their own space. Each co-op has its own bylaws and rules, so it’s important to look over them very closely to decide if you can live with what they require. It’s also important to note that often, co-ops require you to continue paying your monthly fee until someone else moves into your apartment or townhome – and that could be a hefty price tag on top of what you might be paying to live in another facility, perhaps one that offers more care.
KEY QUESTIONS TO ASK
- Question 1: How much does it cost to buy in to the co-op?
- Question 2: How much power do the residents really have?
- Question 3: Are there accommodations in place that allow a person to age gracefully at home for as long as possible?
Senior Apartments
Independent Living
Retirement Communities
Continuous Care Retirement Community
In-Home Help
Assisted Living
Day/Activity Camps
In-Home Care
Skilled Nursing Facility
Nursing Home
Hospice Care
How to Pay for Senior Care
Senior care is a significant financial investment. Luckily, today’s seniors have numerous assisted care funding sources available to them. Some of these methods require careful planning, so start thinking about how to pay for senior care now, even when you’re perfectly healthy. Waiting until the last minute can result in paying more out-of-pocket than necessary. In some cases, it might mean foregoing necessary care because it exceeds your budget. Let’s take a detailed look at the payment options.
Paying out-of-pocket means using your personal funds to cover the costs of care. Without knowing what kind of long-term care will be needed, or how long one will live, predicting these out-of-pocket costs can be almost impossible. With some senior care options costing almost six figures annually, paying for everything out of pocket will require a massive level of savings.
You might be a good candidate if… you’ve been a fantastic saver. It may also be an option for those with a large support network of friends or family members who can provide caregiving assistance to supplement what they pay for out-of-pocket.
Medicare is a federal health insurance program for those aged 65 years and older or for individuals with specific diseases or disabilities. Within the senior living context, it will only cover an individual’s short-term care needs, such as rehabilitation or convalescent care. It will not cover long-term or skilled care services.
You might be a good candidate if… you need only short-term care. Any long-term care needs will need to be funded through alternative means.
Medicaid is a program jointly funded by the federal and state governments. While states operate Medicaid, they must do so in a way that complies with federal rules in order to receive federal funding. Medicaid helps individuals pay for medical costs, including long-term senior care. However, it’s only available to those with limited income or wealth.
You might be a good candidate if… you have limited financial means and can meet the income or financial eligibility requirements.
Also known as Medicare Supplement Insurance, Medigap helps pay for medical expenses that Medicare won’t cover, such as deductibles, copayments and coinsurance. Medigap insurance policies are sold by private insurance companies and will almost never cover long-term care costs.
You might be a good candidate if… you need only temporary nursing care or help paying for hospice care.
Long-term care insurance is exactly what it sounds like: special insurance to pay for the costs of long-term care that’s the result of a chronic condition or disability. Policyholders pay a premium and in return, their long-term care insurance will pay for personal or skilled care within the home, nursing home, assisted living, or other senior care setting. Like other insurance, you must purchase a policy before you actually need it.
You might be a good candidate if… you aren’t eligible for Medicaid and have wealth you’d like to protect from potentially massive long-term care costs.
A reverse mortgage allows those age 62 or older to turn the equity in their home into cash. This money does not need to be paid back until the borrower dies or leaves the home for any reason. No matter what happens in the real estate market, if the value of the home becomes less than the debt, the borrower or their heirs do not need to make up the difference.
You might be a good candidate if… you are old enough to qualify, own your home outright (or have significant equity in the home), and are okay with the idea of having the house sold upon your death.
Life insurance pays a benefit upon the death of the insured. The death benefit is intended to make up for the financial losses that result from the death of the insured. Certain life insurance policies have provisions that allow a covered person to take a percentage of the policy’s value to pay for senior care services.
You might be a good candidate if… you want to buy life insurance, but need greater flexibility in how you take advantage of its benefits.
Accelerated death benefits are a feature of some life insurance policies that allow you to receive an “advance” on the death benefit. However, certain conditions must be met, such as being terminally ill, permanently disabled, or needing long-term skilled or personal care.
You might be a good candidate if… you need to purchase life insurance anyway and have the option of a policy with the accelerated death benefit.
Continuing Care Retirement Community (CCRC) Buy-Ins are special “deposits” or entry fees that residents can pay to lower their monthly fees. These buy-ins are substantial in amount, often topping six figures. Not all CCRCs have buy-ins, but the ones that do allow this entry fee to reduce the monthly costs the residents would otherwise have to pay as their need for personal or skilled care increases. Depending on the CCRC, this buy-in may be partially refundable.
You might be a good candidate if… you have a large amount of cash, know you will need assisted living services for an extended period of time, and wish to receive those services from one place.
A life settlement is the sale of a life insurance policy to a third party. The buyer becomes the new beneficiary and assumes all the responsibilities of the seller, including payment of premiums. In return, the seller gets a lump sum cash payment (that’s usually tax-free) in excess of the cash surrender value of the policy, but less than the death benefit.
You might be a good candidate if… you have a whole life insurance policy and need a large amount of cash now.
Having “the Conversation” with a Loved One
Making the decision to find care for a loved one is not easy. At the very least, it means changing how that person lives, but most of the time, it means changing where they live, too.
For expert insight into how to have that difficult conversation, we spoke to Dr. Regina Koepp, a board certified Clinical Psychologist, Professor of Gerontology, and Assistant Professor at Emory University School of Medicine’s Department of Psychiatry and Behavioral Sciences. She has been a staff Psychologist at the Atlanta VA Health Care System (VAHCS) since 2010 where she provides direct patient care and consultation on the Gero-Psychiatry Outpatient Mental Health team.
Here’s a bit of her advice:
1
Don’t wait until there is a crisis!
Starting these conversations long before your loved one has a medical, mental health, or financial crisis is the best approach. In the midst of crises, people tend to be highly emotional and super stressed. As a result, they do not communicate effectively.
2
Start the conversation sooner than you think you need to.
Starting the conversation early helps you to have a conversation where you’re asking your loved one rather than telling your loved one how things are going to be in their own aging process.
3
Have the conversation during a neutral time
not in the midst of chaos, and not when you’re celebrating! Finding a neutral time will take some of the emotional heaviness or lightness out of what will naturally be a complicated talk.
4
Expect that this will be emotional.
Everyone is entitled to finding this conversation and transition upsetting. Starting this discussion with the understanding that this will indeed be an emotional conversation will set people up for success in managing emotions.
5
Choose the best messenger.
Consider who would be the best person to make this recommendation or start this conversation with the older adult. A trusted doctor (following an assessment), family members, friend, or pastor.
6
Ask your loved ones about their wishes!
Instead of telling your loved one what you plan to do, ask them about what they want related to their medical, mental health, financial, and living needs. Who knows? They may surprise you.
7
The first conversation should not be the last conversation.
When things get heated, take a break and offer to talk about this again at a later date. The second or third attempt may well be easier for everyone.
8
Work together as a team!
As you are starting out in these conversations, it can really help to imagine that you and your loved one are on the same team, tackling a challenge and going through the transition together.
Making the Transition
Moving can be tough at any age – it involves physically moving from one space to another, keeping track of all the logistical concerns, and the stress inherent in simply being in a new atmosphere. Now imagine all of this happening when you are much older, with declining health and reduced physical abilities. In addition, it might be a situation in which the move is not your choice – your health condition requires it. It’s easy to see how the transition can be a traumatic experience for some, but it doesn’t have to be a burden. Let’s review a few techniques that can make care transitions easier and more successful.
For part-time
In-home care
Inviting someone into your home can feel like an invasion, but for many it allows for longer living in their own comfortable space. To prepare, look at the general considerations, such as getting an extra house key, making a list of emergency contacts, and choosing duties for the caregiver. Then consider what will be allowed and what will not; for instance, are certain rooms off limits to the caregiver? Are there any valuables that should be secured for peace of mind? Is there a system in place for communication, such as a white board in a common room of the house?
Remote care
When a person will be leaving the home for part time care in a facility of some sort, other considerations come into play. Will transportation be provided by the facility, or will the patient have to find their own way there? What’s the schedule going to be like? What will the new routine include? Are there any requirements, such as getting a set of shots before being in an area with other seniors? Making short visits with family to build familiarity with the facility is always a good idea.
For full-time
In-home care
Someone who comes into your home to stay – perhaps to live in the home with you – takes even more preparation and planning. That person will need a room of their own if they will be living there, and if not, they will still need a dedicated space for their things and any quiet time they might need. There will need to be boundaries, such as the question of whether meals will be eaten together, whether a caregiver will have access to certain parts of the home, and how to handle visitors who come to see you while the caregiver is there.
Remote care
Those who are moving away from home to receive full-time care at another facility will have even more considerations. Part-time visits before the move, if possible, will help the patient become familiar with where they are going. What to do on move-in day should be covered fully by the staff. What personal belongings can a person bring? In some places, it’s just small personal items – in others, they can bring their favorite furniture. What will meals be like? What activities will be provided? What kind of therapy will be offered? All these questions and many more should be asked well before the move happens.
Who Helps Seniors? A Look at Careers in Care
Running a senior care facility or providing assisted living services is a team effort. Many different types of health care professionals give care to residents and patients. Some of this care involves help with daily living tasks, medication administration, regular treatments, or even emergency medical care. In addition to these professionals, there are the support staff and office personnel that keep things running smoothly. If you’re interested in working in the senior care field, there are many careers to choose from.
Certified nursing assistant (CNA)
Sometimes called nursing aides, CNAs provide personal care for patients in places like hospitals, long term care facilities, assisted living, and even at-home care. Job duties include assisting patients with daily living tasks such as using the bathroom, moving around the senior care community, getting dressed, and eating. CNAs might also complete housekeeping duties. Depending on the state, CNAs may have the ability to dispense medication.
Dietician
A dietician is someone who specializes in the field of food and nutrition. They use their expert knowledge to help individuals be as healthy as possible, as well as meet any other health-related goals, such as improving fitness levels or recovering from an illness or medical issue. Part of a dietician’s job is to evaluate patients to help them identify their nutritional needs and meet their nutritional goals.
Gerontologists are professionals who study aging. Using scientific principles, gerontologists will examine the aging process within various contexts, including biological, social, psychological, and medical. The role of the gerontologist can vary, but might include working with administrators to improve the care for aging individuals. In some cases, gerontologists will take part in providing direct care to seniors.
Healthcare administrators oversee the delivery of medical care and health services. This includes planning, managing, and coordinating among various medical and non-medical professionals to ensure the efficient operation of a healthcare facility, such as a nursing home or hospital. In addition to making sure residents and patients receive effective skilled nursing and personal care, healthcare administrators will also create strategic goals for the senior care organization, make budgeting decisions, and manage the organization’s finances.
Licensed practical nurse (LPN)
LPNs provide medical care under the direction of physicians and registered nurses. The exact scope of this care will depend on the state in which the LPN works. But for most, the medical care they provide includes basic tasks such as changing bandages, maintaining patient records, providing personal care, and taking a patient’s vitals.
Nurse practitioner – gerontology
A gerontology nurse practitioner is a type of advanced practice registered nurse who focuses on providing health care to older patients. Due to their advanced training, a nurse practitioner will usually have some independence in how they treat patients. They will also have additional responsibilities compared to an RN, such as prescribing medication, ordering tests, and interpreting test results.
Medical assistants provide a wide range of support services within a medical setting. This includes basic clinical duties, such as taking patient vitals and helping other professionals render appropriate medical care. Medical assistants also work on the office side of a medical facility. Tasks include scheduling appointments, taking phone calls, updating medical records, and asking patients for basic medical information.
Medical billers provide administrative support in a healthcare setting. Specifically, they convert health services into bills that are then sent to the patient, or more likely, insurance companies. As their job title implies, medical billers send out medical bills so the professionals treating patients can get paid for their services. A medical biller may sometimes have job duties that overlap with a medical assistant or medical coder.
Medical coders are a type of health information technician tasked with assisting in the process of getting an insurance company to pay for medical services provided by a doctor, nurse, or other medical professional. They do this by examining a patient’s diagnosis and the medical care they received, then assigning it a standardized code. These codes are necessary for billing, statistical, and record keeping purposes.
Those who are disabled, sick, or injured may benefit from using the services of an occupational therapist to recover, learn, or improve daily living skills. An occupational therapist will evaluate a patient and their surroundings to determine their needs. The therapist will also create a treatment plan for patients that will utilize everyday tasks to meet these goals.
Occupational therapy assistant
Working under the direction and supervision of an occupational therapist, occupational therapy assistants provide hands on help for patients engaged in occupational therapy activities. Other job tasks include keeping track of a patient’s progress as well as teaching them how to complete activities and exercises on their own.
Physical therapist
The goal of a physical therapist is to help individuals manage pain and improve their physical movement. Most patients of a physical therapist will be those with disabilities, injuries, or serious illness. Physical therapists will not only employ the use of exercises, tools, and equipment to improve a patient’s pain or range of motion, but also assess patients, determine what their goals should be, and choose how to best meet those goals.
A PTA, or physical therapist assistant, will work under the direction of a physical therapist to help patients recover from an injury or illness. PTAs will also help patients who are trying to manage pain or improve their ability to move on their own. A PTA will not only work directly with patients to complete exercises and activities, but may also complete support tasks, such as maintaining equipment and fulfilling an administrative role.
In addition to providing direct patient care, RNs help coordinate patient care as a part of a health care team. RNs supervise CNAs and LPNs. Their other duties include assessment of a patient’s well-being, administering medical treatment, performing medical testing, and consulting with physicians regarding changes in patient status.
