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by Thomas D. Begley, Jr., CELA

Families of many individuals who require long-term care believe that their only option is to place their loved one in a nursing home. Actually, there is an eight-step continuum of care:

  • Informal Caregiving. Most care for Alzheimer’s patients is provided by informal caregiving provided by a family member or friend who aids and supervises the daily care of the patient.
  • Geriatric Care Managers. Geriatric Care Managers generally perform six functions: an initial assessment of the patient, development of a Care Plan, implementation and coordination of the Care Plan, monitoring services, appropriate re-assessment, and appropriate discharge.
  • Adult Day Care. There are two types of adult day care facilities. One is medical, the other is non-medical. Transportation is generally provided by the adult day care facility to pick up the patient at home and transport them to the adult day care center and return the patient at the end of the day.
  • Home Health Care. Elderly persons who require care almost universally prefer to receive the care in the comfort of their own homes. They are familiar with their surroundings, often with loved ones nearby. Home health care is also often less expensive than institutional care.
  • Assisted Living. Approximately one million people live in assisted living facilities. Typically, they provide custodial care and are usually not licensed to provide skilled care.
  • Nursing Homes. Nursing homes provide skilled nursing care and related services as well as custodial care for residents.
  • Continuing Care Retirement Communities. Continuing care retirement communities (CCRCs) are an excellent type of long-term care for the middle and upper-middle income population. Typically residents enter independent living facilities, such as an apartment, and then as their health declines they are eligible to move on to assisted living and then ultimately a nursing home at the same campus as such care is required.
  • Hospice is designed for people who no longer want medical treatment and are preparing to die.

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