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Healthy Seniors


Home Care- Sometimes referred to as Private duty Home Care


No required regulation or licensing in Michigan. Private caregivers are hired with private funds. Typical services are: Shower and dressing assist, feeding, meal prep, dementia care, companion, respite care, medication reminders and  

light housekeeping. Average cost $20-$28 per hour. Price and services vary between agencies, some also have minimum hours. Each agency sets own standards of practice and recently some agencies have become accredited. Possible financial resources paying for these services through; Medicaid Waiver, Veterans Benefits, Long Term Care Policy, Automotive Insurance.

Home Health Care- Sometimes referred to as Skilled Care


A short-term insurance covered care that requires physician order. 

Let's compare the different types of senior communities

Disciplines that are available: Physical Therapy, Occupational Therapy, Home Health Aid (for showering or bathing only), Speech Therapy, Social Work, Registered Dietician, Certified Ostomy and Wound Care Nursing, Infusion and Respiratory Therapy. Certification period of 8 weeks. Patient specific- can last 2-8 weeks and in some cases be re-certified if skilled need is still necessary. Certifications required through CMS. Accreditation through CHAPS or JACHO with annual survey for quality measures. This can be offered to individuals anywhere they call home with exception of l nursing home residents.

Adult Day Care Services 


A cost effective way for respite for those caring for a loved one with memory issues. Some state grants are in place to subsidize, out of pocket expenses to families. An affected individual can use service 1-5 days per week.


Senior Apartments/Co-ops. Communal living for independent seniors. Some offer limited Medicaid funding or sliding scale pending income. Private pay. Usually no additional home care services offered in these communities.


Independent Living. Sometimes referred to as Independent Living with Assistance  


Residents can have their own apartment or share with a roommate, sometimes with a full kitchen. Residents here are for the most part independent with private duty help for activities of daily living, although some communities are moving in those with higher acuity pending their own standard.  Meals and housekeeping may be included in rent, each community sets their own standards, pricing and level of services. If not included in rent, additional services and meals may be available for further payments. A Private Duty Home Care agency may have an office in the community, their services are available in addition to rent. There may also be a hair salon, activity room, exercise classes, gym, movie theatre and a worship room. Price varies based on services offered, location and how new and updated the community is. Private pay.


Assisted Living


Residents in this care setting are provided meals, housekeeping and assistance with activities of daily living. The

community employs its own care staff and a nurse to coordinate care. The community has care staff in the building 24 hours per day. Note some assisted livings go under the category of Homes for the Aged which requires less regulations for the facility. Prices varies based on location, care offered and how new and updated the community is. There may also be a hair salon, activity room, exercise classes, gym, movie theatre and a worship room. Rent is private pay.


Memory Care 


A specialized community that cater to individuals with dementia and Alzheimer’s. Activities, assistance, décor and furnishings should be designed for these special residents. Meals, housekeeping and assistance activities of daily living should be included in the rent. Entrance door will be locked at all times for safety.


Apartments can be private or shared, there are no kitchens in these apartments and bathroom may not have a shower. There may be shared room for


shower/tub where caregivers can take residents in a safe environment. There may also be a hair salon, tv room, sensory room, activity room. Private pay.

Adult Foster Care/ Group Homes


These are usually regular houses that have been turned into or specifically built for the purpose of becoming a group home. If there are only a few residents living there they are not required to be state licensed. Many owners of group homes still become state licensed as this will minimize dangers and hazards for the seniors living there. Usually set in a private residence model of medical care for those with complex health needs. Typically between 8 to 12 residents with at least one trained caregiver in home 24 hours per day. These homes are usually less expensive than Assisted Living and Memory Care communities. Being in a smaller house, services and care offered will differ from the larger communities. If selecting a Group Home, always ask if they are state licensed. Private pay.



Skilled Nursing Care


Also known as Rehabilitation Center/Rehab. After being admitted to a hospital for a minimum of 3 nights, you may qualify for rehab up to 90 days per calendar year. If you have been at the hospital for 3 nights or more, but were not admitted but under “Observation”, you will not qualify. You may however appeal this with the hospital, speak to your social worker/discharge planner. Insurance providers are now contacting rehabs in order to encourage earlier discharges. When your Physical Therapist at rehab feels you are ready to go home and continue therapy at home, they will give the doctor and your discharge planner a discharge date for you . You will usually share room with another patient with a curtain divider between your beds. You will have tv and a phone, meals and laundry will also be provided. Emphasis is on your physical therapy and the exercise room will often be large. Medicare pays for the first 20 days and at day 21 co-pay goes into effect and can be covered by patient’s secondary insurance.


Continuing Care


A larger community with separate neighborhoods for Independent Living, Assisted Living, Memory Care and sometimes also Skilled Nursing Care. Memory Care and Skilled Nursing care neighborhoods may be on a separate floor requiring a key to enter as the residents there may wander. These larger communities will often have plenty of activities, gyms, movie theatre, hair and nail salon, worship room, and sometimes even a pool. Private pay.



Long term Care Facilities. Also known as Nursing Home


For individuals requiring around the clock nursing home care.  Payment source includes private pay or if financially eligible (assets of under $2.000.00) Medicaid can provide payment to nursing home for costs exceeding what individual has coming in as income on a monthly basis. Not all nursing homes participate with Medicaid, if they do, they will have a select number of beds assigned for those on Medicaid. When selecting a nursing home knowing you will run out of money and will need a Medicaid Bed, keep in mind that it would be very difficult to promise there will be a Medicaid Bed available at the same time you run out of money. Private pay.

Palliative Care


Designed for those who are still seeking curative treatment options or who are not quite ready to transition to hospice. May be provided by a hospice group but with limited services. This is a great option for those who would like to build a relationship with a hospice group for when they will qualify for those services. Mostly consultative – provides emotional, physical and psychosocial support to improve quality of life for patients facing a life-limiting illness. If you are resident at a senior community, enrolling in palliative care can be helpful if you would like to avoid being sent to the hospital. This is also a great vehicle to eliminating unnecessary medications and procedures. Community service or paid for be insurance. No cost to patient. Requires physician order.  Can be provided in any home or care setting.


Hospice Care


A service focusing on providing comfort care for an individual facing a life limiting illness or injury. Some patients under hospice may “graduate”, which means they go off services if they no longer meet criteria. The family of the client will receive support and often find hospice services to be a great help for them personally. Requires a physician order and must qualify under specific criteria. Qualifications include but not limited to terminal illness diagnosis, prognosis is limited to 6 months, patient may still receive therapy and care for issues not related to the enrollment diagnoses. You may choose to keep your primary care doctor or transfer to the hospice doctor. Services include a team of professionals of RN, Medical Director, Clergymen, Pharmacist, Nursing Aides, Dietician and therapists if indicated for caregiver training. The focus in on quality of life and comfort measures for the patient. Covered by insurance.

What's the deal with Independent, Assisted


Independent With Assistance?

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