Care Options
Types of Care
Recognizing Good Care
Knowing When to Get Help
Screening Care Providers
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Home and Community Care
If you are helping a person or need help yourself, where can you turn? There are many resources available to help you live at home comfortably. These include:
In-home care
These care services involve professionals coming to the home to help the caregiver and the person with dementia. Services vary in type and can include:
- Companion services
Help with supervision, recreational activities or visiting
- Personal care services
Help with bathing, dressing, toileting, exercising or other personal care
- Homemaker services
Help with housekeeping, shopping or meal preparation
Home health
Some home care can only be given by licensed health workers, such as skilled nursing care, rehabilitation or other in-home services for the treatment of an illness or injury. Medicare may pay for some home health care, but only if you meet certain qualifications and conditions.
Medicaid home and community based programs
If you receive Medicaid and need help with daily activities such as eating, bathing or dressing, you may be receiving help from a paid caregiver in your home. If you are, your state may have a program that allows you, rather than a healthcare provider, to decide who will provide services in the home, when the services will be provided and how the work will be accomplished. These programs are most commonly called “Cash and Counseling”, although individual states may call it by another name. The person or a representative is responsible for developing and following a spending plan, which is based on the need for care, and may hire and manage paid caregivers.
States have different rules for who can be a representative and different approaches to deciding whether a participant with a cognitive impairment will use a representative. Cash and Counseling is a voluntary program and participants can return to the traditional service model at any time.
Learn more about Cash and Counseling and if it is available in your state
Community services
Many communities provide services and programs to help seniors and people with disabilities with a variety of personal activities. These services are often available through the local Department on Aging and may include senior centers, transportation services, home repair programs, State Health Insurance Counseling and Assistance Programs, legal assistance, and home delivered meals.
Learn more about Community Services
Adult Day Care
An adult day center provides care outside the home and is designed to meet individual needs while supporting strengths, abilities and independence. Participants have the opportunity to interact with others while being part of a structured environment.
Learn more about Adult Day Care
Residential Care
If the person with dementia prefers a community living environment, or if home care is no longer possible, residential care may be an option to consider. Residential care can be temporary – a few days or weeks after a hospital stay, for example – or it can be long-term.
These residences offer different types of services. Understanding what they offer will help you decide which kind of care residence is best. Not all states use the same names to describe the types of care settings, and different states have different regulations. Contact the Alzheimer's Association for more information about what is available in your community.
Independent living for seniors is usually in a small, easy-to-maintain private apartment or house within a community of seniors.
Board and care homes provide meals and help with some daily activities (such as money management, scheduling transportation, reminders to take medication, laundry and housekeeping). Board and care homes may also be called adult foster care, elder care homes or residential care homes. Back to top
Assisted living residences generally provide 24-hour staff, recreational activities, meals, housekeeping, laundry and transportation. Definitions of assisted living and the specific regulations differ from state to state. Residents may choose which services they receive from the residence such as house cleaning, help with grooming or medication reminders.
Learn more about assisted living services
State laws and regulations require certain assisted living services. These may include but are not limited to the following.
- 24-hour awake staff to provide oversight and meet scheduled and unscheduled needs
- provision and oversight of personal and supportive services
- health-related services
- social services
- recreational activities
- meals
- housekeeping and laundry
- transportation
Continuing care retirement communities provide different levels of care (independent, assisted living and nursing home) based on individual needs. A resident is able to move throughout the different levels of care within the community if his or her needs change.
Nursing homes may provide a full range of care needs, including acute care and long-term care.
Acute care rehabilitation is short-term care offered for people with injuries, illnesses or post-operative care needs who will eventually be able to recover outside a hospital.
Long-term care is provided to individuals who require longer stays. Medicare may pay for some nursing home care, but only if you meet certain qualifications and conditions.
Respite Care
Caregivers and individuals with dementia both need a break from daily routines. Respite care can help, by providing a new environment or time to relax. It can be for a few hours or several days or weeks, depending on needs and interests. Respite care can be provided at home, at an adult day center or in a care setting.
Hospice Care
Hospice care is provided to individuals who are terminally ill in their homes or in a care setting, generally with an expected survival of six months or less. Hospice is a benefit of Medicare, most state Medicaid programs and many private health insurance plans. Members of hospice teams have special training in end-of-life care and can provide oversight of medical care, counseling services, medical equipment and supplies, planning for end-of-life needs and bereavement support. Back to top
Special Care Units
Alzheimer Special Care or Memory Care Units (SCUs) exist to better meet the special needs of residents with dementia. More than 50 percent of residents in assisted living and nursing homes have some form of dementia or cognitive impairment and that number is increasing every day. SCUs usually are a floor or a unit inside a larger residential care facility, such as a nursing home.
Until recently, facilities did not have to meet any specific standards, beyond the nursing home regulations and standards to which all nursing homes are held, in order to promote themselves as being a special care unit. The Alzheimer's Association supports the enactment of state legislation regarding the disclosure of claims made by facilities relative to their Alzheimer special care units. Currently, 27 states have legislation requiring nursing homes and assisted living residences to tell exactly what specialized services their SCU provides, including a trained staff, specialized activities, ability of staff to care for residents with behavioral needs and what fees they charge.
State-by-State Laws
The purple states in the map below have disclosure laws. Click on a state to view these laws, or select a state from the list. |
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