Providing quality care for aging loved ones is a concern for more and more families as the population grows older. We know that navigating the types of senior care services and facilities can be overwhelming, especially when you’re making the decision for a loved one.  Many factors go into determining the best assistance and care. Two prominent factors are the nature of care needed and cost. The type of care chosen largely determines the cost. There are many options, for both care and financing. In part one of this series, we will define the options available for safely providing quality living environments, both in-home and residential. In part two we discuss the financial responsibilities and ways to pay for assisted living.

How to Choose the Appropriate Care

The goal for all senior care is to provide the best care in the chosen environment. One of the first decisions to be made is if a loved one can be cared for properly in-home or if a new home solution is needed. With today’s technology and training available, there are more opportunities for loved ones to stay in their homes for care, both with daily living activities and more acute medical care.

Once a determination has been made that a loved one needs assistance with daily living tasks, it is time to choose between in-home care and residential care. Most individuals and families would prefer that their elderly be able to stay in their home or familiar surroundings. However, it is vital that families, caregivers, doctors and other interested parties agree on what type of care a person needs. Placing an individual in an assisted living community when in fact they need around the clock management sets both the facility and the family up for disappointment, frustration, and needless expense.

This chart quickly summarizes pros & cons for each option. But at Assisted Living Services we understand that each situation is different, and each individual is just that – a person with unique needs.

Type of Care Advantages Disadvantages
In-Home Care
  • Allows a person to “age in place” with family
  • Privacy & comfort
  • Independence and control in scheduling & routine
  • Can be burdensome or intrusive to other family members
  • Support & supervision limited to hours designated
Assisted Living
  • One monthly cost
  • Facilities designed for safety & mobility
  • Nutritional & fitness support
  • Housekeeping, laundry, meal preparation, and transportation
  • Limited on-site healthcare
  • Socialization & recreation
  • Separation from home & family can cause emotional distress
  • Low independence and control over schedule & routine
  • Additional services are an added cost
CCRC (Continuing Care Retirement Communities)
  • “One-stop” facility
  • Added healthcare support on-site.
  • Planned activities and additional services available
  • Buy in for care + monthly cost
  • Additional services are an added cost
Long term/Short term Care
  • Addresses chronic illness
  • Designed for long-term care or medical rehab
  • Sterile, hospital-like environment


Types of Senior Living Care

Home Care can be defined as “a health service provided in the patient’s place of residence for the purpose of promoting, maintaining, or restoring health or minimizing the effects of illness and disability.” (

Types of care are broken down into two broad categories: Non-medical Home Care and Skilled Home Healthcare. The type of care chosen depends on current and anticipated needs of the client and the ability of the patient’s family and friends to assume responsibility for care.

Non-medical Home Care:

Home Care that does not provide certified medical practitioners (M.D. or R.N. for example), employs caregivers for support with Activities of Daily Living (ADLs) and personal care services such as bathing, dressing, transferring, eating, toileting, or shaving. Caregivers can provide care for a few hours per day all the way up to 24-hour care.

A caregiver will generally do whatever is needed for clients who can’t live alone without help. This assistance could include light housekeeping, meal preparation, transportation, and vital personal interaction. They help keep a home running as normally as possible and make it possible for the individual to stay at home instead of moving to a long-term care facility or assisted living center. Home care is often appropriate for those with Alzheimer’s disease or other forms of dementia who may be physically healthy but require supervision.

At Assisted Living Services we are proud that all our caregivers providing help with ADL’s have attained training in a Home Health Aide or Certified Nurse’s Aide program. This is not a requirement in our home state of Connecticut, but we feel strongly that additional training helps meet the needs of more individuals.

Skilled Home Healthcare:

A skilled home healthcare worker is exactly as the term implies; someone that is trained as a medical professional and can administer medical services. These individuals can be registered nurses or physical therapists, as examples. Skilled home healthcare workers act under doctor’s orders and typically are used for immediate, short-term needs such as recovery from surgery, wound care or medicine management. These types of organizations are often referred to as VNAs (Visiting Nurse Association Agencies) or Home Healthcare Agencies.

Residential facilities are numerous and provide different levels of amenities and care. They can be broadly identified as independent living facilities and assisted living facilities. Senior Communities and Continuing Care (or step) communities are designed for a high-functioning elder, with step communities adding a basic level of care with daily personal needs.  Assisted Living facilities and Long-term care facilities, while similar, are differentiated by the care provided at these facilities.

Senior Communities:

Senior housing communities, or independent living communities, are designed for high-functioning elders, or those that do not require assistance with daily care. Senior communities are usually neighborhoods or towns that limit residency to people of a minimum age. They are designed for active seniors and have a variety of social clubs such as golf, arts and crafts and cards. This is like living in any neighborhood and assistive services are not generally provided.

Continuing Care Facilities:

Continuing care is an option that lets a resident move to the area of specialized care needed. Residents are usually admitted when they live independently. As their needs increase, they are guaranteed vacancies in the next lower level of care. This solution can bring peace of mind and minimize disruption in a person’s routine and surroundings should different levels of care be needed at different times. An entry fee is often required, making this option quite expensive.

Assisted Living Facilities:

An assisted living facility is a senior living option for those with minimal needs for assistance with daily living and care. The purpose is to help adults live independently in a safe environment when aging in place is no longer a safe option. Assisted living facilities can vary widely, from smaller home type environments to larger communities that offer a large variety of activities and amenities. Most facilities at a minimum provide secure living spaces, meals, assistance as needed for daily activities, transportation, and medication management.

Long-term/Short-term Care Facilities:

A long-term care facility provides 24-7 care for seniors requiring medical support. These facilities are sometimes compared to hospitals. For those requiring ongoing intensive medical assistance, specialized medical care residences are often the only viable option.  Sometimes referred to as nursing homes, these facilities can also be a temporary solution for someone that needs immediate medical assistance (to recover from surgery or injury for instance), but who are expected to transition back to home or assisted living after the critical care is no longer needed.

There is a lot of information available on senior care options and the research can be overwhelming. As you navigate these decisions, take your time if you can and if you have questions, please reach out to the many resources available. Begin by determining which options you would like to explore. Then, look for our next article when we will break down the costs and funding options for the various types of care. Once you have all the pieces, we are hopeful you will be able to transition your loved one to the most appropriate level of care.