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What is Long-term Care? Long-term care covers a broad spectrum of services, some of which you may be surprised to learn about. Although it is often thought to serve only individuals who require skilled care, it frequently begins much sooner than that. Long-term care begins when a previously independent individual can no longer perform the same activities that he or she once could. Long-term care includes: custodial care, which provides assistance with activities of daily living, such as grocery shopping, bathing, or driving; skilled care, either in a nursing facility or at home, such as rehabilitation after surgery or an illness; care for cognitive impairments such as Alzheimer's or dementia; and palliative care for individuals who can no longer benefit from regular medical treatment. Care Assessment What It Is A care assessment is a comprehensive evaluation that identifies the care needs of an individual. The objective of an assessment is to draft a plan of care, which is based on the health, social, emotional and physical needs of that person. There are two sources for obtaining a care assessment: case managers and geriatric care managers. Geriatric care managers and case managers are trained to recognize telltale signs in your loved one that indicate specific needs — signs that are clear to trained professionals, but which you may not be able to recognize yourself. A care assessment ensures that you will be focused on what to look for. In the long run, this will prevent frustrating wrong turns, save you time and money, and ensure that your loved one receives the appropriate care. Getting a professional care assessment up front is one of the strongest recommendations Gilbert Guide can make. The average cost of an assessment runs between $300-700. Care managers usually charge by the hour, and the cost of an individual assessment depends on the amount of time it takes. Free Online Tool for Initial Care Assessment Gilbert Guide's online Senior Care Planner is a useful tool for determining the kind of long-term care you or your loved one will need. After identifying your unique needs, you will receive a customized care plan that contains recommendations about the level(s) of care that best suit your needs, and why. Geriatric Care Managers (GCMs) What They Do A geriatric care manager is a professional advocate who helps your loved one and you lead the highest possible quality of life. Trained in any of a number of fields related to long-term care, the GCM acts as your guide, primarily identifying problems and offering solutions. What to Expect GCMs begin the process by conducting a comprehensive care assessment of the elderly individual to determine his or her needs. GCMs often work with other long-term care professionals to coordinate as few or as many services as are necessary to meet the specific needs of your loved one. The services a GCM provides include screening, arranging and monitoring the services your loved one requires; preserving financial resources by helping you avoid inappropriate placements and duplicated services; intervening in a crisis; counseling and supporting; educating and advocating; and much more. The GCM will continue to monitor care on an ongoing basis, and will modify the care plan when appropriate. Find a Geriatric Care Manager in San Francisco County In-home Care What It Is In-home care is non-medical care provided in the client's home. It includes custodial care and assistance with activities of daily living such as medication reminders and transportation. In-home care workers are professionally trained caregivers who provide companionship and are responsible for maintaining a safe environment for the person receiving care. In-home care can be arranged without a physician's order. In-home care is different from home health care, in that caregivers do not provide nursing care. For example, while they may provide medication reminders, they are not allowed to administer medication. Neither are caregivers housecleaners; although some light housekeeping may be necessary and appropriate, heavy housecleaning is normally not expected. There are three sources for obtaining in-home care: full-service agencies, referral agencies, and private hire homecare workers. Care can also be received at home through home health care, but it must be prescribed by a doctor. Full-service Agencies There is no standardized agency for overseeing in-home care agencies; however, the National Private Duty Association (NPDA) is an organization with highly regarded standards of practice within the industry. Not all reputable agencies are listed with the NPDA; it is still a fledgling organization. Full-service agencies prescreen employees for criminal background checks along with checking multiple references. These steps ensure that the agency's caregivers are experienced and competent. Additionally, these agencies usually provide worker's compensation insurance, maintain professional liability insurance or bond and cover all payroll taxes. These agencies often provide ongoing supervision of caregivers and continuing education opportunities for employees. Referral Agencies Referral agencies refer caregivers to the client, but are not considered the caregiver's employer. Once the referral has been made, the relationship ends. The client becomes the employer and is directly responsible for scheduling, training, supervising and paying the caregiver directly. Caregivers who are referred for employment by a referral agency are not independent contractors, and therefore the client is also responsible for payroll taxes and carrying worker's compensation insurance. Not all referral agencies will check references and backgrounds like full-service agencies. Private Hire Caregivers Caregivers who do not work through an agency are known as "private hire" caregivers. The client is the employer, and is responsible for paying the caregiver directly. The client is also responsible for meeting all federal and state payroll requirements, carrying worker's compensation insurance, screening, supervising, training, and assuming all professional liabilities associated with an employer-employee relationship. Home Health Care Home health care agencies provide in-home skilled nursing and other health care services, such as physical and occupational therapies. Home health care agencies are licensed by the state, but must adhere to federal regulations as well. Home health care must be prescribed by a physician. Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Licensed Vocational Nurses (LVNs) provide the care, sometimes in conjunction with other health professionals. These providers may also enlist the assistance of a home health aide who can help with personal care such as bathing and using the toilet. Home health aides can also administer medication under the supervision of a nurse. Who pays for Home Health Care? Find an In-home Care Provider in San Francisco County Adult Day Care What It Is Adult day care provides a safe and caring setting for adults during the day. Adult day facilities are licensed by the California Department of Social Services. Programs are structured and designed, often through the development of a personal care plan, to cover the daily individual needs of each participant, including a variety of social and supportive services. Participants may be physically, mentally, or functionally impaired, or they may simply need companionship or supervision during part of the day. What to Expect Adult day care is based primarily around participants' social needs. Most programs offer meals and some provide transportation. A variety of activities are offered with the purpose of providing stimulation and socialization for participants. Some common activities are mentally stimulating activities such as word association, trivia questions and crossword puzzles; physically stimulating activities include exercise and dance. Find an Adult Day Care Center in San Francisco County
What It Is Like adult day care, adult day health care provides a safe, caring setting for adults who require supervision or care during the day; the facilities are also licensed by the California Department of Social Services. Adult day health programs are designed for individuals who require a more skilled level of care. These programs offer medical services, like rehabilitation, therapy, nursing care, and special nutrition. The programs are structured and designed, often through the development of a personal care plan, to cover the daily individual needs of each participant. Participants in adult day health care require some health care, unlike adult day care participants. What to Expect Adult day health care is based primarily around participants' health care needs. Most programs offer meals and some provide transportation. The activities and programming reflect the diverse needs of participants, and their levels of functioning. Common activities include current events classes, arts and crafts, music, mind-stimulating games, and exercise, as appropriate to each individual. Find an Adult Day Health Care Center in San Francisco County Who pays for Adult Day Health Care?
Continuing Care Retirement Communities (CCRCs) What They Are A CCRC, also referred to as a life-care community, combines residential accommodations with health services. The purpose of a CCRC is to allow residents to receive the appropriate care across a continuum from independent living, to assisted living, to skilled nursing care, as their needs change, without having to leave the community. This ensures that residents will be cared for through end-of-life. What to Expect CCRCs usually charge residents an entrance fee as well as a monthly payment. The community provides housing and defined long-term care services for the life of the resident. Residents can select different options, which are noted in their contracts. Find a CCRC in San Francisco County Assisted Living Facilities What They Are Assisted living is a general term used to describe residential facilities that provide care for individuals who cannot live independently, but do not require twenty-four hour skilled nursing care. These facilities are licensed and inspected by the California Department of Social Services, and they must meet care and safety standards set by the state. In California, all assisted living facilities are licensed as Residential Care Facilities for the Elderly. Assisted living typically serves individuals age sixty and older, although younger persons with similar needs may be served as well. A number, but not all, assisted living facilities offer Alzheimer's and dementia care. There are two types of facilities: Large-scale assisted living facilities may have both shared and private rooms, as well as private apartments. Board and care homes are smaller-scale assisted living facilities licensed for six or fewer residents housed in a private residential home setting. They typically do not offer Alzheimer's or dementia care. What to Expect Assisted living facilities provide room and board, some housekeeping, social activities, supervision and assistance with basic activities like personal hygiene, dressing, eating, and walking. Facility staff either provides or arranges transportation for residents. Most facilities offer three meals per day, as well as snacks in between meals. Assisted living facilities are considered non-medical facilities and are not required to have nurses, certified nursing assistants or doctors on staff, although some have medical staff either on-site or on-call. Medications can be stored and distributed for residents to self-administer. Assisted living staff who provide hands-on care must have criminal record clearance. Find an Assisted Living Facility in San Francisco County Who pays for Assisted Living Facilities? Skilled Nursing Facilities (SNFs) What They Are Skilled nursing facilities, or SNFs (pronounced "sniffs"), are also known as nursing homes or convalescent homes. Skilled nursing facilities are live-in facilities, licensed and regulated by the California Department of Health Services, that provide medical treatment prescribed by a physician. These facilities cater to several types of patients: some patients require short-term rehab while recovering from surgery; others require long-term skilled nursing and medical supervision. In addition, some skilled nursing facilities offer specialized care programs for Alzheimer's or other illnesses, or short-term respite care for frail or disabled persons when a family member requires a rest from providing care in the home. Many hospitals have skilled nursing wings, but those facilities generally accept only patients who have been discharged directly from that particular hospital. Skilled nursing facilities are inspected at least every twelve to fifteen months. When a skilled nursing facility fails to meet state and federal minimum standards for care, a deficiency is issued. A citation is issued when a skilled nursing facility is fined for noncompliance with the state minimum standards. There are different levels of deficiencies — ranging from minor, which do not pose harm to residents, to major, which poses or causes harm to residents. It is important to keep in mind that most facilities receive some deficiencies and/or citations. Deficiencies and citations are a matter of public record and can be viewed on the Medicare Web site. What to Expect Skilled nursing facilities provide twenty-four hour skilled nursing care; rehabilitation services such as physical, speech and occupational therapies; assistance with personal care activities such as eating, walking, bathing and using the toilet; coordinated management of patient care; social services; and activities. Find a Skilled Nursing Facility in San Francisco County Who pays for Skilled Nursing Facilities? Hospice What It Is Also known as end-of-life care, hospice is palliative care designed to help the patient through the last stages of a terminal illness. The goal is to keep pain and suffering to a minimum, not to cure the illness — by this point, the patient's doctor has determined that he or she can no longer benefit from regular medical treatment. Although hospice care is usually administered in the patient's residence, it can also take place in a hospice facility. When necessary, hospice services can be called into assisted living facilities and skilled nursing facilities, as long as those facilities carry a hospice waiver. What to Expect Hospice agencies provide many services, some of which include: nursing, physical and occupational therapies; speech therapy; medical social services; home health aides; medical supplies and appliances; drugs for symptom control and pain relief; physician services; psychological, spiritual, and nutritional counseling; group and bereavement counseling; caregiver support groups; and grief support. Find a Hospice provider in San Francisco County What options are available to pay for long-term care? Learn more here. Find out what each type of reimbursement covers for each level of long-term care. |
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