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The holidays are a time when many people are traveling to spend time with aging parents and loved ones they may not have seen in a while. After visiting, it may be very evident that they are struggling to care for themselves in their home. This may bring up difficult conversations among family members as to what next steps are needed for their loved one to be safe.

There are different housing and care options available to meet the needs of older adults. The following will help you better understand the core differences between independent living communities, assisted living facilities, and skilled nursing centers.

Skilled nursing care is for those who may be medically complex, need assistance with activities of daily living (ADL’s), and require 24/7 nursing care. One needs to qualify for skilled nursing based on an assessment completed and signed off by the person’s physician to meet the level of care required. Although many centers offer short-term rehabilitation following hospitalization, which is covered by Medicare, Medicaid, and Managed Medicare plans, long-term care is not covered by insurance. Options for compensation include private pay, long-term care insurance, or Medicaid /Title 19. 

For those not requiring skilled nursing care, understanding the distinctions between an independent living community versus assisted becomes important. Independent living mirrors that of assisted living in many ways, providing social engagement, program activities as well as meals; however, there are a few key differentiators. Independent living does not provide care to assist residents with bathing, dressing, medication reminders, and other ADLs in the monthly cost. Any of these services can be contracted with an outside agency. In some communities, these services are located conveniently on-site. Meal options are offered three times a day with assisted living (typically twice a day in independent), and the monthly fee is usually more expensive. Additionally, long-term care insurance can be used to offset costs when in assisted living if one meets the criteria to receive this benefit. Even if an older adult is independent and does not require additional services, they can reside in an assisted living facility with peace of mind knowing care amenities are available if needed down the road. 

Assisted living or skilled nursing centers offering secured memory care and specialized programming may be appropriate choices when researching care options for loved ones diagnosed with Alzheimer’s or dementia. However, if having a loved one stay at home is a goal, 24/7 or hourly care can be brought in at an additional cost, and some long-term care policies do provide a homecare benefit for reimbursement. There are also programs available for those with a financial need to help defray these costs; for more information contact the town’s senior services department.

Additionally, subsidized HUD housing may be an option for those who qualify, however, amenities such as meals, transportation, and daily recreational activities are not included. Availability may also be limited.


Column is written by Laura Falt, director of business development in Connecticut. Laura welcomes the opportunity to be a resource to the community on services for older adults and is often featured in local publications.