Housing and Long-Term Care for Your Loved One

What are the options and what do they mean?

by: Karin Pauly

As you care for your loved one, or are preparing for your own future, there are a multitude of housing options and additional support for activities of daily living and health care available. It can be confusing understanding the differences and what they have to offer.

Everyone’s situation is different, depending on where you and your loved one live, or the health care challenges you are facing. For example, rural areas may have limited home health care options, yet have a robust volunteer community through churches, or other programs such as Meals on Wheels or Faith In Action.

Be creative in your search for support! Sometimes, it is not necessary to jump into the next level of elevated long-term housing care if you can meet the needs of your loved one with additional services where they are living.  Stay in communication with the health care providers to ensure health requirements and safety needs are met – but, keep options open, ask questions and research additional services in your area.

For example, your loved one may want to live at home for a longer period of time, and the home may be made safer and more accommodating. See the Caring for Nancy blog: “Make Your Home Safe Now”. Or, you may be able to utilize volunteer or paid services for meals and transportation while your loved one is in an Assisted Living facility.

To help you, here are some definitions for long-term housing options:

  • Home Health Care – Professionals come into the home to provide health care services and/or aid in activities of daily living. Health care services may include skilled medical or nursing care, administering medication, occupational, physical or speech therapies, wound treatment, oxygen support, and basic monitoring of health-care status. Support for activities of daily living may include companionship, basic housekeeping, grooming and bathing, monitoring safety and more. 
  • Adult Day Care Services – A non-residential, professionally-staffed facility offering socialization, nutritional meals, and daily living needs. Typically, open during business hours, they are often located in senior centers, nursing facilities, faith organizations, hospitals, or schools. Some may have transportation services. 
  • Assisted Living – Residential care, providing housing, health care and personal services for activities of daily living.  Often there is a base rate for rent or “residential services” and then a menu of additional services may be provided including meal services, medicine and health care services, bathing, and more. They may be freestanding communities or near and integrated with skilled nursing homes and hospitals to provide a continuum of care. Be sure to talk to the housing manager about options before you sign a contract, so you understand what is included in basic rates and when there will be extra charges.

    Ask specifics about socialization programs and meal plans to ensure your loved one is comfortable and happy.  My mother, Nancy, was in an Assisted Living facility that did not meet her dietary needs as a vegetarian and eater of fresh foods, so she did not participate in meals with the residents and so I delivered meals regularly to her. This was detrimental to her socialization. However, the geographic proximity to my home made it the most convenient option. 

  • Housing Cooperatives – This is a unique option for seniors, who want to live in single-family homes, high-rises, or townhomes – and don’t necessarily want to own their own home, or rent. The senior cooperative housing community is a corporation. As a resident, you own the building and land collectively with the other residents. You and the other residents buy stock in this corporation and become shareholders. Your stock is typically prorated in value based on the size (square footage) of your home/apartment. Seniors co-ops are operated as non-profits.
    A benefit of a cooperative is that the residents’ voices are heard, which improves services. Many have created support for activities of daily living and have a strong social network and support systems. Amenities may include a gym, laundry facilities, unique dining experiences, group activities and libraries. My experience is that the residents look out for one another, which is invaluable! However, each facility is unique, and it is important that all financial aspects are carefully reviewed before signing a contract.
  • Memory Care – A distinct type of care that focuses on patients with memory loss, such as dementia, Alzheimer’s, and other brain diseases impacting memory. Skilled professionals provide additional safety measures and provide support specific to patients with memory loss.

    When evaluating a memory care facility, be sure they honor, respect, and will act upon your loved one’s history and preferences. The staff should be educated and aware of the history of your loved one including occupation, personality, preferences (for example clothing, temperature, and food preferences). And be aware of how their life experiences may impact them in the facility. Provide them with a legacy document including the history of your loved one.

  • Respite Care – Planned or emergency care to provide short-term or time limited breaks for caregivers. This is a tough one that takes research ~ as it may be provided by an adult day-care or an overnight facility. Check with your local “Area on Aging” organizations, senior centers, or health care clinics in your area for references.
  • Palliative Care – Specialized medical care for people living with a serious illness. This may occur in hospitals, nursing homes, out-patient clinics, or at home. In addition to medical care, they may provide social, spiritual, and nutritional support.

    Palliative care may be provided with curative treatment. It may transition to hospice care if the doctor does believe the person is likely to die within 6 months – BUT, it is important to note, this is not hospice and that curative options are still available.  Patients may graduate from palliative care and live longer than 6 months – and do not wait to inquire for this support as the additional care may help your loved one, providing and increased quality of life and time!

  • Hospice Care – Care for the end of life. Focused on comfort and care versus curative treatment. This may be offered at home, in a nursing facility or hospital or at a hospice house. Hospice care brings together medical professionals, spiritual advisors, and additional emotional support as needed for the family and loved ones. Leaders of the hospice team remain in communication throughout hospice care providing support and adjusting comfort care as needed for the patient.

    This is often one of the most difficult treatments for families to incorporate for their loved one  ~ because they think it is the end of life. In some ways, this is correct thinking because to qualify for hospice care, health care professionals typically estimate 6 months or less of life. However, the great thing about hospice is that the additional care may add so much to the quality of life for your loved one and for you as a caregiver.

  • Nursing Care – An option for housing where there are skilled nursing staff present and providing services. Important to note is they may provide short-term care for rehabilitation from an illness or injury or be a long-term care solution. Typically, there is a room with a hospital style bed, dresser, closet, and chairs. Some are single occupancy or house multiple residents. When a loved one has progressed beyond their abilities to move out of nursing care, this may become a long-term care solution. My mom, Nancy, spent almost two years in a nursing facility, and we did our best to make it feel like home for her with her photos, artwork, decorations, and special belongings. 

Looking for services?
If you live in Minnesota, contact the Senior Linkage Line at 1.800.333.2433. If you live outside of Minnesota, most states have councils on aging and local chapter areas on aging you may contact to find housing and long-term care services.