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Old Paradigm – Step 1
IndependentLiving
AssistedLiving
SkilledNursingHome
Independent LivingEnjoying “carefree” life in the company of older adults
www.CareHavenHomes.com
Independent Living
• Private homes, condos, townhouses or apartments
• Maintenance free: meals, basic housekeeping & laundry services
• Impressive amenities & social calendar
www.CareHavenHomes.com
What Does Independent Living Offer?
Active life with peers• 100 to 200 residents per community • May enjoy meals in restaurant-like setting • Wide range of organized gatherings, classes, clubs,
activities & outings
www.CareHavenHomes.com
What Does Independent Living Offer?
Luxury amenities• Well-appointed lobbies & common areas • Fitness centers, swimming pools, tennis courts, golf courses • Club houses, game rooms, activity rooms, libraries, chapels • Private meeting or dining rooms • Beauty parlors & barbershops • Onsite medical clinics • Covered parking
www.CareHavenHomes.com
What Does Independent Living Offer?
A more convenient life• Freedom from worry & isolation of home ownership • Easier to order basic necessities & engage with others • Shuttles to stores, medical offices & other local sites • Built-in safety & security measures
www.CareHavenHomes.com
How Much Does Independent Living Cost?
– Initial “Community Fee”
– Monthly rent & fees total $3,000 to $5,000 (Johnson County, KS)
• 12-month lease
• Monthly rent may increase at annual renewal
• A la carte fees for meals, maintenance, amenities & special programs vary
www.CareHavenHomes.com
How Do You Pay for Independent Living?
Covered by resident’s private funds• Pension
• Social Security
• Proceeds from the sale of family home
• Personal savings
www.CareHavenHomes.com
When Do People Leave Independent Living?
www.CareHavenHomes.com
When they need more than minor help– Bathing, dressing, toileting & other personal care – Taking medications or – Meeting other medical needs
Communities require that residents- Perform all activities of daily living on their own OR
- Arrange & pay for any personal care services they need OR
- Contract with private caregivers provided by the community
Old Paradigm – Step 2
IndependentLiving
AssistedLiving
SkilledNursingHome
Assisted LivingEnjoying privacy & independence with a little help
www.CareHavenHomes.com
Assisted Living
• Simple apartments or private/semiprivate rooms
• Maintenance free • Assisted social & recreational activities • Limited help with personal care: getting out
of bed, bathing, toileting, dressing, walking, medications
www.CareHavenHomes.com
What Does Assisted Living Offer?
Help maintaining an independent life• Onsite caregivers available round the clock • Scheduled care & emergency response • Nurse to monitor medical condition, oversee medications &
coordinate healthcare services • A la carte billing for medical or personal services delivered by
onsite or visiting professionals
www.CareHavenHomes.com
What Does Assisted Living Offer?
Peers with similar interests & abilities• 40 to 80 residents per facility • Most meals served in group dining area • Assisted activities & outings, designed to keep residents
engaged.
www.CareHavenHomes.com
How Much Does Assisted Living Cost?
– Initial “Community Fee”– Monthly rent & fees total $3,000 to $6,000 (Johnson County, KS)
• 12-month lease or month to month
• Cost higher for private versus shared room
• Monthly rent may increase upon renewal
• A la carte fees for special programs & services vary
www.CareHavenHomes.com
How Do You Pay for Assisted Living?
May be covered by• Resident’s private funds
• Long-term care insurance
• VA Aid & Attendance benefit
• In some cases, in participating facilities, Medicaid provides limited benefit to qualifying residents
www.CareHavenHomes.com
When Do People Leave Assisted Living?
When they need more than a little help– Bathing, dressing, toileting, walking & other personal care – Transfers, especially those requiring 2 people or lifts – Feeding – Incontinence management – Medication (insulin-dependent diabetes, IV therapies) – Significant medical & behavioral concerns (e.g., infectious disease,
open wounds, intensive rehab or therapy, feeding tubes, aggression) – Alzheimer’s or another dementia presents wandering, exit-seeking & other safety concerns
www.CareHavenHomes.com
Old Paradigm – Step 3
IndependentLiving
AssistedLiving
SkilledNursingHome
Skilled Nursing (Nursing Homes)
Complex medical care & extra physical assistance, 24/7
www.CareHavenHomes.com
Skilled Nursing
• Private & shared rooms in healthcare
setting • Long-term medical & physical care • Short-term rehab
www.CareHavenHomes.com
What Does Skilled Nursing Offer?
Highest level of medical care outside a hospital
• Skilled, complex medical or psychological care • Physical assistance routinely includes feeding & 2-person
transfers • Care directed by facility’s physician • Nurse onsite round the clock • Once the only solution for long-term care
www.CareHavenHomes.com
What Does Skilled Nursing Offer?
Encouragement to remain engaged• 30 to 80 residents per facility • Opportunity to share meals in group setting • Group entertainment, assisted activities
www.CareHavenHomes.com
How Much Does Skilled Nursing Cost?
$6,000 to $9,000 per month (Johnson County, KS)
• Cost higher for private versus shared room
• Monthly rent may increase upon renewal
• Additional fees for special programs & services vary
www.CareHavenHomes.com
How Do You Pay for Skilled Nursing?
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– The only long-term care for which Medicaid pays 100% of costs of qualifying residents
– Also may be covered by• Resident’s private funds
• Long-term care insurance
• VA Aid & Attendance benefit
• Medicare (only for specified short-term medical services)
• Private health insurance
Old Paradigm – Continuing Care
IndependentLiving
AssistedLiving
SkilledNursingHome
Continuing Care Retirement Communities Attempting to provide for all long-term needs
www.CareHavenHomes.com
Continuing CareRetirement Communities
www.CareHavenHomes.com
• Single campus may include independent living, assisted living & skilled nursing
• Buy-in guarantees lifelong care within community
• With either buy-in or monthly rental, residents move across campus as needs change, but remain members of umbrella community
What Does Continuing Care Offer?
Old friends & familiar places• 150 to 300 residents per community • Atmosphere of “elder village” • Remain in vicinity of friends & favorite amenities, even after
moving to different level of care • Ideal for couples who need different levels of care but wish
to remain close together
www.CareHavenHomes.com
What Does Continuing Care Offer?
With buy-in, long-term security• Similar to buying home with long-term care insurance • Popular choice if you have no one to oversee future care or
wish to make your own arrangements • Nonprofit facilities may offer attractive safety net • Critical to know – What entry fee covers – What portion is refundable (70 - 90%) & whether
community can afford to repay – Likelihood that advanced care will be available
www.CareHavenHomes.com
How Much Does Continuing Care Cost?
www.CareHavenHomes.com
– For purchase, initial buy-in fee (from tens to hundreds of thousands of $s)
– For rental, initial community fee + monthly rental
– A la carte monthly fees for meals, maintenance, amenities & special programs• Buy-in fee may fund advanced care when needed • More likely, funds limited number of days in advanced care
before additional fees are charged
• Some contracts are fee-for-service. Fees increase with higher levels of care
How Do You Pay for Continuing Care?
– Use funding sources appropriate for resident’s current level of care
– Resident’s private funds must be used for buy-in & independent living
– Some have limited number of Medicaid beds reserved for buy-in residents
www.CareHavenHomes.com
Why Would Someone Leave Continuing Care?• Dissatisfied with new level of care
• Higher level of care unavailable within community
• Require memory care, which currently isn’t offered in many CCRCs
www.CareHavenHomes.com
New Paradigm - +Memory Care
IndependentLiving
AssistedLiving
SkilledNursingHome
MemoryCare
www.CareHavenHomes.com
Memory Care:A Growing Demand
According to the Alzheimer’s Association *
• 1 in 9 people age 65 & over has Alzheimer’s disease
• Chance of receiving a diagnosis increases with age
• About 1/3 of people age 85 & older have Alzheimer’s
* https://www.alz.org/documents_custom/2016-facts-and-figures.pdf
www.CareHavenHomes.com
Why Memory Care?
Dementia’sphysical, psychological,
emotional & behavioral challengesrequire special care
www.CareHavenHomes.com
Why Memory Care?
Special Staffing• Caregivers & nurses trained to
- Provide comforting care - Avoid problem behaviors - Encourage social interactions that residents no longer can
initiate or continue on their own • Higher staffing levels for closer supervision
www.CareHavenHomes.com
Why Memory Care?
Special Schedules• Comforting daily routines • Stimulating activities to
- Encourage socialization - Jog long-term memory - Preserve physical abilities & cognitive skills
www.CareHavenHomes.com
Why Memory Care?
Special Places• 25 to 50 residents per unit, in private or shared rooms • Self-contained, with secure entry & enclosed outdoor courtyard
to prevent wandering • Amenities typical of assisted living, but separate from other
portions of retirement community • The best feature small pods with plenty of “landmarks,” not long
corridors with over-stimulating common areas • Alarms & other safety features effective for people with memory loss disorders
www.CareHavenHomes.com
How Much Does Memory Care Cost?
– Initial “Community Fee”– Monthly rent & fees total $5,000 to $8,000 (Johnson County, KS)
• Month to month
• Cost higher for private versus shared room
• Monthly rent may increase upon renewal
• A la carte fees for special programs & services vary
www.CareHavenHomes.com
How Do You Pay for Memory Care?
Much the same as Assisted Living• Resident’s private funds
• Long-term care insurance
• VA Aid & Attendance benefit
• In some cases, in participating facilities, Medicaid
www.CareHavenHomes.com
When Do People Leave Typical Memory Care for Skilled Care?
Personal, medical and/or behavioral needs require frequent, significant attention– Bathing, dressing, toileting, walking & other personal care – Transfers, especially those requiring 2 people or lifts – Feeding – Incontinence management – Medication (insulin-dependent diabetes, IV therapies) – Significant medical & behavioral concerns (e.g., infectious disease, open wounds, intensive rehab or therapy, feeding tubes, aggression)
www.CareHavenHomes.com
Memory Care:A Better Model
IndependentLivingHome
ResidentialCare Home
AssistedLiving
www.CareHavenHomes.com
Residential Care Home
• House in residential neighborhood, modified for optimum care of older adults with dementia
• Up to 12 residents, usually with private rooms • Higher staffing levels than traditional facilities • In Kansas, licensed & regulated as “Home Plus”
www.CareHavenHomes.com
What Do Residential Care Homes Offer?
Comfort care• Family-style setting – most calming & appropriate for people
with memory loss • Familiar, non-threatening environment that avoids over-
stimulation. May reduce need for medication • Flexible routines, adapted to personal preferences • Caregivers & activities assistants given time to calm, reassure
& engage each resident
www.CareHavenHomes.com
What Do Residential Care Homes Offer?
Individualized care• Consistent caregiving & nursing staff - Close, personal relationships - Understand resident preferences & abilities
• More caregivers per resident - Anticipate needs - Quickly respond to requests & emergencies - Closely monitor changes - Better able to prevent frustration & challenging behaviors
www.CareHavenHomes.com
What Do Residential Care Homes Offer?
Safety & security• Caregivers easily spot when & where they're needed • Nurses know each resident. Fully informed when responding
to emergencies • Able to use personal alarm/paging systems • Houses equipped with safety features found in larger
facilities: grab bars, handrails, ramps, zero entry showers, fenced yards, keypad door access controls, emergency generators & fire safety systems
(including fire doors, sprinklers & alarm)
www.CareHavenHomes.com
How Much Do Residential Care Homes Cost?– Initial “Community Fee”– Monthly rent & fees total $6,000 to $7,500 (Johnson County, KS)
• Month to month
• Monthly rent may increase upon renewal or in the event of change in level of care
• Generally a flat pricing structure. Limited additional fees
www.CareHavenHomes.com
– Much the same as other Memory Care– May be covered by
• Resident’s private funds • Long-term care insurance • VA Aid & Attendance benefit • In a few cases, in participating homes,
Medicaid
How Do You Pay for a Residential Care Home?
www.CareHavenHomes.com
Residential Care Homes: A Chance to Age in Place
www.CareHavenHomes.com
• Many support the changing needs of people at all dementia’s stages
• Most coordinate to provide any healthcare services & medical equipment required
• Many partner with local hospices to provide dignified end-of-life care, avoiding the move to skilled nursing in all but the most extreme circumstances
Families Feel at Home, Too
www.CareHavenHomes.com
• A real home, where Mom can enjoy the rest of her days
• Best round-the-clock, personal dementia support available
• Helps avoid painful & upsetting medical or behavioral crises – for quality time together
• Simpler pricing structure – to better plan Mom’s future
Find Better Memory CareVisit Us Online
www.CareHavenHomes.com
Get tips for better caregiving – Take a peek at our blog/newsletter www.CareHavenHomes.com/A-Better-Way-of-Care
See what better care looks like – Visit our website www.CareHavenHomes.com/
Get daily updates – Follow us on Facebook www.Facebook.com/CareHavenHomes