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Types of senior and eldercare

It's one thing to wrap your head around what type of care your loved one needs today, but it's another thing to realize those needs may change over time. There is a wide range of communities, homes, services, and facilities designed to help people with daily living. 

Activities of daily living

Caregiving needs can generally be split into 2 main categories: medical care and nonmedical care or basic and instrumental. Health care providers and insurance companies tend to characterize someone's eligibility for services based on their need for help with these 6 things, known as basic activities of daily living:1 
 
  • Bathing 
  • Dressing 
  • Using the toilet 
  • Continence 
  • Transferring (to or from bed or chair) 
  • Eating 

In-home caregivers

The right caregiver is someone who can make a positive impact on your aging loved one's quality of life. It can also reduce your concerns to know your loved one is in good hands. Whether there's a need for just a few hours per week or something much more intensive, in-home care is a great way to help your loved one age in place.

Tips for hiring caregivers

It can be hard to know where to start when you're looking for help with your loved one, but there are a few steps you can take to find the right fit.2 
 
  • Understand your loved one's needs 
  • Understand what's financially possible 
  • Involve the whole family—including your loved one 
  • Draft a job description 
  • Decide whether to use an agency or hire privately 
  • Ask around—word-of-mouth can be a powerful tool 
  • Do interviews 
  • Run background checks and check references 
  • Set expectations with an employment contract 
  • Pay fairly and legally 

Different types of caregivers

There’s a range of skillsets and certifications for in-home caregivers that may fit your loved one's needs. You may encounter some or all of these roles and certifications in your search.3 
 
Home health aide (HHA) and Personal care aide (PCA) 
 
  • Helps with your loved one's daily activities, such as cleaning, bathing, toileting, dressing, housekeeping, scheduling, transferring, grocery shopping, and serving meals 
  • If qualified with training, can check vital signs 
  • Education requirements: Typically a high school diploma 
 
Certified nursing assistant (CNA) 
 
  • Provides basic care needs for your loved one's daily activities 
  • Can also measure vital signs and blood pressure 
  • Some can administer medications 
  • Education requirements: Complete a state-approved education program and pass a competency exam 

License practical nurse (LPN) and licensed vocational nurse (LVN) 
 
  • Provides more advanced care needs under the supervision of a Registered Nurse (RN) 
  • Checks vitals, changes bandages, inserts catheters, and reports back to RN or doctors 
  • Some can administer medication and IV drips 
  • Educational requirements: Certificate or diploma through a state-approved educational program and must pass the National Council Licensure Examination 
 
 
Registered Nurse (RN) 
 
  • Provides advanced care needs 
  • Can assess medical conditions, administer medication and treatments, run medical equipment, perform diagnostic tests and analyze results 
  • Can educate the patient and family on how to manage illnesses and injuries 
  • Some oversee LPNs, CNAs, and HHAs 
  • Educational requirements: Bachelor of Science in nursing (BSN), Associate Degree in nursing (ADN), or diploma from approved nursing program. Must also pass the National Council of Licensure Examination 

Care options outside the home

Your loved one may be interested in exploring the possibility of moving into a care community, or there may come a time when continuing to live at home becomes unmanageable or unsafe. 
 
As you assess what's right for your loved one, keep these questions in mind: 
 
  • What is your loved one's overall health? 
  • How active or independent are they? 
  • What kinds of access and activities are important to them? 
 
 
From providing no hands-on care to full 24/7 monitoring with medical care on-hand, there’s a range of housing options that provide varying levels of care. The costs cited below may vary depending on region or location. 
 
Independent living communities 
 
Average cost: $2,664 per month4 
 
  • Restricted to residents of a certain age (generally 55+). 
  • Offer independent homes or apartments for those who require little to no extra help. 
  • May offer social activities, landscaping and housekeeping services, transportation or dining options. 
 
 
Adult day cares 
 
Average cost: $1,793 per month5 
 
  • Provide a safe environment for loved ones who may be isolated, need structured services, or supervised care during at least part of the day. 
  • Not a residential facility. Daytime services only. 
  • Typically provide socializing, activities, meals, and sometimes some health care. 
  • May have nursing staff and offer transportation. 
  • Can be used to offer respite care for caregivers. 
 
Assisted living communities 
 
Average cost: $4,500 per month6 
 
  • Provide a range of independence and hands-on care in apartment-sized homes. 
  • Offer help with daily living, such as getting dressed, bathing, and managing medication. 
  • Typically include meals, housekeeping, social activities, and certain utilities. 
  • Depending on the facility, units may be either rented or owned. 
 
 
Skilled nursing facilities 
 
Average cost: $7,908 per month for semi-private room or $9,034 per month for a private room7 
 
  • Provide 24-hour intensive medical care for the very ill or those recovering from a serious health event. 
  • May include activities, opportunities for socializing, and exercise programs. 
  • Typically accommodate both long-term stays and short-term rehab stays. 
 
Continuing care retirement communities 
 
Average cost: Can vary widely. Average entrance fee is $402,000, and monthly costs can range from $3,000 to $5,000
 
  • Offer a range of living and caregiving options that keep pace with residents' changing needs. 
  • Designed to offer a range of residence types and levels of care from periodic personal care to full-time skilled nursing and in some cases, memory care. 
  • Tend to involve an entrance fee or home purchase in addition to monthly fees or rent in exchange for some assurance that needs will be met for the rest of the resident's life. 
 
Memory care facilities 
 
Average cost: $6,935 per month9
 
  • Secure units on a separate floor or wing of an assisted living, skilled nursing, or continuing care retirement community. 
  • Offer specialized care for those with Alzheimer's or other forms of dementia. 
  • Design of the unit and training of the caregivers is specific to the needs of memory loss and related impairments. 

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1. Peter F. Edemekong, Deb L. Bomgaars, Sukesh Sukumaran, and Caroline Schoo, “Activities of Daily Living,” National Library of Medicine, November 19, 2022, https://www.ncbi.nlm.nih.gov/books/NBK470404/. 2. “How to Hire a Caregiver,” AARP, September 27, 2021, https://www.aarp.org/caregiving/home-care/info-2018/hiring-caregiver.html. 3. “FYI: Different Types of Home Care Workers,” ALS Association, June 10, 2020, https://www.als.org/navigating-als/resources/fyi-different-types-home-care-workers 4. “WHAT IS INDEPENDENT LIVING AND HOW MUCH SHOULD IT COST?,” AssistedLiving.org, January 11, 2022, https://www.assistedliving.org/independent-living/. 5. Sarah Goldy-Brown, “Adult Day Care Cost 2023,” Senior Living, July 18, 2023, https://www.seniorliving.org/adult-day-care/costs/. 6. “How Much Does Assisted Living Cost,” A Senior Living Resource, May 9, 2023, https://www.whereyoulivematters.org/how-much-does-assisted-living-cost/. 7. Jeff Hoyt, “Nursing Home Cost 2023, Senior Living, July 18, 2023, https://www.seniorliving.org/nursing-homes/costs/. 8. Maureen Stanley, “Continuing Care Retirement Communities (CCRCs),” SeniorLiving.org, June 14, 2023, https://www.seniorliving.org/continuing-care-retirement-communities/. 9. Scott Witt, “Memory Care Cost,” Senior Living, July 14, 2023, https://www.seniorliving.org/memory-care/costs/.

This information is general in nature and provided for educational purposes only.

Fidelity does not provide legal or tax advice. The information herein is general in nature and should not be considered legal or tax advice. Consult an attorney or tax professional regarding your specific situation.

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