Types Of Facilities - Long Term Residential Care: Alzheimers

Content provided by the Faculty of the Harvard Medical School

Types of facilities

Four general types of living arrangements are available for people with more advanced Alzheimer's disease. Because many high-quality centers have waiting lists, it's important to investigate a variety of options early in your planning, even if you're not yet ready to place your family member outside the home (see "Evaluating a long-term care facility").

Because the average cost of long-term care is $34,860 a year for an assisted-living facility and $74,095 a year for a private room in a nursing home, you'll have to investigate payment options. Aside from Medicaid, there is no national government program that funds long-term residential care. Medicaid is administered at the state level and covers only those who are impoverished. It's not uncommon for people to pay for their own care, often until they use up their resources and then become eligible for Medicaid. In some instances, usually if the person with Alzheimer's is also suffering from an acute illness, Medicare may cover a short-term living arrangement for up to 150 days. Your local Alzheimer's Association chapter is an excellent place to start identifying possible sources of assistance (see "Resources").

Nursing homes

For years, nursing homes were the only choice for people with Alzheimer's disease, but these facilities often don't specifically meet their needs. Nursing homes were created for people who were not cognitively impaired but required some functional assistance because of medical problems. These facilities are typically hospital-like and don't provide the general supervision and space that enable a person with Alzheimer's to move about freely.

Special care units (SCUs)

Many nursing homes have organized dementia care units that are located in a separate wing of the facility. These special care units (SCUs) often offer patients with dementia homelike environments and activities and programs conducted by specially trained providers.

Ideally, dementia programs include small-group activities geared toward different levels of ability, short programs, and activities arranged by functional or cognitive ability levels. These facilities may also include special design features, such as secured exits, small dining rooms, single-occupancy rooms, or special indoor or outdoor areas for wandering. Currently, however, the care provided in such programs varies widely because there's no standard definition of what constitutes an SCU. Therefore, if you're considering this type of long-term residential care, visit the facility to find out what services and programs it offers.

Assisted-living facilities

These are typically large complexes with apartments or townhouse units that offer communal dining, assistance with personal care, monitoring of medication, and housekeeping services. Many offer special residences for people with dementia and features similar to those offered in special care units, without the level of ongoing medical care that's available at a nursing home.

Retirement communities

Sometimes called "life care centers," retirement communities offer several levels of services so that as the needs of the resident changes, he or she moves within the complex to receive more specialized care.

Last updated:	January 23, 2007