Levels of care

Independent living with assistance

In-home non-medical assistance

Services are provided a few hours per week, including companionship, light housekeeping, meal preparation, assistance with personal care, transportation to medical appointments.

Home health services
Services include short-term physical, occupational, and speech therapy; nursing services; and medical social work.

Asssisted living
Apartment or condo living within a planned community that may include meals, laundry services, transport, or medication management.

Short-term care

Respite care
Temporary residential care for patients that provides a period of relief for their permanent caregivers.

Skilled nursing facility (SNF)

Includes physical, occupational, and speech therapy as well as skilled nursing care (e.g., wound care or IV antibiotic administation) on a short-term basis within the confines of a nursing home.

Short-term rehabilitation (Rehab)

Intensive rehabilitation (e.g.; 3-hr per day) includes physical, occupational, and speech therapy for elders after having experienced a serious cardiovascular, neurologic or orthopedic malady (e.g., stroke, hip fracture, deconditioning).

Facility hospice

Small residential institution for terminally ill patients that focuses on the patient's well-being rather than a cure. It emphasizes pain management and emotional support. Treatment can extend to family members in the form of bereavement counseling.

Home hospice

Like facility hospice, the aim of home-hospice care focuses on the well-being of the patient rather than cure. Hour-to-hour care is provided by family members. Nurses and counselors perform home visits a few times during the week to address changes in the patient's condition. Hospice nurses are available by phone 24-h a day.

Long-term care

Nursing home care
Provides a room or apartment within a large facility. Residents receive assistance with activities-of-daily-living. All meals are catered and activities are scheduled throughout the day to entertain residents.

Residential care homes
Provide services similar to assisted living or nursing home facility but in a smaller, intimate setting. Such homes can specialize in particular needs such as diabetes care, dementia, a particular language (like Spanish) or residents with specific religious or cultural backgrounds.

Alzheimer's ward
Skilled nursing facility specializing in the needs of those elderly with dementia. Most wards are locked-down to ensure that residents wander away and put themselves in harm's way.

PACE: Program of all-inclusive care for the elderly
The mission of PACE is to provide elders who qualify for nursing home care requisite services to keep them living within the community. It is an interdisciplinary effort including, but limited to the following:

• Adult day care: supervision, recreation, personal care, and meals
• Therapeutic services: occupational/physical therapy, nutritional counseling, social work
• Medical services: Coordination between PCP and specialists
• Respite care
• Hospital and nursing home treatment when needed

PACE can be thought of as a virtual skilled-nursing facility, but which can serve the needs of patients more quickly. In comparison to non-coordinated care, patients on PACE have significantly less hospitalizations.

To qualify for PACE, a patient must have at least 2 ADLs they need help. Payment can be covered by Medicaid, Medicaid plus Medicare, Medicare plus a copay, or private insurance. The cost for PACE is generally less than a nursing home.

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