How to Qualify for Assisted Living

David Bolton

/

May 6, 2021

Assisted Living
How to Qualify for Assisted Living | Retire Fearless

These are the requirements you must know before seeking admission for your aged ones in assisted living facilities or senior care services.

Before you qualify for assisted living service in any state, you must have a physician recommendation, complete all related paperwork, and meet the care facility criteria which varies from one state and agency to another.

There is a lot to learn about the care service industry in terms of how seniors can qualify for assisted living, what type of care is the best for them, and the criteria to qualify for these cares. In this article, we are going to equip you with all the necessary information that will make you adequately plan for your senior’s assisted living admission.

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Available Care Options for Seniors and How to Qualify

In the USA, the senior care industry is wider than you can imagine and there are many options for your aged loves. However, you cannot just decide to put a senior in any senior care facility you wish because every one of them has its own criteria based on the level of care required for a senior.

Here are the different types of care, the situations they are perfect for, and how to qualify:

Nursing Homes

Nursing homes are for seniors that are completely dependent and require the most attentive care. It is also on a long-term basis, and on average, any patient they accept will last about 2 years. This is the place for seniors whose ADLs and IADLs scores are very low. Almost all of them will need help with activities like bathing and dressing up. Caregivers in nursing homes are registered nurses, and they work around the clock to meet the needs of their patients.

Nursing homes are usually the costliest senior care services with an average price of $90,000. Although this might vary depending on state, region and insurance policy.

Admission to nursing homes requires a lot of paperwork. They include:

Physician Order for Nursing Facility

If the senior gets a nursing home admission from a hospital, the hospital will provide this. But, if it is a personal decision, then a family doctor must give this order.

Treatment and Medications Order

This is the order that will put the nurses through on what treatment and drugs they are to give the senior. You will get this from the hospital that gave this admission, or from the family doctor if it is a personal decision.

Medical History

Nursing homes will also require a medical history of the senior. You can get this from the hospital that made the admission or a family doctor.

State Form

A state form indicates that the patient meets all requirements for admission into a nursing home. These requirements vary from state to state.

Nursing Home Paperwork

This is the admission paperwork from the nursing home.

Chest X-Ray

Nursing homes require a patient’s chest X-ray test upon admission.

Financial Paperwork

This is the paperwork that assesses your finances and shows that you have paid all the necessary fees.

Assisted Living Care

Assisted living care facilities are like nursing homes in that caregivers work around the clock to meet the needs of patients.

But unlike nursing homes, seniors in these facilities are more independent and they can do a lot of activities but cannot live alone safely.

In assisted living facilities seniors have living spaces to themselves and they can socialize freely with other residents.

Residents that are capable of cooking for themselves can do so, while caregivers will provide food for those that cannot cook.

Caregivers in assisted living do not have as much workload compared to nursing homes.

Fees for Assisted Living are smaller compared to nursing homes, with an average of $25,000 to $50,000 per year, based on the state and region.

Seniors that do not qualify for assisted living are those with:

  • Serious cognitive impairment
  • Wheelchairs
  • Serious medical needs and
  • Those in need of daily nursing services.

Seniors may get assisted living recommendations from nursing homes, hospitals, rehabs, and personal homes.

Regardless of where they are coming from, the paperwork for assisted living facilities include:

  • Admission paperwork
  • Medical history
  • Chest X-ray Test
  • Negative Tuberculosis Test.

Home Health Care

This is the most common care for aged people because they do not have to move out of their home, which they are already comfortable with. Also, family and friends can check up on them at any time without rules and regulations like in other care homes.

The caregiver will only help with activities such as:

  • Cooking
  • Transporting to places they need to be
  • Dressing
  • Bathing

Home care is not expensive and caregivers get paid hourly. Sometimes they only come once or twice a week. To qualify for home health care, a physician must confirm that a senior is in need of one of these:

  • Physical therapy
  • Speech services
  • Occasional nursing services.

For home care, seniors can:

  • Leave home for reasons such as socializing or religious gatherings
  • Leave home for health treatments.
  • Visit adult daycare.

Note that seniors that require frequent nursing services or expertise nursing care require more than just home health care.

Hospice Care

Hospice care is for seniors and patients that are facing serious life-threatening medical conditions. Having to put a senior there can be quite emotional because it means that his or her life is in a very delicate state. Hospice care is majorly to ensure that patients spend their final days and moments being pain-free.

Before qualifying for hospice care, the patient must have a Medicare plan and must be terminally ill with a life expectancy of not more than 6 months. Before admitting for hospice care, a doctor or representative from the hospice agency will visit the patient or a family member to do the following:

  • Counsel about hospice care and other options available.
  • Talk about other care planning
  • Explain the reasons for pain management

Only a doctor can give admission for hospice care with Local Coverage Determination (LCD).

Admission for hospice care is possible with:

  • The recommendation of a physician in the presence of an attending doctor.
  • Consideration and analysis of the terminal illness, other health complications regardless of if they relate to the terminal illness or not, and all ensuring diagnosis.

Alzheimer Care

This is a care house for seniors and other patients that suffer from Alzheimer disease. Alzheimer is the most occurring memory loss disease with more than 5 million patients in a year.

In its serious state, the disease can make patients wander, and this is why these facilities usually have a large sparse of land and increased security. In most cases, Alzheimer care serves as primary health care to facilities like nursing homes. Caring for Alzheimer patients goes beyond just helping them with daily activities because they need supervision and security also.

Admission to Alzheimer or Memory care facilities can be through a rehab center, nursing home, hospital, or private residence.

The requirements are:

  • Facility paperwork for admission.
  • Negative Tuberculosis test.
  • Chest X-ray
  • Medical History.

Independent Living Communities

These are care homes for fairly independent seniors, and they are also called retirement homes and villages. Residents in these places do not require a lot of help from caregivers.

Independents living helps aged ones battle isolation and health issues that come with it. They have a lot of recreational and social activities like tennis, golfing, and other sports to keep residents engaged.

This caregiving service is one of the cheapest for seniors, with costs ranging between $2,000 to $4,000 monthly.

It is important to note that show symptoms or have been diagnosed with severe cognitive impairment may not be admitted into an assisted living facility. Also, they may not be considered if they have behavioural symptoms like wandering, use wheelchairs, or have a wide range of medical assistance and needs.

Types of Assisted Living and Their Qualifications

Before moving your senior into an assisted living facility, it is important to know the types of assisted living care and their qualification status. The three types of assisted living are:

  • Basic assisted living
  • Enhanced assisted living and
  • Special need assisted living.

Basic Assisted Living

Basic assisted living facilities will only accept seniors declared to be medically stable. Even after admission, the senior will routinely undergo physical tests, and a physician in the facility will provide medical assessments based on a schedule.

The type of seniors that basic assisted living admits are those who:

  • Can live in an environment designed for social support with round-the-clock supervision.
  • Have sight and hearing issues.
  • Need assistance with basic daily activities like bathing, using the toilet, feeding, dressing, etc.
  • Are stable enough for direction when an emergency occurs.
  • Do not require steady medical attention, or have a medical issue that makes them in need of 24 hours nursing care.
  • Are not suicidal, or pose a danger to themselves and other residents.

Ultimately, facilities that offer basic assisted living do so to meet seniors' social and basic habitation needs. In the USA, assisted living facilities can only receive certification for providing either enhanced care or special need assisted living.

Enhanced Assisted Living

Seniors with difficulties that basic assisted living cannot handle will be referred to enhanced assisted living facilities. Admission into an enhanced assisted living facility can also be from an agency that offers basic care. The reason for this is because most times, the seniors' condition becomes too critical for basic care.

Enhanced assisted living residents usually need extensive care and assistance such as getting out of the bed and chair, using the stairs, and urine and feces incontinence. Patients in need of this kind of care are seniors with chronic arthritis that make them unable to eat or work.

In enhanced assisted living facilities, there will be medical and nursing care at hand. But should the senior need 24 hours’ attention, then he or she must be transferred to a nursing home or hospital.

Seniors in enhanced assisted living facilities that are due for nursing homes and hospitals but prefer to remain in the facility must meet the following criteria:

  • Hire daily suitable nursing care to meet their medical needs
  • The medics in the enhanced assisted living facility agree that the senior care can be met on ground.
  • The operator of the assisted living facility agrees to coordinate the care services
  • The senior and his or her family agree with the whole plan.

Special Need Assisted Living

Facilities that offer special need assisted living services only deal with seniors that are in need of special attention and suffer from complications like dementia.

Certification requirements for special need assisted living varies from state to state. In New York, the Department of Health certifies special needs assisted living based on requirements such as the special services they offer, their environmental features, and the skills and level of their staff.

Special need services are more individual-based than other assisted living care. They have a tailored program for each resident. It is not all seniors with dementia that will be remanded to special need assisted living facilities. The most determining factor is the degree of the condition.

Upon admission to a special need assisted living home, a doctor will determine the kind of service for the patient and other environmental features that he or she needs.

Seniors that require special need care include:

  • Those with dementia and other related medical issues.
  • Those who need 24 hours’ supervision.
  • Those in dire need of help for daily activities.

In addition to the provision of care and attention, the facility must have a specified plan to assess the behavioral patterns of the patient.

If the resident condition worsens or becomes unmanageable by the facility, the manager in charge will assist to find the most befitting senior care, or move the senior to a hospital.

Admission Requirements for Assisted Living

All these assisted living care carry the same requirements and paperwork for admission. The requirements are:

  • Assessments, including medical, physical, and mental.
  • Application form provided by the facility.
  • A contract for residency agreement.
  • Financial statement.
  • Disclosure statement.
  • State law for assisted living residents' rights, responsibilities, and protection.

Before you sign any of these agreements, it is important to do a legal review of all paperwork involved.

How to Qualify for Assisted Living

About THE AUTHOR

David Bolton

With multiple family members currently in senior living facilities, David is in the trenches every week, learning the ins and outs of nursing homes, assisted living, memory care, and general senior living.

Read more about David Bolton

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We love planning for retirement. It's somewhat of a hobby, and we want to share what we've learned with you. Over the years we've found the best ways to live, how to travel, take on new hobbies and give back. Happiness in retirement is the main goal, and having the right information allows us (and you) to achieve that.

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