A Guide to Levels of Care.
By Wendy Simons
This is a basic overview of areas of care: Retirement,
Assisted Living and Skilled Nursing. As you review this, keep in mind that individual needs may overlap several areas. This is a basic review of the care parameters in the three areas. I have not included the cost factor as each operation charges differently according to amenities. ADL is an abbreviation for Activities of Daily Living.
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Retirement Living
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Assisted Living
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Skilled Nursing Facility
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Independent
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Minimum Assistance
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Standby Assistance
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Hands-on Assistance
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Total Assistance
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Able to respond independently in an emergency.
Able to negotiate stairs in an emergency and exit the building.
ADL - resident is able to accomplish
all without intervention from staff.
1. Bathe, dress, groom
2. Transfer & Ambulate
3. Toileting and personal hygiene
4. Eat/take medications
Able to communicate with clarity.
No personal care assistance or monitoring.
Meals/housekeeping.
Provided if chosen .
Would benefit from socialization and activities with minor
encouragement.
No memory impairment.
Capacity for decision making and understanding consequences
of actions.
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Able to respond in an emergency.
Walks/transfers independently - Infrequent falls.
ADL - Independent to verbal reminders.
Independent with medications & Dr. appointments.
Continent of bowel and bladder.
Independent in bathing.
Meals, nutrition, housekeeping assistance is helpful.
Able to independently plan and participate in social activities.
Oriented to self.
Little memory impairment.
Some decline in capacity for self care and understanding consequences
of actions.
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May need assistance in an emergency.
Transfers - Standby assistance may be needed. Subject to falls.
ADL - Reminders to giving verbal cues.
Medication reminders and management.
Occasional incontinence assistance.
Bathing set up and monitoring.
Meals, nutrition, housekeeping assistance is helpful.
Reminders and encouragement to participate in activities.
Mild memory impairment - sometimes disoriented.
Declining capacity for self care and understanding consequences
of actions.
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Needs assistance in an emergency.
Transfers - 1 person assist usually needed. Fall risk.
ADL - Verbal cues and/or hands-on assist.
Medication management.
Incontinence management.
Bathing assistance.
Meals, nutrition, and housekeeping assistance needed.
Encourage and escort to participate in activities.
Impaired memory. Poor orientation and mild confusion.
Limited capacity and inability to understand consequences.
Limited capacity and inability to understand consequences of actions.
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Needs supervision and hands-on assistance in an emergency.
Transfers - 2 person assist may be needed/Mechanical lift/bedfast.
ADL - Hands-on assistance.
Medication adjustments and behavior management.
Incontinence management.
Bathing assistance.
Verbal cues and hands-on assistance to eat.
Encourage and escort to activities.
Needs 24 hour nursing supervision or skilled services such as Physical, Occupational and/or Speech therapy.
Limited or no capacity for self care and understanding of consequences of actions.
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Family does not "need" to move.
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Family "slightly concerned."
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Family "concerned."
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Family "very concerned" - "Have to do something."
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Needs continuous assistance and medical monitoring.
Family must do something.
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