What you didn’t know you didn’t know about senior living: IL vs. ALF vs. SNF vs. ALZ.
The outside of my ALF on a rare sunny day
I recently had a resident move into our community from a Skilled Nursing Facility, or SNF, which is essentially the highest level of care in senior housing. Most residents are bed-bound, need 24/7 nursing care, have wounds that will never close, or something along those lines. Not this resident. She is very bright and alert, is in a wheelchair but is otherwise in great physical health, and she is always earnestly seeking out activities and ways to get involved in our community. She was living in a SNF with residents quite unlike her for three years simply due to the fact that she didn’t know there were other types of senior living, and no one bothered to tell her.
The following is my personal breakdown of the most common forms of senior living (note: there are a few other less common types of senior living, such as RCFs which are Resident Care Facilities or ICFs which are Intensive Care Facilities to name a few, but I’m going to discuss the facilities I deal with frequently).
Independent Living (IL): When mom can’t keep up with the big house anymore, or is struggling with gardening or housekeeping, it might be time to consider making a move to senior living. IL is a great first option.
Pros:
Least expensive form of senior housing (approx. $100/day)
Resident can maintain most functions of their previous lifestyle - outings, hobbies, etc
Increased socialization which helps maintain cognitive function
Light assistance – meals provided, weekly housekeeping, landscaping/gardening, etc
Community bus (usually) which decreases the need to drive
Cons:
Limited care – most ILs require outsourced in-home care if there are increased care needs
Most likely will have to move again in a few years
Assisted Living Facility (ALF): ALFs provide a range of care, but typically everyone living in an ALF requires some assistance with one or more ADL (Activity of Daily Living). This is considered a mid-range option of care, and works best for residents who need more assistance than provided at an IL, but are still able to engage with activities or remain social on some level.
Pros:
More care offered, such as assistance with bathing, dressing, arranging medical appointments, etc.
Full-time Activity Director who strives to keep residents social and active
The option to be semi-independent, but have access to assistance when it’s needed
On-site care around the clock
State-regulated with an assigned Ombudsman for quality assurance
Cons:
More expensive than IL with care costs related to the amount of care a resident is receiving – Oregon state average ALF rent increases are between 2%-5% yearly (approx. $175/day)
Sudden health changes could result in an eviction notice due to a higher level of care need
Skilled Nursing Facility (SNF): Skilled nursing is exactly what it sounds like. This is the option for residents who have incredibly high care needs and typically need Registered Nursing (RN) oversight, rather than just a trained med-aide or caregiver.
Pros:
RN oversight 24/7; most have an onsite Nurse Practitioner or House Doctor
Very few reasons that a SNF-admitted resident would need to move out
Can provide end-of-life care with an emphasis on quality and comfort
State-regulated and maintained similar to an ALF
Cons:
Very clinical feel
Some activities, but with many bed-bound residents, socialization is low
Very expensive (approx. $300/day)
Memory Care (ALZ): This is specifically a care facility for someone with an advanced dementia diagnosis, such as Alzheimer’s or Lewy Body dementia. A common misconception is that anyone with a dementia diagnosis belongs in an ALZ community – this is incorrect. I would guess that about 60% of the residents in my ALF have a dementia diagnosis. Because they are not at risk for harm to themselves or others and are not an elopement risk, they actually aren’t memory care appropriate, and woulnd't be allowed to be admitted to an ALZ unit.
Pros:
Often attached to an ALF or SNF building, which allows for a smoother transition from one building to the next when the time comes
Locked doors for the safety of residents who are an elopement risk
Highly-trained staff with nursing oversight
Most ALZ units welcome family members and visitors
Practiced in dealing with the unique symptoms that come with advanced dementias
Mid-range in cost for senior care (approx. $180/day)
Cons:
Often when only one member of a couple requires memory care, the two must be separated
Seen as the ‘final step’ in senior care – it is very rare for someone to move out of an ALZ unit
Again, these are observations from my almost-year in the industry, which has involved a lot of exposure in these four main styles of senior living. There are options out there for your loved one, and there is a place that will be a right fit for them. My advice for anyone beginning their search for senior living is to start with these generic descriptions, decipher where your senior would best fit, and then begin researching locations in your area to go and tour. Look for an upcoming blog post from Generations on questions to ask when you visit a potential home for your loved one.
