Types of Senior Care

The financial options and care coverage available to help pay for senior care are dependent on the type of care required. For example, some government programs will help pay for a skilled nursing facility, but not in-home care. If you are just beginning the research process, it is helpful to have an idea about the type of care you or your loved one will require. Also please be aware that a type of care is often referred to by many different names.

Skilled vs. Custodial Care
At the highest level there are two types of care, skilled and custodial care. Skilled care describes services that can be given only by skilled or licensed medical personnel. Custodial care (also called non-skilled care) helps with activities of daily living (ADLs), such as bathing, dressing and eating.  This is typical for seniors with Alzheimer's / dementia.  Both skilled and custodial care can be provided at home, in Adult Day Care or in residential communities.

Geriatric Care Managers

Geriatric Care Managers (or GCMs) help families create and implement long term care plans for their loved ones.  Typically this includes an in-person needs assessment, the development and review of a care plan and arranging and monitoring care services.  Only a third offer financial planning; most leave that for specialized eldercare financial planners.  GCMs do not usually provide hands-on care themselves.

GCMs will also be referred to as elder care managers, case managers and service or care coordinators.  In addition to a certification from the National Association of Professional Geriatric Care Managers (NAPGCM), many are licensed by their different professional backgrounds; which include social workers, nurses, therapists and assisted living or home care professionals.   There are both public and private care managers.  Medicare and Medicaid will sometimes pay for public GCMs under the Community Waiver Program, but do not pay for private ones.  Long term care insurance, if available, may help.  

In addition to the convenience, time-saving and security they provide, Care Managers can save families money because their needs assessments align an individual’s present condition with only those services that are necessary at that time.

Care Locations

• At Home - If provided at the senior’s home, Home or Personal Care Aides provide custodial care. They bathe and dress the senior, help with laundry, cooking and accompany them to doctors’ appointments or on other errands. Home Health Aides offer skilled care such as checking patients’ pulse, temperature or respiration. They assist with braces, artificial limbs and other medical equipment such as ventilators.
• At Adult Day Care - In a manner similar to Children’s Day Care, Adult Day Care provides elders with supervision and care in a structured setting during daytime hours allowing their caregivers to go to work. There are two types of Adult Day Programs. Adult Social Day Care offers basic health services, meals and activities while Adult Day Health Care provides intensive health services for individuals that might otherwise need to reside in a skilled nursing community.
• In Residential Communities - There are four categories of residential communities and each is referred to by many different names.