Senior Living 101: An Overview of Care Options


Do you know the difference between assisted living and independent living? Do you know what services an adult day care center provides? How about hospice and palliative care?

The spectrum of senior living and care options is crowded and complicated. Sometimes, these services overlap or their availability varies by provider or state. Here, we’ll offer a basic overview of each option so you can start your search with a clearer understanding of what’s out there, with the caveat that this list only scratches the surface.

Home Care (skilled health or companion care): Medical services provided in a person’s home by a medical professional such as a licensed nurse: for example, IV care, catheter care, or wound care. Home care also encompasses a range of non-skilled services: for example, help with laundry, housekeeping and meals, as well as simple companionship and escorted transportation. Services provided by a professional caregiver like a certified nurse’s aide (CNA) would include assistance with activities of daily living (ADLs), like dressing, showering, eating, or ambulating. Medication management — such as medication reminders — may be included depending on the agency’s capacity. Medication administration would be handled by a nursing professional.

benchmark-hands-heart-iconAdult Day Services: Adult day centers offer activities, meals and social interaction for older adults during daytime hours. Some centers may provide assistance with activities of daily living (ADLs) and medication assistance, or transportation to/from the center.

benchmark-nurse-iconNursing Home, Skilled Nursing Facility, or Skilled Nursing & Rehab Center: This setting is for individuals needing round-the-clock on-site supervision, support and medical care provided by nurses and other licensed clinical professionals.

Benchmark-Home-iconAssisted Living/Personal Care: Assisted living or personal care settings offer private and semi-private apartments and a range of services for older adults who require assistance with ADLs (activities of daily living) and IADLs (instrumental activities of daily living) as detailed in chart below. The spectrum of support is flexible to meet a low to higher level of needs. These settings typically include three meals per day, a rich program of activities and experiences and transportation. 

What’s the difference between ADLs and IADLs?

These daily life tasks are what define the levels of assistance and support an older adult requires in various settings, particularly assisted living:

Benchmark-ADLsADLs: These are the basic skills required for daily living, for example: eating, bathing/grooming, dressing, using the bathroom and continence management, and transferring (in and out of bed or chairs).     

Benchmark-IADLsIADLs: These skills are more complex but are fundamental to living independently, for example: cleaning and maintaining the house, managing money, scheduling appointments, making social phone calls or engagements, and preparing meals.

benchmark-independent-living-communitiesIndependent Living Communities: Residents in these settings can manage life on their own with or without help, reside in private apartments, townhomes, or single-family homes, and enjoy a low-maintenance lifestyle. They have access to a wide range of social activities, meal plans, and other community-based amenities like a fitness center or pool. In some cases — and depending on the regulatory environment in the state — a resident in independent living may engage home care for ADLs and IADLs.

Memory Care: Alzheimer’s or dementia-specific care usually offers 24-7 supervision in a secured setting, either stand-alone or as part of a larger assisted living residence, nursing facility, or retirement community. Experienced memory care communities focus beyond care to include programs designed to stimulate the mind, strengthen the body and nourish the spirit.

LifeCare, LifePlan, or Continuing Care Retirement Community 

benchmark-lifecare-lifeplan-ccrc (CCRC): Multiple levels of care are available at this senior living setting. It’s very common for residents of these type of communities to pay an up-front entrance fee for their independent living apartment, plus monthly fees. As they age in place, they move through the available spectrum based on care needs, be it to assisted living, memory care, or skilled nursing — at a monthly fee that may increase from the initial fee, or remain relatively stable (subject to annual increases) depending on the type of contract signed. There are financial and emotional advantages to this type of care setting, which we’ll cover in a future piece.

benchmark-hospiceHospice & palliative care services can be delivered at the end of life or during a period of extended illness in a person’s home, in a stand-alone hospice community, or in a nursing home, assisted living, or independent living apartment.


What’s the difference between hospice & palliative care, and who is eligible for services?

benchmark-pallative-carePalliative Care: Palliative care can begin at the time of diagnosis and can be delivered alongside other life-saving or life-sustaining treatments. Examples of palliative care measures include medication, occupational therapy, nutritional guidance, counseling, support groups, and more.

benchmark-exceptions-on-timingExceptions on Timing: Although the definition of hospice usually includes the idea of a person having less than 6 months to live, if it is determined the resident would like only care and comfort measures, then the conversation will usually include hospice. Sometimes the hospice patient’s condition improves and hospice care can be discontinued.

benchmark-eligibilityEligibility: Older adults receiving Medicare are entitled to a hospice benefit if they qualify for services. Many are unaware of this fact, so the services are entered into the resident’s plan of care later rather than sooner. Learn more about the Medicare hospice benefits (how to find a provider, what services are covered, and who’s eligible) and start conversations earlier to access the benefits of this important care resource.

benchmark-doveHospice & Palliative Care: Hospice & palliative care services can be delivered at the end of life or during a period of extended illness in a person’s home, in a stand-alone hospice community, or in a nursing home, assisted living, or independent living apartment.

Stay tuned for more tips and insights at Open Conversations

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