Assisted
living has been earning a lot of recognition these days as a good alternative
to home care, and there are about 800,000 American elders staying in those
assisted living facilities. This type of care provides homier atmosphere than of
nursing home care -- residents may enjoy personal care and assistance with daily
living activities – but there are some limitations. However, most people
thought that assisted living will provide the same services from either in-house
or nursing home care that is far different from one and the other. And one the most unconvincing myth is that
assisted living will replace home care.
Most
AL programs are conservatively established to promote long term care services for seniors with chronic ailments, but not
those with acute illnesses. AL
facilities have respective staffing architecture and guidelines to attend the
various requirements of its residents and to meet the expectations of the
latter’s families. Registered or licensed health professionals are hired to
ensure the health and welfare of its residents.
The
program may offer more advanced services to elders who have developed acute
illnesses. Nevertheless, Medicare does not qualify coverage for assisted living
services, so it is more likely people will pay on their own. Medicare demands extensive
assessment of the services; for example, home health agencies must provide
documentation or reference on every visitation by the caregiver or home health
aides. Unfortunately, home care services can be covered by Medicare, but not on
assisted living services.
Patients
or recipients must be “homebound” as part of the part A (the Hospital Trust
Fund) before they become entitled for Medicare home health benefits. The
definition of ‘homebound” is a bit complicated and incomprehensive, so what
does it exactly mean? Residents or participants who gather together – share
meals, participate in activities, etc. – are considered as homebound, and this
condition ma y not be permanent. Moreover, residents can still attend other
activities other than the acceptable activities such as participating in day
care programs, attending church, and visiting a doctor. Medicare Part B covers
medically-necessary services (physical, occupational, speech therapy) on some
selected home health agencies for non-homebound patients.
However,
some assisted living providers have their own Medicare-certified home health
agency. They do this simply to organize things better in compliance to Medicare
requirements on services and focus more on the management of care for the
residents. Medicare prohibits any AL provider from restraining patients in
choosing their Medicare reimbursed home health providers. AL residents may
choose which certain providers or Medicare-certified agencies they want to
obtain the services.
Medicare
is also aware of the possible changes in the person’s medical needs, for
instance the need for nursing home care rather than home care. Seniors become
more frail and vulnerable as they age, and, thus, their needs increase. Any
drastic changes in the person’s health (weight loss, nausea, etc.) that require
round-the-clock monitoring and supervision explain the shift from assisted
living. Rehabilitation therapy is needed when a person receiving AL is no
longer capable of moving around, or loses any functional abilities. The
Medicare outpatient rehabilitation benefit can be used along with assisted
living and is less strict than the home care benefit. Otherwise, it is
important to get long term care quotes
to know the costs of assisted living services.