Individuals who require some or total assistance using the bathroom regularly, walking, transferring themselves, and who require daily medication administration and/or injections may find it extremely difficult to remain in an independent setting without a great deal of help from care givers or home care professionals. Care in one's home or apartment can be very expensive and may not be able to be provided in an independent living setting. If one requires assistance with activities of daily living and cannot obtain help in their home or apartment and must move, a residential care community may be an option to consider.

Following are the types of Residential Care facilities:

Adult Family Home

Adult Family Homes offer care in a much smaller home-like setting. Staff to resident ratios may be higher than in other types of care settings because the number of residents is typically relatively low, from as few as 2 in some homes to over 10 in others. Generally, assistance with activities of daily living, 3 meals a day, and activities are provided. Residents may have a private or shared room. Transportation may also be provided (fee may apply) to local appointments, shopping malls, and attractions. Adult Family Homes are not available in every state and the quality of care and services varies tremendously. Some board and care homes may be able to care for individuals with early or middle stage Alzheimer’s. Be sure to ask if this is possible.

Adult Family Homes cost anywhere from $500 to $3,000 per month. Medicaid, although it is rare, may help pay for this type of living option, if certain criteria are met. You may be eligible for coverage of Adult Family Home services through the Department of Veteran’s Affairs. Eligibility requirements depend on each person's circumstance and service history. Medicare and general health insurance do not cover rent and/or services provided in an Adult Family Home.

Long Term Care Insurance is an excellent way to protect your self from the expenses of Residential Care Services. Long Term Care Insurance typically covers room and board and may also cover some additional direct care costs depending on your individual plan. Premiums vary according to age, health, duration of daily benefits and optional features.

Continuing Care Retirement Community

A Continuing Care Retirement Community (CCRC) is a community with a variety of living environments and services, ranging from Independent Living to skilled nursing care, all in one location. Continuing Care Retirement Communities typically require that individuals considering entering the community be healthy, alert, and able to take care of themselves. Some communities, especially if one chooses a life care contract (one that ensures that there is coverage for care as needed) require that a physical evaluation be performed to verify that one is in good health and has no pre-existing conditions. Often one enters into the independent living component and moves to the assisted living or nursing section as help/assistance is needed. Possible, but not common, an individual could be admitted directly to the assisted living portion of the CCRC. For example, if a spouse requires care and the other does not, a CCRC may be able to accommodate the couple together or in separate areas depending on how much care and assistance is required. There are no set rules regarding such a situation. Ask whether this is possible.

A large entrance fee of many thousands of dollars may be required followed by monthly rates that can also be expensive. Entry fees for CCRC’s vary widely from $50,000 or less to well over $400,000. Most then also have a monthly fee of at least $1000. Medicare does not cover rent, entrance fees, or monthly fees at Continuing Care Retirement Communities (CCRC). Medicare and general health insurance may cover CCRC nursing home services if one eventually requires such services, if the nursing facility is Medicare certified or a preferred insurance provider, and if the person meets the qualifications for Medicare or insurance benefits for a skilled nursing facility. Medicaid does not cover the cost of rent or assist with the purchase of a condominium, apartment, or home in a Continuing Care Retirement Community. The Department of Veteran’s Affairs does not offer financial assistance for Continuing Care Retirement Communities.

Long Term Care Insurance is an excellent way to protect your self from the expenses of Residential Care Services. Long Term Care Insurance typically covers room and board and may also cover some additional direct care costs depending on your individual plan. Premiums vary according to age, health, duration of daily benefits and optional features.

Assisted Living

Assisted Living communities are generally large residences in which individuals have private apartments with bathrooms and 24-hour supervision and assistance with activities of daily living, such as bathing or dressing, is available. Some Assisted Living Centers provide nursing services. Regulation of these centers varies by state. Three meals a day are served and generally there is a set, yet varied schedule of activities and social events for all the residents. Transportation may also be provided to local appointments, shopping malls, and attractions. Some assisted living communities are devoted solely to the care of individuals with Alzheimer’s. Others have separate Alzheimer’s or dementia units in addition to apartments for those that do not have Alzheimer’s or dementia.

Nearly all assisted living communities accept only private funds and costs per month average $2000-$3000 or more. Medicaid, although it is rare, may help pay for this type of living option, if certain criteria are met. You may be eligible for coverage of assisted living services through the Department of Veteran’s Affairs. Eligibility requirements depend on each person's circumstance and service history. Medicare and general health insurance do not cover rent and/or services provided in an assisted living community.

Medicaid or other state-based assistance may help cover the cost of personal care services in some assisted living communities or adult family homes for individuals that are eligible. Called Medicaid waivers, these programs are meant to help keep individuals from being in nursing homes unnecessarily. These programs are not common, do not exist in every state, and have been focused more towards helping individuals remain in their own homes. For information about Medicaid coverage in an assisted living community or at home, contact your state’s Medicaid Department.

Long Term Care Insurance is an excellent way to protect your self from the expenses of Residential Care Services. Long Term Care Insurance typically covers room and board and may also cover some additional direct care costs depending on your individual plan. Premiums vary according to age, health, duration of daily benefits and optional features.

Skilled Nursing Facility

A skilled nursing facility, or nursing home, provides skilled nursing services, rehabilitative care and medical services; protective supervision for individuals with cognitive impairment; and full assistance with activities of daily activities such as eating, bathing, using the bathroom, or dressing. A skilled nursing facility may be an option for you to consider if other things such as therapies or skilled nursing care are required. By themselves, moderate assistance with several activities of daily living (bathing, dressing, etc.), do not necessitate nursing home care and are not covered by Medicare or general health insurance. However, if you do not possess the finances for the other types of residential care, Medicaid can cover costs of long term care, provided certain requirements are met.

Nursing home care averages over $4,000 per month, although it can often be higher depending on the services and care that is required. Most nursing home care is paid for by Medicaid. Medicaid can pay for nursing home residents, but only for those that meet low-income eligibility requirements. Eligibility requirements for Medicaid vary by state. Most individuals pay using private resources first until they have spent down and are eligible for Medicaid.

Long Term Care Insurance is an excellent way to protect your self from the expenses of Residential Care Services. Long Term Care Insurance typically covers room and board and may also cover some additional direct care costs depending on your individual plan. Premiums vary according to age, health, duration of daily benefits and optional features.