First, you need to figure out what level of care your parent needs.  Our dad needed the highest level of care, which meant a nursing home.  There may be a lot of different names for “senior care,” but when you get right down to it, there are three basic levels to choose from.

The Minimum Level of Care:
A senior residence (also known as senior independent living) typically provides some type of:

• meal service in a dining room, offering from one meal a day to all three,
• housekeeping and laundry service,
• local transportation service,
• recreation program, and
• bus service for outings.

This level of care is worth considering if your parent is feeling a little socially isolated and is starting to have trouble managing his or her own home.

The Next Level of Care:
An assisted-living facility typically provides:

• everything listed above, including three meals a day,
• limited nursing assistance, allowing dispensing of medication, and
• personal care for such needs as bathing and dressing.

You’d consider this level of care if your parent is starting to have difficulty getting around, and if it is no longer safe for your parent to be home alone.  An everyday activity like preparing a meal is too difficult, and falls are also common.  Managing a home as well as managing his or her own personal care is a challenge.

The Maximum Level of Care:
A nursing home (also referred to as a skilled-nursing facility) typically provides:

• everything listed above,
• full-time nursing care, with the ability to perform some treatments, such as handling IVs and catheters,
• a higher level of personal care beyond just bathing and dressing, including assistance with walking, eating and using the bathroom, and
• the services of other related professionals, like social workers and therapists (physical, occupational, and speech).

What separates a nursing home from assisted-living is the focus on nursing care.  You’d consider this level if your parent needs constant nursing and personal care.

A nursing home can also be a place for short-term care when functioning as a rehabilitation facility, and it is usually referred to as a “skilled-nursing facility.”  Often, after difficult hospital stays, doctors will recommend their patients stay in a rehab center before going home.

Our dad was resistant to the suggestion of a rehab stay because he was always eager to get home.  Eventually, his doctors stopped recommending rehab and just insisted on it.  When we had to consider a long-term nursing home choice for our dad, his time in two different rehabs/nursing homes – one good and one bad - helped us make our decision.  The transition from rehab to long-term care is a bit smoother if you are already comfortable with the staff and the surroundings.