Below are the various types of Senior Housing and Senior Care settings available to care for and support our aging population in New Hampshire. Due to state licensing regulations, options may vary from state to state. Each of the below offers varying degrees and types of support, all focused on improving the quality of life of its residents.
- Independent Retirement Communities
- New Hampshire Licensed Assisted Living Communities
- Residential Care: He-P 804
- Supported Residential Care: He-P 805
- Alzheimers / Dementia Care Communities
- Continuing Care Retirement Communities (CCRC)
- Respite Care
- Nursing Home Care
Independent Retirement Communities
Independent Living Communities cater to seniors who seek a retirement lifestyle. As the name implies, residents must be able to live independently, safely, within their residence. Residents enjoy the peace of mind of not having to maintain a residence and convienences that make life easier. Services and support varies and may include: weekly housekeeping, laundry, utilities, availability of meals, local transportation, organized social activities and on-site management/support.
In New Hampshire, Independent Living Communities are governed by Housing Regulations. Adult Day Programs, Assisted Living and Nursing Homes are regulated by Department of Health and Human Services-Health Facilities Administration.
Assisted Living Communities:
Assisted Living Communities licensed as Residential Care/He-P 804 are able to provide assistance with ADLs (Activities of Daily Living) such as bathing, grooming, dressing and medication reminders. For the convenient of its residents, some bring in services such as primary care, podiatrist, rehab ( all billable via Medicare ). In addition to assistance with ADLs, the monthly rent includes meals, housekeeping, some utilities and 24/7 staff oversight. Laundry may or many not be included in the monthly rent. Personal living quarters vary significantly-private bedrooms, suites with private bathroom, roommate suites and even private apartments.
With the exception of a handful of communities in Southern NH, there is typically no medical oversight and therefore they are unable to care for residents whose care needs to be delivered or overseen by licensed medical staff. Due to building codes, these communities are restricted to caring for residents who are able to self-evacuate the community with minimal staff cuing and/or assistance. These communities are more economical than Supported Residential Care Assisted Living Communities. In addition to private funds, many also accept Choices For Independence.
Supported Residential Care
In addition to the care and services provided within a Residential Care Community, Supported Residential Care/He-P 805 have licensed medical staff 24/7 who are able to provide skilled nursing services and they have stricter fire codes. Because of the high level of care offered and safety of the building, they can care for the frailest of the frail many whom can be cared for until end of life. The cost is substantially more than a Residential Care Community and typically less than Nursing Home care. These communities are predominantly private pay.
Alzheimer’s/Dementia Care Communities
Persons with Dementia can be cared for within Residential Care and Supportive Residential Care Assisted Living Communities-dependent on the amount and type of care needed. For those whose dementia has progressed to a level that it interferes with their ability to socialize with peers or communicate with staff, who need substantial cuing throughout the day and need to be in a secured space due to wandering tendencies, a Memory Care Specialized Program/Community will be best suited to support and care for them.
Some Assisted Living Communities offer a secured Memory Care Specialized Program within their building. There are also free standing Memory Care Specialized Assisted Living Communities who are dedicated to caring for residents with all forms of dementia, including Alzheimer’s.
In New Hampshire, Memory Care Specialized Assisted living Communities/Programs who are able to care for those with progressed forms of dementia are more expensive than non-specialized assisted living communities and predominantly private pay. They are still less expensive than nursing homes. For those without private funds, who are relying on Medicaid, a Nursing Home will be their only option.
Continuing Care Retirement Communities
Also referred to as a CCRC and within the last few years changing the term to Life Plan Communities. These communities require a large entrance fee ( buy-in fee), in addition to a monthly rent, and require residents to be independent to enter their community. A resident’s entrace fee is based on the size of the apartment and what type of refundable/ amoritized program they choose. Residents are able to age in place through the use of assisted living, memory care, nursing and rehab services all on one campus. These communities provide peace of mind to seniors and their families because they are able to stay in one setting without having to worry about moving to another community as level of care increases. They have stringent medical and financial eligibility guidelines compared to Assisted Living and Memory Care Specialized Assisted Living Communities.
Respite care refers to a short-term stay/services. It can be applied to , adult day care, inhome-care services or an assisted living or nursing home stay. Lengths of stay can vary from a few days to a few weeks. In addition to giving families/caregivers relief, it provides a low pressure way to introduce seniors to various forms of support.
Nursing Home Care
Care within a Skilled Nursing Care Facility ( SNIF ), also referred to as Long Term Care ( LTC ) and most commonly referred to as Nursing Homes. These facilities specialize in the 24-hour care and observation of individuals whose needs are usually critical enough where they need constant supervision, but not serious enough where hospitalization is required. When a person is dependent on Choices for Independence ( Medicaid) to cover the cost of care and they need more care than provided within a Residential Care Community however can not afford the level of care provided with a Supported Residential Care Community, the only option becomes a Nursing Home.
In-Home : Home Health Services
Home Health Agencies are licensed and divided into two groups: non-medical or medical Home Health Agencies. Non-Medical services may include support around Activities of Daily Living ( bathing, grooming, cooking, house work, transportation, medication reminders ect. ). Medical Home Health Agencies employ licensed medical staff for patients who have complex medical conditions that need to be managed, as prescribed by a physician. Care may include taking vitals, medication management, wound management and the benefit of having a medical professional to montior their health.