Senior Living Options When You Need More Than Home Care

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Oasis Senior Advisors- Florida

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Mar 27, 2025

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Florida - Sarasota, Bradenton & Charlotte Counties

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Home care can be a great choice for older adults in need of some assistance, but there may come a point when their care needs exceed what home care can provide. Here, we explore different senior living options for older adults who need to transition from home care to a different type of care. Photo Credit: iStock.com/andreswd

Home care is an excellent solution for older adults who need a little extra support to live independently at home. However, it is common for home care services to become too expensive to be sustainable, especially as chronic needs or complex medical conditions require additional hours of service from a home care agency. Fortunately, there are senior living options that can ensure your loved one continues to get the support they need. 

Senior living communities are all unique, but it can be helpful to learn about how the different types of care might or might not be appropriate for your loved one during their transition from home care to residential care. Here, we explore the different types of senior living options and why someone might choose each one.

Assisted living

Assisted living communities are residential care facilities that provide 24-hour caregiver oversight in addition to amenities and services designed to enhance wellness. Assisted living is an excellent solution for older adults who need some support with a few activities of daily living (ADLs), such as grooming, showering, dressing, eating, ambulation, transferring, or toileting. An all-inclusive lifestyle is also a highlight, often with housekeeping, maintenance, and even transportation services included in the monthly fee. 

Assisted living communities typically offer:

  • Caregivers on-site around the clock.
  • Personalized support and care based on an individualized service plan.
  • Nurses on staff to assist with medication management, emergencies, and physician communication.
  • Events and activities held daily, including in the evenings and on weekends.
  • Chef-prepared meals served three times daily in a social dining room setting. (Meal services and dining programs differ from state to state and community to community. You’ll want to check with the facility to learn whether and how often they serve meals and snacks.)
  • Laundry services. (These services often come with an extra fee. Check with each community to learn their policy and laundry services fee schedule.)
  • On-site visiting physical and occupational therapists.
  • Shared community spaces that might include a library, living room, nature trails, outdoor patio, gazebo, and more.

Why move to assisted living after home care?

The transition from home care to assisted living is often quite smooth, in part due to the similarities of the services provided. Most adults transition from home care to assisted living due to needing more hours of home care oversight and support. For many families and senior budgets, around-the-clock or live-in home care is simply too expensive to be sustainable. If your loved one is in this situation, assisted living can offer around-the-clock support and oversight in addition to more amenities and services not available with home care.

You might also find that your senior loved one is lonely and isolated while living at home. Even if they have a friendly home care caregiver stopping by daily, these visits are not a substitute for connections with peers. Social isolation and feelings of loneliness are common among older adults, especially those who live at home alone. Being isolated from peers can lead to serious health complications, including a higher risk for anxiety and depression, heart disease, obesity, and more rapid cognitive decline. Assisted living communities are designed to create opportunities for meaningful peer connections, whether neighbors attend an exercise class together or meet up at the dining room table for a meal.

Memory care

Memory care is a specialized type of senior care created especially for those living with Alzheimer’s disease or another type of dementia. This type of care can be provided in stand-alone memory care communities or in dedicated memory care wings of assisted living communities or nursing homes. The environment itself is designed to enhance comfort while meeting challenges that can come with cognitive decline, and staff are specially trained in best practices for dementia care. The daily routine of the community mimics familiar rhythms, which can decrease the anxiety and restlessness that can come with dementia.

Memory care communities are staffed 24/7 with experienced and specially trained caregivers. In addition, nurses are available to assist with health monitoring, medication management, emergency response, and physician communication. A social worker is also commonly on staff to support residents and their family members. 

Other amenities and services often available in memory care communities include:

  • Chef-prepared meals served three times daily in a social and comfortable family dining room setting. (Check with the facility to learn about their specific meal offerings.)
  • Prescribed diets and other adaptive dining interventions available for residents who need extra support.
  • Events and activities that occur daily, including evenings and weekends.
  • Family night events and educational opportunities.
  • Assistance and support individualized based on resident abilities and the progression of dementia.

Why move to memory care after home care?

Dementia is a progressive condition, which means it gets worse over time. While a home care provider can give occasional oversight and support with ADLs for someone in the early stages of dementia, it is common for seniors with dementia to eventually need 24-hour oversight for safety and engagement as they move into the middle and late stages of the condition.

Memory care communities provide a safe environment, oversight, and assistance in addition to care and activities specifically designed for those with cognitive decline. These specialized communities also provide a routine, which can decrease the anxiety and restlessness that often accompany the disease. In addition, specially trained staff ensure personalized interventions occur at any time of day or night so that your loved one can feel safe and calm.

Nursing home care 

Nursing home care, also referred to as skilled nursing care, is a senior living option that provides support that is more clinical in nature. Nursing homes provide around-the-clock care from both nurses and certified nursing assistants (CNAs) for seniors with more complex care and medical needs or chronic conditions.

Nursing homes are known for their skilled care capabilities, which may include wound care management, IV management, and chronic disease management. They also offer inpatient therapy services for short- and long-term rehabilitation needs. 

Other services and amenities in these communities can include:

  • Chef-prepared meals served three times daily in the dining room, with special attention to preferred and prescribed diets, including mechanical soft diets.
  • Activities and events scheduled daily, including nights and weekends.
  • Private or semiprivate rooms.
  • Nurses on staff 24 hours a day to assist with emergency response, acute medical care, medication management, and physician communication.
  • Events and educational opportunities, including those that involve family.

Why move to a nursing home after home care?

If your loved one has significant personal care needs that require around-the-clock or live-in home care, it may become too expensive. If they have a complex medical condition that requires skilled care interventions, nonmedical home care services cannot provide that type of acute support. Home health care services can provide medical support to your loved one for some time, but around-the-clock medical home health care can become expensive quickly. A move to a nursing home environment is often the best decision based on safety and medical needs.

Continuing care retirement community 

A continuing care retirement community (CCRC), sometimes called a life plan community (LPC), is a senior living option that offers multiple types of senior care — independent living, assisted living, memory care, and skilled nursing — all on one expansive campus. CCRCs are a popular choice for adults who want to be assured they will be able to receive the support they need as their needs change without having to move to a different senior living community.

Why move to a continuing care retirement community after home care?

A move to a CCRC might be a good solution for your loved one if they have a medical condition that may cause them to decline over time. Instead of finding home care agencies that can increase hours or levels of care as your loved one’s needs increase, a continuing care retirement community can provide ongoing care and support while forecasting what might be coming next for your loved one based on their history and diagnosis.

CCRCs are also, like many other senior living options, a good solution for someone who feels isolated, overwhelmed by caring for the home, or unstimulated in the home environment. These communities provide amenities and services that can help older adults live maintenance-free, socially active lives.

Choose the right senior living option after home care

Home care services are an excellent solution for many seniors who want to stay at home for as long as possible. However, costs, safety, socialization, and increasing needs might create a situation where a residential facility is the better (and sometimes less expensive) senior living option. Knowing how the different amenities and services available at each community align with your loved one’s needs will help you make the right choice so they can live a safe, healthy, and fulfilling life.

Senior care facility rules and requirements vary based on company-specific policies and state-level regulations. The content above represents common guidelines but may differ from a particular facility’s policies or requirements. To learn the regulations that apply in your state, contact your local Oasis Senior Advisor.

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Providing care for a loved one is a profound commitment, and in Pennsylvania, various programs exist to support family caregivers in this vital role. While Personal Care Assistance (PCA) broadly refers to services that help individuals with daily living activities, its important to understand that paid family caregiving in Pennsylvania primarily operates through specific Medicaid waivers. These initiatives aim to support the invaluable work of caregivers while allowing loved ones to remain in the comfort and familiarity of their own homes or the homes of family members.Understanding Personal Care Assistance (PCA) in PennsylvaniaIn Pennsylvania, Personal Care Assistance (PCA) refers to the services that help individuals with daily living activities and household tasks, enabling them to live independently. Its crucial to differentiate this from Personal Care Homes (PCH), which are residential facilities that provide housing, meals, supervision, and assistance, but typically do not offer third-party reimbursement for family caregivers providing care within them.Instead, paid family caregiving for PCA services in Pennsylvania primarily operates through various Medicaid waivers, also known as Home and Community-Based Services (HCBS) waivers. These waivers are designed to provide direct assistance with Activities of Daily Living (ADLs) and household services for older adults or individuals with disabilities who live in their own homes or the homes of loved ones. The services provided under these waivers are what constitute Personal Care Assistance in the context of paid family caregiving.Key Pennsylvania Medicaid Waivers for PCAPennsylvania offers several Medicaid waivers that facilitate paid family caregiving for Personal Care Assistance, each with specific eligibility criteria and rules regarding family members.1. Community HealthChoices (CHC) Waiver: Getting Paid to Care for Loved OnesThe Community HealthChoices (CHC) waiver is Pennsylvanias most common Medicaid managed care program that facilitates paid family caregiving for PCA. It is designed for individuals aged 21 or older who are eligible for both Medicaid and Medicare and require a nursing facility level of care. This program consolidates several former waivers into a single, comprehensive system and is administered by private healthcare insurance companies contracted by the state.Recipient Eligibility for CHC: To qualify for the CHC program, the individual needing care must meet several criteria: Age: The recipient must be 21 years of age or older. Dual Eligibility: They must be eligible for both Medicaid and Medicare. Functional Eligibility: A physician must certify that the individual has a condition requiring long-term services and supports, specifically an inability to perform essential Activities of Daily Living (ADLs) such as bathing, toileting, or transferring. A trained assessor will also conduct a functional eligibility determination to confirm the level of care needed. Financial Eligibility: The individual must meet specific income and/or asset requirements, determined by the local County Assistance Office (CAO). 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Understanding ADLs and IADLs: Keys to Pennsylvanias Medicaid HCBS Programs

Pennsylvania offers Medicaid waiver programs under the Community HealthChoices (CHC) umbrella and the Pennsylvania Department of Aging (PDA) Waiver (often referred to as the PA Council on Aging Waiver). These programs help older adults and individuals with physical disabilities remain in their homes or community settings instead of entering nursing facilities. CHC and the PDA Waiver provide long-term services and supports (LTSS) based on assessed functional needs, emphasizing assistance with ADLs and IADLs. Covered services may include personal care assistance, adult day services, home-delivered meals, transportation, home modifications, assistive technology, and respite care for family caregivers. In addition, Pennsylvanias CHC Waiver offers Participant-Directed Services that allow participants to hire and manage their own caregivers, including family members. 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Administered by the Office of Long-Term Living (OLTL), CHC is a managed care program that combines physical health, long-term services and supports, and pharmacy benefits under a single plan (with behavioral health carved out). To qualify for CHC: Be age 21 or older. Meet Medicaid financial eligibility guidelines. Require a nursing facility level of care (confirmed through functional assessment). Live in a setting that meets HCBS requirements (e.g., home, apartment, assisted living). Be a Pennsylvania resident. Once enrolled, participants receive a comprehensive package of services tailored to their needs. Covered services may include personal assistance, home-delivered meals, adult day services, behavioral support, professional nursing, home modifications, assistive technology, transportation, and respite care. CHC also offers Participant-Directed Services, allowing participants to recruit, hire, train, and supervise their own caregiversoften family membersto assist with ADLs (bathing, dressing, toileting) and IADLs (meal preparation, medication reminders).PDA Waiver (Council on Aging Waiver)The Pennsylvania Department of Aging (PDA) Waiver, also called the Council on Aging Waiver, serves seniors aged 60 and over who require nursing facility level of care but choose to remain at home or in other community-based settings like domiciliary care homes. To qualify: Be age 60 or older. Meet Medicaid financial eligibility requirements. Be assessed as requiring nursing facility level of care (through the functional assessment). Live in a qualifying community setting. Covered services under the PDA Waiver may include personal care assistance, home-delivered meals, homemaker services, personal emergency response systems, respite care, adult day services, minor home modifications, and transportation. Like CHC, the PDA Waiver emphasizes managing ADL and IADL needs to keep participants safely in their homes.Participant-Directed ServicesBoth CHC and the PDA Waiver offer Participant-Directed Services, which empower participants to choose and manage their own caregivers, including family members, friends, or neighbors. Under this model, participants develop a service plan with guidance from a care coordinator, set schedules, and handle payroll tasks. This flexibility helps ensure that personal care and IADL support align with participants preferences and routines.Signs That Your Loved One May QualifyBelow are practical indicators that someone may be eligible for Pennsylvanias CHC or PDA Waiver due to difficulty with ADLs and IADLs: Trouble with Personal Care: Skipping showers, unkempt hair, or wearing dirty clothes may indicate difficulties with bathing and dressing (ADLs). Malnutrition or Weight Loss: An empty fridge or significant weight loss suggests issues with meal prep or feeding oneself (ADLs/IADLs). Mobility Decline and Falls: Struggling to walk without assistance, needing help to stand, or experiencing frequent falls signals reduced mobility (ADL: transferring/ambulating). Medication Errors and Memory Problems: Missing doses, mixing up pills, or forgetting appointments point to challenges with medication management and scheduling (IADLs). Household Neglect: Piles of mail, unpaid bills, or a cluttered home reflect trouble with housekeeping and money management (IADLs). A combination of needing help with several ADLslike bathing and toiletingand difficulties with IADLssuch as meal prep and housekeepingstrongly indicates a nursing facility level of care. Document these challenges for the functional assessment to demonstrate eligibility.Were Here to Help: Next Steps and Contact InformationNavigating Pennsylvanias Medicaid waiver programs can be complex, but you dont have to go it alone. At Passion to Care, we specialize in guiding Pennsylvania families through the CHC and PDA Waiver application processesfrom the initial functional assessment of ADLs and IADLs to completing paperwork and coordinating services once approved. If you notice your loved one struggling with daily tasks or if a professional has recommended nursing facility care, it may be time to explore CHC or the PDA Waiver. Our compassionate, family-first team ensures your loved ones needs are met with dignity and respect. Call us or contact us today to learn how to get started with Pennsylvanias Medicaid waivers for home and community-based services.

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Transition Specialists 3135 42nd St. S.W., Naples, Florida, 34116

There are over 31,000 assisted living communities in the United States. That number easily doubles when you start to add in the other types of senior living communities. And, that number continues to grow every day as more and more seniors are less able to stay home because of safety or security concerns. With so many amenities, services, and possibilities to choose from, how do you navigate the seemingly endless maze of senior living options?

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Moving Services 3135 42nd St. S.W., Naples, Florida, 34116

There are over 31,000 assisted living communities in the United States. That number easily doubles when you start to add in the other types of senior living communities. And, that number continues to grow every day as more and more seniors are less able to stay home because of safety or security concerns. With so many amenities, services, and possibilities to choose from, how do you navigate the seemingly endless maze of senior living options?

Oasis Senior Advisors

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There are over 31,000 assisted living communities in the United States. That number easily doubles when you start to add in the other types of senior living communities. And, that number continues to grow every day as more and more seniors are less able to stay home because of safety or security concerns. With so many amenities, services, and possibilities to choose from, how do you navigate the seemingly endless maze of senior living options?