Retirement and Active Adult Living
Skilled medical care includes services of trained professionals that are needed for a limited period of time following an injury or illness. Skilled care may also be needed on a long term basis if a resident requires injections, ventilation or other treatment. Custodial or personal care includes assistance with what are known as the activities of daily living, such as bathing, dressing, eating, grooming, getting in and out of bed or walking around.

People who are able to recover from a disabling injury or illness, may temporarily need the custodial care as they are getting back the strength and balance to be independent again. For people who are losing their ability to function independently due to chronic disease and increasing frailty, custodial care may be a long-term need.

In the most severe cases where a person is bed-bound, ongoing supervision by an RN is necessary along with the custodial care, to ensure proper hydration and nutrition and to prevent skin breakdown. If a custodial care resident becomes ill or injured, they may spend a period of time in skilled care, and then return to custodial care. Whether a resident is under skilled or custodial care is important in terms of who provides the care and who pays for the services provided.

— Memory Care Communities
Alzheimer’s care communities are special units or free-standing communities designed to care for individuals living with Alzheimer’s, which is a degenerative disease that attacks the brain, impairing one’s memory, mental processing ability and behavior. Special on-site care is provided to residents 24-hours a day. While these communities are for early-stage Alzheimer’s patients, alternative senior assisted care centers may be appropriate for residents. Long-term insurance or personal monies usually fund the care in these communities.

SELECTING A COMMUNITY
In order to best match a senior’s needs with his preferences, there are numerous factors to weigh in making a decision about care.
  • Temporary versus long term care: An older person may go to a nursing home for rehab following a surgery or stroke, then return home. In other circumstances, a senior’s needs are better served by planning a move into a situation that is likely to remain the same for the many years to come.
  • Independence: Can the senior live alone, and more importantly, does he/she want to? Or would living in a more service-oriented environment be more nurturing?
  • Privacy: If the senior’s desire for privacy is important, independent living, assisted living or a Continuing Care Retirement Community would be preferable to a nursing home.
  • Needs for personal care: How much and what kinds of personal or “custodial care” are needed or desired? There are online needs assessment questionnaires to help determine this and then match the care needs with the right type of housing.
  • Needs for medical care: If the senior has a chronic illness that necessitates special medical care, or ongoing services of medical professionals, independent living and even assisted living may not be suitable.
  • Costs: Learn about the financial aspects of senior housing to determine what options are affordable for you. Certain options may be unaffordable, such as Continuing Care Retirement Communities.

In making any housing selection for yourself or a loved one, ask your doctor or your attorney to review the contract, especially if you feel uneasy signing it. However, there are many residents who make the decision on their own and don’t feel the need to ask anyone else.

STATE OF TEXAS RESOURCES
The Texas Department of Family and Protective Services (DFPS) is also charged with managing community-based programs that prevent delinquency, abuse, neglect and exploitation of Texas children, elderly and disabled adults. The agency's services are provided through its Adult Protective Services, Child Protective Services, Child Care Licensing and Prevention and Early Intervention divisions. Every day, almost 6,800 DFPS employees in more than 249 offices across the state protect the physical safety and emotional well-being of the most vulnerable citizens of Texas.

Adult Protective Services (APS) Facility Investigations – APS investigates allegations of abuse, neglect, and exploitation in facilities that care for adults including: private homes, adult foster homes (with 3 or fewer consumers), unlicensed room and board, state facilities and community centers that provide mental health and mental retardation services, home health agency staff, exploitation in nursing homes when the alleged perpetrator is someone outside the facility.

Abuse Hotline for APS Facility Investigations: 1-800-647-7418

Texas Department of Aging and Disability Services (DADS) – Nursing homes, assisted living facilities, private ICF/MR, adult day care. For complaints (reports of abuse), call 1-800-458-9858 and Nursing Home Information: 1-800-252-8016

Texas Department of State Health Services (DSHS) – Hospitals, psychiatric hospitals (including private psychiatric facilities), and various other medical facilities. Complaints: 1-888-973-0022

   
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