Today,
at least in Texas, seniors have a comprehensive array of services
to meet whatever need they may require at almost any point in time.
These programs include Meals on Wheels, Emergency Response, Adult
Day Care, Emergency Care, Alzheimer's Care, Home Health Care, Respite
Care, Assisted Living (also referred to as Personal Care),
Nursing Home Care, and Independent Living (also referred
to as Retirement Communities). While the small nursing home has
all but disappeared, we are beginning to see large number of assisted
living care facilities, who care for 16 recipients or less, springing
up in many communities. In the future, we will also see more "campus
of care" arrangements where a number of programs and services
will be provided to clients in the same location. The three most
common options are Assisted Living, Nursing Home Care and Retirement
Community Living. These options are profiled below:
Assisted
Living is established in the statutes under Section 247 of the Health
and Safety Code, Vernon's Texas Civil Statutes. In the statute,
assisted living is defined as "an establishment, including
a board and care home, that furnishes, in one or more facilities,
food and shelter to four or more persons who are unrelated to the
proprietor of the establishment, and provides personal care services."
Assisted
living services include assistance with meals, dressing, movement,
bathing or other personal needs or maintenance. It also includes
"general supervision or oversight of the physical and mental
well-being of a person who needs assistance to maintain a private
and independent residence in an assisted living facility or who
needs assistance to manage the person's personal life." These
facilities are licensed and regulated by the Department of Aging and Disability Services(DADS).
Often times,
the principal need of the assisted living resident is to be reminded
to take their medication. This is called ASSISTANCE with
medication. On the other hand, many personal care residents are
very independent. They take care of all their needs on their own,
including their medication. With respect to medication, this is
called SELF-ADMINISTRATION. There are also cases where residents
cannot take their own medication and need more than just assistance.
This is called MEDICATION ADMINISTRATION, which is the direct
application of medication or a drug to the body. In this care, licensed
personnel would be required, but this is the only instance where
licensed people are utilized and administration is not a requirement
unless the facility chooses to care for residents who need this
service.
Understand,
assisted living IS NOT a medical program. Statutes and regulations
do not require any personnel to be licensed, although some facilities
choose to employ such personnel. Individuals in personal care usually
have a high state of wellness, mobility, and independence. Assisted
living is really apartment living with a little bit of assistance
with daily living.
Many
of today's seniors who simply do not wish to continue the responsibility
of maintaining a yard, a household, and all that goes with it, choose
a retirement community in their area. This is independent living
because no assistance or protective services are provided. Most
communities offer spacious apartments in varying sizes and provide
a specific number of meals per day, maid service, scheduled transportation,
and social and recreational opportunities. The residents are on
their own and may come and go as they please, as if they were still
living in their own homes. Most retirement communities have a Resident Council who provide substantial input into the services and
programs conducted for their benefit.
Aside from
meeting building codes, fire codes, and health requirements for
food service operations, retirement communities are not licensed
or inspected and have no licensed medical practitioners on staff.
If they do, it is a voluntary program at the option of management.
Many retirement
communities today have chosen to dedicate certain wings of buildings
or portions of the complex to personal care or nursing care. In
these cases, those particular separate operations would be regulated
by the Department of Aging and Disability Services and by the licensure and
operational rules promulgated by the Department.
In some cases,
residents of retirement communities who have the temporary need
for nursing services may contract for these directly with a licensed
home health agency. In these cases, a licensed practitioner would
come to the individual apartment of the resident to perform these
services. This would be the very same situation as an individual
living in their own private residence in the community. The contractual
agreement for these services is made between the resident and the
outside practitioner, and does not involve the retirement community.
Nursing
home care is established in the statutes under Section 242 of the
Health and Safety Code, Vernon's Texas Civil Statutes. In the statute,
nursing home care is defined as furnishing: "in one or more
facilities, food and shelter to four or more persons who are unrelated
to the proprietor of the establishment; and provides minor treatment
under the direction and supervision of a physician licensed by the
Texas State Board of Medical Examiners, or other services that meet
some need beyond the basic provision of food, shelter, and laundry."
Nursing home facilities are licensed and regulated by the Texas
Department of Aging and Disability Services.
Unlike personal
care and independent living, nursing homes are medical facilities
providing medical care to chronically ill individuals. All patients
are admitted by physicians and their care continues under the supervision
of the attending physician. All nursing homes must have a director
of nursing service and nursing personnel are on duty around the
clock. The ratio of nurses to patients depends on the number of
patients in the facility. Nurse aides and orderlies are also utilized
by nursing home facilities, and these individuals must be trained
and certified.
The nursing
home of today cares for much sicker individuals than in the past.
They are like small hospitals except that they do not perform surgical
procedures. Operating under very extensive rules and regulations,
these facilities have many other types of practitioners like medical
directors, dietitians, dietary consultants, pharmacy consultants,
therapists, and the like.
Unlike the
assisted living facility or the retirement community, administrators
of nursing homes must be licensed. They must complete an extensive
course of study which includes an internship in an actual facility,
and pass a state-administered licensure examination. To retain their
license, they must take additional courses each year for which continuing
education credits are offered.
Today,
at least in Texas, seniors have a comprehensive array of services
to meet whatever need they may require at almost any point in time.
These programs include Meals on Wheels, Emergency Response, Adult
Day Care, Emergency Care, Alzheimer's Care, Home Health Care, Respite
Care, Assisted Living (also referred to as Personal Care),
Nursing Home Care, and Independent Living (also referred
to as Retirement Communities). While the small nursing home has
all but disappeared, we are beginning to see large number of assisted
living care facilities, who care for 16 recipients or less, springing
up in many communities. In the future, we will also see more "campus
of care" arrangements where a number of programs and services
will be provided to clients in the same location. The three most
common options are Assisted Living, Nursing Home Care and Retirement
Community Living. These options are profiled below:
Assisted
Living is established in the statutes under Section 247 of the Health
and Safety Code, Vernon's Texas Civil Statutes. In the statute,
assisted living is defined as "an establishment, including
a board and care home, that furnishes, in one or more facilities,
food and shelter to four or more persons who are unrelated to the
proprietor of the establishment, and provides personal care services."
Many
of today's seniors who simply do not wish to continue the responsibility
of maintaining a yard, a household, and all that goes with it, choose
a retirement community in their area. This is independent living
because no assistance or protective services are provided. Most
communities offer spacious apartments in varying sizes and provide
a specific number of meals per day, maid service, scheduled transportation,
and social and recreational opportunities. The residents are on
their own and may come and go as they please, as if they were still
living in their own homes. Most retirement communities have a Resident Council who provide substantial input into the services and
programs conducted for their benefit.
Nursing
home care is established in the statutes under Section 242 of the
Health and Safety Code, Vernon's Texas Civil Statutes. In the statute,
nursing home care is defined as furnishing: "in one or more
facilities, food and shelter to four or more persons who are unrelated
to the proprietor of the establishment; and provides minor treatment
under the direction and supervision of a physician licensed by the
Texas State Board of Medical Examiners, or other services that meet
some need beyond the basic provision of food, shelter, and laundry."
Nursing home facilities are licensed and regulated by the Texas
Department of Aging and Disability Services.