Section 1: Types of Care for Persons with Dementia

There are two main types of senior living communities in Connecticut.

• Skilled Nursing Facilities (SNF): also known as “nursing homes,” these residences are for people who cannot live independently, need significant help with personal care and have physical or mental conditions requiring medical help SNFs provide 24-hour supervision and medical care, help with daily living activities, meals, and recreational activities. Rooms can be private or semi- private. Some SNFs may have units or are specifically for people with dementia, called “memory care.”
  • Because nursing homes are federally funded and assessed, Medicare offers a website that allows you to review the quality of nursing homes near you: You can enter a street, town, or zip code to will see the overall ratings of nursing homes within a certain distance that you select. Ratings are based on stars. Facilities receive between 1 and 5 stars, with a 1-star rating indicating the lowest rated and 5 stars indicating the highest rated. The rating system takes into account the results of a health inspection, the staffing, and quality measures such as the number of patients who develop urinary tract infections or pressure ulcers. This is the only option that offers a website to review quality ratings. Assisted Living and Home Care services do not have similar websites.

• Assisted Living Facilities (ALF): These residences are for people who cannot live independently but do not require the same level of care or supervision as required in SNFs. In Connecticut, all ALFs offer private apartments with communal spaces and must include meals, laundry, transportation, scheduled housekeeping, chores and maintenance, and recreational activities. They also provide as-needed assistance with daily living activities, personal care, and health care. Some ALFs have units or are specifically for people with dementia, called “memory care.”

There is a third option, Continuing Care Residential Communities (CCRC). These senior living communities offer lifetime living accommodations from independent senior housing to SNF. Residents move in with the intention of needing additional care as they age, including SNF, assisted living, or memory care. They usually require a contract and sizable down payment. Some CCRCs have eligibility criteria (e.g. minimum ages; only requiring independent living services at move-in). Due to financial requirements and eligibility criteria, this may not be a viable option for everyone.

Home care services are provided by individuals who come to the patient’s home. These services consist of medical home care and non-medical home care. Medical home care services are provided through licensed agencies. Non-medical home care services are provided both through licensed agencies and private caregivers. Licensed agencies conduct background checks, provide oversight, and handle items like payroll and taxes. However, they are more expensive and less flexible than private caregivers.

• Medical home care: This includes: a) skilled nursing care: medical treatments, wound care, and health monitoring, which is provided by registered nurses or licensed practical nurses; b) different forms of therapy: physical, occupational, and speech, which is provided by therapists; c) medical social services: counseling and making connections with community resources, which is provided by a social worker.
• Non-medical home care: This includes: a) personal care: assistance with daily activities, like bathing and dressing, which is provided by home health aides or personal care aides; b) companionship, which is provided by personal care aides or companions; c) transportation; d) homemaking: light housekeeping, meal preparation, and grocery shopping, which is provided by homemakers.

Adult Day Care Centers can be an alternative to or addition to homecare services. They typically offer transportation to and from the center, meals, supervision, and social activities. Some also offer personal care services, such as bathing, and many will administer medications as well. Services differ, so it is important to ask about the details of services offered, but generally Adult Day Care Centers are the most affordable option for providing either half days or full days of supervision, activities, social interaction, and meals.

Connecticut offers information on both senior living communities and home care.