Intermediate care is a level of nursing care available for those seniors who are in need a little bit more care than what is provided in assisted living communities. Yet, it provides a level of are that is lower than what is provided in a skilled nursing home. Here is a brief explanation of what each level provides to the senior:
Assisted living – The senior needs help with his/her activities of daily living (ADLs) meaning bathing, dressing, walking, toileting, transferring, and eating. The care is normally standby assistance. However, hands on care is available at some communities for an additional charge.
Intermediate care – The senior needs hands on help with some of his/her activities of daily living and needs 24 hour supervision with a nursing home staff present. S/he doesn’t require skilled nursing care yet.
Skilled Nursing – The senior needs hands on help with most or all of his/her activities of daily living and has a serious medical condition like a tracheotomy, that requires the presence of a nurse for appropriate care.
Unfortunately, intermediate care is being phased out at many of the nursing homes. But, intermediate care still exists at some skilled nursing facilities, at stand alone intermediate care facilities, and as part of many Continuing Care Retirement Communities. I am seeing quite a few of the assisted living communities practicing intermediate nursing care in the assisted living residents’ apartments (against their licensing), and many of the results have been disastrous as revealed in the following real life story.
REAL LIFE STORY
My clients were the children of a woman in her mid-eighties. She had a stroke for which she was admitted to the hospital. She was released to a skilled nursing community for Medicare rehabilitation. After 6 days of rehab., it was determined that she had hit a plateau and was ready for release to assisted living. The children objected vehemently to her being released on the premise that she needed more therapy. Their request for further therapy was denied, and they frantically began the search for an assisted living community.
The community where she was placed was owned by the skilled nursing home where she had completed her rehabilitation. The assisted living affiliate assured them that they could take care of their mother. Yet after only several days, she had fallen out of bed two times and needed total assistance with two of her activities of daily living. She needed a wheelchair on a full time basis, and was a two-person assist with several activities of daily living. At the end of a week’s stay, the staff informed the children that they couldn’t care for her properly, and they needed to hire a full-time caregiver to stay with her. The additional cost was close to $200 per day, which is just as much as a nursing home on a monthly basis!
When I did my assessment of this lady, she told me about her need for a two-person assist. She complained that the staff woke the staff up very early for breakfast and then kept them waiting in the dining room. On the occasions when she fell out of bed, it took the staff over an hour to answer the emergency call. The CNA (Certified Nurse Assistant) admitted they were understaffed, with the staff to resident ratio being 1 to 20.
I was able to recommend three communities that could offer her intermediate care in the southern Cook and Du Page County areas in Illinois. The intermediate care communities are out there. You just need to know where they are.