Chicago-Area Retirement Homes, Independent Living, Assisted Living, and Nursing Homes (generally Western Suburbs)
Here are my notes from a five-month search for a good new home for my mother-in-law, whom I love and who was suddenly hospitalized in November 2000 and could no longer live in her house by herself. It is a scary prospect to suddenly confront, knowing nothing about all the types of care available, the quality of the local facilities, the costs and financing, and a thousand other questions. And of course, my wife and I had all the typical reactions to that phrase "nursing home" and were determined to find the right place for her where she would be happy and healthy and active.
These are the personal notes I compiled from my "crash course," including the results of numerous phone calls, visits to facilities, and conversations with others in the same boat. I will start by defining a few terms describing different levels of care and which you will need to know before shopping for such important services. Following that will be my notes from our search, which I have cleaned up so they are understandable to one of you whom I hope they might benefit. Also, these notes in no way represent a PROFESSIONAL ENDORSEMENT, because I am not qualified to render such an opinion.
Terms
Independent Living refers to a facility where the residents maintain their own living units (apartments, usually) but are offered communal meals and other services (like housecleaning or linen service, for free or for extra fees) and activities (like clubs, excursions, classes, etc.). Each facility is different and offers different living arrangements, and their information and marketing people are always very helpful (because that's their business to be).
Assisted Living is a living arrangement that requires more assistance than independent living. I spoke with one professional in the industry who described the line between independent living and assisted living as being drawn around toileting issues. In assisted living, care extends to toileting and bathing help, assistance with medications, and other issues. Usually this level of care is more expensive than independent living. Again, services offered vary from place to place, and you should call to gather more complete information.
Nursing Care or Full-Time Care centers around daily and regular supervision. I didn't have as many dealings with this aspect of care, since my mother-in-law required something closer to independent living.
Continuing Care or Aging-in-Place refers to a facility's being able to care for an elderly resident throughout the different levels of care, from independent living through full-time nursing care, and this concept also extends not only to medical capabilities but also financial matters, where the contract might stipulate that once the resident's money is exhausted after an agreed number of years, that the facility and Medicare will assume the financial burden of care. This again varies from facility to facility and the potential resident must ask very specifically about such considerations, perhaps even retaining legal counsel to review the relevant clauses and contracts.
Entrance Fee is a buy-in fee of upfront money that a new resident must pay to gain entrance at some facilities. Most often, a resident will pay an entrance fee and then a monthly fee after that. Sometimes there is an option to pay a higher entrance fee in exchange for the resident's estate being returned some portion of the upfront money, and there are some with refund provisions if the resident changes their mind and chooses that they do not wish to remain there. Some facilities charge no entrance fee, and in these the monthly fee is generally higher.