Plenty, as it turns out. Earlier this year, my cousin and I were talking about her dad’s living arrangements. He’d been in independent living for some time, but he needed more help than was available to him.
“I don’t understand,” she said. “He’s in a home … why aren’t they helping him more?” She and other members of the family spent 12 hours every day with him, and they hired help for the other 12 hours.
It was exhausting for everyone, and Uncle Don still didn’t quite have the care he needed.
This led to a conversation about the difference between ‘aging in place’, ‘independent living’, ‘assisted living’, and ‘long term care’.
Aren’t they pretty much the same? Well, no, but it can be hard to know the difference.
Aging in Place (AIP)
Aging in place means you live in your own home as long as possible. This option is good for people who are independent and healthy. You don’t need help with daily tasks such as getting dressed, personal grooming, or cleaning, you correctly take medication, and you manage your finances. If you need more assistance, you arrange services that come to your home. You don’t really need any help.
Independent Living (IL)
Independent living is great when you’re ready to downsize and simplify. Options range from free-standing homes in a retirement community to apartments. Rent usually includes a simple kitchen (no stove), two meals per day, light housekeeping, and laundry services for linens. IL options are most often private pay, but some subsidized units may be available.
IL doesn’t offer any assistance with daily tasks such as dressing, eating, managing finances, or taking medications. There isn’t any medical support. Sometimes additional services can be purchased on site or brought into the home. You don’t need any help, but choose to simplify your life.
Assisted Living (AL)
Assisted living homes are similar to independent living, but some additional help is provided. AL is usually a suite in a building rather than a free-standing home, and usually, no medical staff are on site. Wait lists can be shorter than for long term care. Some subsidies are available for those who qualify.
You’re ready for assisted living when you need a little help with daily tasks from time to time. For example, getting dressed, remembering to take medications, managing finances, and eating. You could use a couple hours of help daily.
Long Term Care (LTC)
This is what many of us are more familiar with. Grandma’s in a home, and we go visit her. LTC is full-time accommodation with 24-hour professional medical supervision and care. Personalized care plans are prepared. The home may offer activities and programs designed to engage mind and body.
LTC is appropriate when you or a loved one need help with daily tasks such as getting in and out of bed, personal grooming, eating, or taking medication. All meals are provided. Outings and in-house activities or entertainment might be available. There is likely a Power of Attorney or Substitute Decision Maker in place. You, or your loved one, needs help for basic tasks every day.
In Canada, IL does not require a referral, nor is it regulated by a health authority (locally, Island Health). AL and LTC are available on both a private pay basis and in publicly funded homes. Private accommodations are more expensive with shorter wait lists, and do not require a referral. In British Columbia, the cost to live in public homes is far less, but wait lists can be lengthy. For publicly funded AL or LTC homes, the health authority determines eligibility. Visit islandhealth.ca for more information.
So, what’s in a name? Plenty, as it turns out: your preferences, your opinions, your choices. I know I tend to put off thinking and talking about aging, but what if something happened and I needed one of these options tomorrow? It’s important for those around you to know what you want, before those decisions are needed.
Guest author submission. This article first appeared in the September 2024 issue of Seaside Magazine.
Aging in Place | Independent Living | Assisted Living | Long Term Care |
People live in their own homes as long as possible. Help comes into the home. No medical assistance is offered unless arranged by the person or their caregiver. Keeps someone in a familiar environment as long as possible. | No medical support. People are mobile and independent. They might still drive. A variety of housing styles from free-standing homes to apartments. May offer a more luxurious environment, health and wellness options, and concierge services. | Some medical and caregiver support. People are fairly mobile but may require some assistance with day-to-day activities. May have a personalized care or assistance plan. Good for people who may not be able to live on their own, but do not require full time care. May offer activities and common areas such as libraries and dining rooms. | Full-time accommodation with 24-hour professional medical supervision and care. People are no longer able to live at home, or in another living environment such as IL or AL communities. Personalized care and assistance plans are provided. Usually have structured activities that provide engagement for mind and body. |