Navigating the Continuum of Long-Term Care

The journey through long-term care involves various types of facilities, each offering a different level of care. As your loved one’s condition changes, they may find it necessary to transition between care facilities.

It’s essential to understand that residents of care facilities often need to move along what is known as “the long-term care spectrum” based on their evolving needs and increasing care requirements. This understanding is particularly important to consider if your loved one is contemplating a move to a residential care facility. Before signing any agreements, ensure that both you and your loved one have a clear understanding of the level of care they require and what the facility can provide. It’s also crucial to anticipate any future care needs. Take the time to carefully review contracts or residents’ agreements, familiarize yourself with the facility’s policies regarding moving out (including deposit refunds), and be aware of circumstances that may necessitate a forced relocation if your loved one’s care requirements exceed the facility’s capabilities.

Your hospice social worker and your hospice team can help you navigate the different options and the implications of each decision. We are with you every step of the way and will help you choose the right place to provide care for your loved one. Remember, hospice services can be provided anywhere, regardless of which facility you choose.

Typically, facilities at the beginning of the following list primarily offer basic residential services, such as housekeeping, while those at the end provide round-the-clock medical care and specialized services. The progression of care facilities, moving from greater resident independence to more comprehensive care, includes:


Individuals receive assistance with various activities, such as meals, shopping, or nursing care, while continuing to live in their own residence. The level of support can range from minimal tasks like housekeeping and companionship to extensive help with daily activities such as bathing, dressing, and medication management.

Independent Living / Retirement Communities

Residents live in their own houses, apartments, or condominiums, often with the option to purchase the residence. These communities offer additional services, including social activities, meals, or housekeeping for an additional fee.

Group Homes

These facilities cater to individuals who require assistance with personal needs, such as bathing, grooming, and toileting. Individuals are usually more independent, but with right type of support anyone can be taken care of here. The distinction lies in the fact the atmosphere is more of a residential atmosphere than a facility atmosphere with a maximum of 4-5 residents per home.

Assisted Living Facilities

These facilities cater to individuals who require assistance with personal needs, such as bathing, grooming, and toileting. They also offer less intensive services like meals, housekeeping, and medication administration.

Nursing Homes

Designed for long-term care, nursing homes provide 24-hour medical care under the supervision of a doctor. They offer room, board, assistance with daily activities, and recreational activities. Most residents in nursing homes have physical or mental impairments that make independent living unsafe.

Continuing Care Facilities

These comprehensive communities cover the entire spectrum of long-term care. They provide seniors with a living arrangement that ensures they never have to leave the community. Residents are encouraged to maintain as much independence as possible. If their needs change and they can no longer live independently, they are moved to an attached facility that can accommodate their requirements. Continuing care facilities can be expensive and may involve a one-time fee based on factors like age, financial assets, income level, physical health, and mobility.