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Your Guide to New Hampshire Senior Living Options

When you’re seeking out a new community for yourself, a relative or a friend to call home, you can’t have too much information. That’s especially true when you’re looking into senior living options since there are so many different choices.

You likely already know about some of the main options and their differences, including independent living, assisted living, in-home care, nursing homes, and rehab. In this article we’re going to go deeper and learn about the critical differences between each option so you can make the best choice for your situation.

Independent Living

Independent living is most suited for people who are fully independent day-to-day but prefer to live in a community with peers.

Independent Living Services and Amenities

Conveniences of an independent living community often include:

  • Community dining with a restaurant atmosphere
  • Availability of housekeeping services
  • Transportation to appointments or leisure activities in the area
  • Planned activities and social programs, potentially including wellness services

Most people in independent living reside in apartment-style settings, either studio style or with one or more bedrooms. Other communities offer detached cottage-style homes, often with garages and typically without stairs to improve accessibility.

Independent Living Health Care and Daily Assistance

Since independent living is designed for people who can perform all activities of daily living on their own, home health care usually isn’t included. You will need to pay for any support services yourself, just as you would if you were living in a private apartment or home.

Independent Living Cost

In New Hampshire, you’ll pay an average of $3,537 per month for a spot in an independent living community. You may need to pay extra if you’re moving in as a couple or if your chosen community charges extra for amenities and services.

Assisted Living

Assisted living is best suited for people who are mostly independent but need help with things like dressing, grooming, and keeping track of medications. Assisted living communities tend to have medical personnel on staff.

Assisted Living Services and Amenities

Residents of assisted living communities may have their own private units or live in double-occupancy units. Amenities vary between communities, but you’ll usually find many of the same housekeeping and dining services as you’ll get in independent living. Social and enrichment programs are common as well.

Types of Assisted Living

There are two types of assisted living communities in New Hampshire: supported residential health care and residential care.

Supported Residential Health Care

The more comprehensive of the two options, supported residential health care provides social and health services as well as short-term medical care if a resident is recovering from illness. Services include:

  • Personal care
  • Medication services
  • Social programming
  • Help with medical appointments
  • Health and safety services
  • Access to nursing care as needed
  • Crisis support
  • Supervision for residents with cognitive challenges

Team members in a supported residential health care community can help with medication, but only in limited ways, as regulated by state law.

Residential Care

A residential care community offers minimal supervision but does offer personal care help. Services include:

  • Help with activities of daily living
  • Assistance with arranging healthcare appointments and accessing community services
  • Supervision of those with cognitive challenges
  • Crisis intervention

As in supported residential health care settings, team members in residential care communities may help with medications, but only certain authorized personnel may assist.

Neither type of community is allowed to provide 24-hour nursing care to any resident for more than 21 days according to New Hampshire state law.

Who Is On Site at Assisted Living Communities?

New Hampshire assisted living communities typically have coordinators and staff members responsible for housekeeping, dining and administration. Many communities have full-time activities directors who plan enrichment programs like movie nights, educational programs and wellness activities. Some communities have opportunities for residents to participate in off-site activities as well.

Unlike independent living centers, assisted living communities also have on-site nursing and direct care staff. There are no staff-to-resident ratios for direct care providers in New Hampshire assisted living communities, but there are required professional competencies.

Residential Care centers must have direct care personnel and at least one licensed nurse. Overnight care must be available if there are 17 or more residents or if certain safety concerns are present.

Supported residential health care communities must have at least one awake staff member 24 hours a day unless there are fewer than eight people in residence. There must also be direct care personnel and at least one licensed nurse.

Assisted Living Eligibility

The state of New Hampshire requires that all assisted living community residents undergo annual evaluations to make sure that the community can safely meet their needs.

Individuals in residential care communities should be able to evacuate themselves in the case of an emergency. People living in supported residential health care facilities only need to be able to transfer themselves from bed to chair to standing, but facility staff can take over this task if they are trained.

Assisted Living Cost

In New Hampshire, someone in an assisted living community will pay an average of $4,855 per month. That’s higher than the national average but less than the median cost in most surrounding states. It’s more than you’d pay for independent living but less than memory care and much less than skilled nursing.

Skilled Nursing and Rehabilitation

People who need 24-hour care from health professionals are most suited to skilled nursing facilities or communities that offer rehabilitation services. These facilities may provide care on a short-term or long-term basis and are available not just to older adults but to persons of any age.

Medical Care Services

There are more services available in skilled nursing and rehabilitation centers than there are in assisted living communities. When needed, residents may receive:

  • Post-inpatient and post-surgical care
  • Help with activities of daily living
  • Incontinence care, including colostomy and catheter care
  • Administration of oral and IV medications
  • Personalized diet plans
  • Medical supplies and durable medical equipment such as hospital beds, oxygen tanks or wheelchairs
  • Speech-language, occupational and physical therapy
  • Ambulance transportation

Every resident in a skilled nursing facility should receive a thorough evaluation that leads to a personalized care plan. In many cases, the goal of the care plan is to prepare the patient for a return home or to a lower level of care, but skilled nursing centers are also equipped to provide long-term care.

Other Skilled Nursing Community Amenities

Like assisted living communities, skilled nursing centers provide needed support as well as nutritious meals, housekeeping support, and community activities. Activities in a skilled nursing community are geared toward the capability of the community’s residents. There may be transportation offered to off-site activities and many skilled nursing centers offer their own “field trips,” including trips to cultural and community events. Participating in these activities helps residents to stay connected to the broader community.

At Havenwood Heritage Heights, a Concord nursing home and continuing care community, residents receive personalized care and the attention of a multidisciplinary team dedicated to providing every resident with a life worth living. The entire team helps residents to grow and thrive emotionally, socially, spiritually, and physically, making Havenwood a real home for everyone in it.

Skilled Nursing Cost

The cost of skilled nursing care is $9,612 per month, the second highest in New England. Only Massachusetts has a higher monthly cost of $10,737.

Paying for Care in New Hampshire

Medicaid may cover long-term care for some New Hampshire residents, but coverage is competitive. The applicant must:

  • Be least 65 years old, blind, or disabled
  • Possess proof of US citizenship or legal residency and be a New Hampshire resident
  • Demonstrate needed care for at least 30 days
  • Have an income below the Medicaid cost-of-care reimbursement rate
  • Use all available income to pay for care
  • Not have available assets above the state’s pre-determined limit

If you or someone you care about needs assisted living services but can’t afford the cost, you may be able to get a Choices for Independence waiver from the state. The waiver is available to people who meet certain income requirements and would otherwise need skilled nursing care.

Although an applicant has to demonstrate the need for care, a Choices for Independence waiver doesn’t need to be used for skilled nursing. Covered resources include in-home care, home health aides, residential or respite care, and supportive housing.

Long-Term Care Insurance

Some residents of New Hampshire senior housing communities pay their costs using long-term care insurance. Coverage can help many people protect their assets, especially if they have more than would qualify them for Medicaid but less than they would need to cover costs without spending their life’s savings.

Long-term care insurance is best when purchased sooner rather than later. Around 25 percent of people in their 60s have a hard time qualifying, but people in this age group can still apply. See an attorney or insurance professional if you’re interested.

Your Senior Living Options

The US Department of Health and Human Services predicts that 70 percent of people who reach age 65 will go on to need long-term care. It’s never too early to start considering your options.

If you’re interested in learning more about New Hampshire senior living, check out Havenwood Heritage Heights and our three beautiful campuses. Come visit and find out why so many people choose to call Havenwood “home.”

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