3 years, 6 months ago
Not all seniors need the same amount of care. Some only need a little help around the house while others need round-the-clock medical monitoring. Every senior who goes into Alberta’s continuing care system is assessed to determine how much care they need and then placed in one of five levels. As they get older and more frail or their medical conditions deteriorate, they move to a higher level.
To the uninitiated, it can be a confusing and intimidating system. To help you out, here is a primer of the five levels of care.
Level 1 – Home Care
This is for seniors who live fairly independently, but need some assistance with their daily routine. They can be living on their own or in a seniors residence.
Individuals are responsible for arranging and managing any home care and support services they require. Some services are paid for by Alberta Health Services, while others are paid for out of the senior’s pocket.
Home care is paid for by AHS only if the senior is assessed by an AHS case manager, who determines what the client needs. The case manager is a Registered Nurse (RN). In-home services can include nursing and rehabilitation, and personal support services like housekeeping, bathing or grooming assistance.
If the senior wants additional services that AHS doesn’t cover, they can hire extra help from a private home care provider, but they must pay for it themselves. Otherwise, their family and friends are expected to help out.
Level 2 - Supportive Living – including various seniors’ facilities, retirement centres and lodges
Supportive living combines housing and “hospitality services” (meals, housekeeping, laundry etc.). The facility operators are responsible for coordinating and arranging hospitality services and may also coordinate or provide personal care and other support services.
Seniors who are fairly independent, with or without the help of home care, are a good fit for this level.
Publicly-funded home care can, if a need is assessed by the AHS case manager, provide in-home professional support services such as nursing and rehabilitation, and personal support services like housekeeping, meal preparation or bathing. This will either be provided for by home-care workers or staff employed by the facility.
Many of these facilities offer a wide variety of services – but there will be a charge for any that are not paid for by AHS. Typically, full meal service will be available in a central dining area, as will housekeeping, laundry and linen services, transport services, as well as various organized social activities.
Seniors in level 2 can also arrange and manage their own care and be responsible for decisions about day-to-day activities. They can manage some but not all of their daily tasks independently. All or most personal services can be scheduled. A basic set of services/supports is required. They may require some assistance or encouragement to participate in social and rehabilitation programs.
Level 3 – Assisted Living – DSL 3 (Designated Supportive Living 3)
Seniors with health needs that, in the case manager’s assessment, require 24 hour personal care and support are eligible for placement in a Designated Supportive Living 3 (DSL3) facility. Seniors in DSL3 have higher care needs that cannot be scheduled, but can still use a call system to get the help they need. They should not be considered a risk to themselves or others and should be medically stable.
Health Care Aides are on site 24 hours every day to provide support and personal care. Again, only those services assessed as required by the AHS Case Manager will be paid for by AHS. All other services will be the resident’s responsibility. Seniors will have to provide their own furniture and household items, medications and medical supplies, and equipment. Residents pay an accommodation fee to cover the costs of providing accommodations and services like meals, housekeeping and building maintenance.
DSL3 spaces are contracted by AHS within lodges and other supportive living facilities, or within higher-care facilities (SL4). SL3 residents must not need complete meal assistance, two-person transfers (in and out of bed, the bath etc.) or toileting assistance.
Seniors in level 3 may need assistance in making some decisions about day-to-day activities. – and will require help with many daily tasks. The need for unscheduled personal assistance is infrequent, but can come up occasionally. Increased assistance is required for participation in social and rehabilitation programs.
Level 4 – Enhanced Assisted Living – DSL 4 and DSL 4D (Designated Supportive Living 4 and 4 Dementia)
Seniors with complex medical needs that require 24-houron-site professional nursing and high levels of personal care and support (in the case manager’s assessment) are eligible for placement in a Designated Supportive Living 4 or 4 Dementia facility. These spaces may be stand-alone or be separate areas within other seniors’ facilities.
Care is managed on-site by a licensed practical nurse (LPN) under the direction of a home care registered nurse (RN) and delivered by health care aides.
Residents may require complete meal assistance (including tube feeding), mechanical lift transfers, medication administration, total assistance to move from place to place and total assistance to manage toileting. Residents in the secure dementia units may suffer from moderate to severe dementia.
Again, only those services assessed as required by the AHS case manager will be paid for by AHS. All other services will be the resident’s responsibility. Seniors will have to provide their own furniture and household items, medications and medical supplies, and equipment.
Residents pay an accommodation fee to cover their room rental and services like meals, housekeeping and building maintenance.
Seniors in level 4 will need assistance in making decisions about day-to-day activities. They will also require assistance with most or all daily tasks. The need for unscheduled personal assistance is frequent. They will require enhanced assistance for participation on social and rehabilitation programs.
Level 5 – Facility Living - Long Term Care (Nursing Homes and Auxiliary Hospitals)
To be placed in a nursing home or auxiliary hospital, seniors are assessed by AHS as having serious, chronic and/or unpredictable medical conditions that require access to registered nurses able to respond immediately on a 24 hour basis. They may have unpredictable behaviours that put themselves or others at risk.
Residents in long term care pay an accommodation fee to cover the costs of providing accommodations and services like meals, housekeeping and building maintenance. Health services in long-term care are publicly-funded and provided through Alberta Health Services.
Medical/surgical supplies, medications and medically necessary transportation are paid for by the facility not the resident, nor do the residents need their own furniture.
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