The Different Levels of Care for Adults with Disabilities
People, whether they have a disability or not, vary greatly in skills and needs for independence. Even two people with the same disability may want different levels of care. Because of that, there is a huge range of services available for adults with disabilities. It’s important to compare and contrast levels of care for disabled adults are available when choosing which services is best for you or your loved one. At the minimal end of the spectrum, someone occasionally looks in on a person with a disability to make sure they’re all right. The maximal end of the spectrum involves providing 24/7 assistance with nearly every aspect of life for that person. Here’s what some of the different levels of care look like:
This is the lowest level of care and can have different arrangements:
- The person receiving services lives independently, in a house or apartment. A case manager or other designated person visits on a mutually-agreed-upon day and time. Any assistance is arranged for by the individual with the disability.
- The person with a disability lives with family, or someone who is not a professional caregiver, so has a professional care assistant (PCA) visit on a (semi)regular basis.
The features these arrangements have in common is that there is no 24/7 on-site individual involved. This level of care presupposes a high level of independence and a certain level of mental acuity. Periodic monitoring is about the same frequency as checking on a senior who is not disabled but lives alone.
This works best when the person with the disability has some measure of independence. Day programs shine at this level of care. Professionals monitor and are available during business/daytime hours. Other arrangements are made for the evening and nighttime. Family and friends are often off from their jobs, and can be available during these time segments.
In another scenario, the disabled person can handle IADLs (Instrumental Activity of Daily Living, i.e., functioning in society) but needs help with some or all the aspects of self-care, so a PCA visits daily. An example of this could be a paraplegic, or someone in a wheelchair.
This level is the most comprehensive and is often an ongoing need.
- The disabled person manages their ADLs (Activity of Daily Living, i.e., all aspects of physical personal self-care) independently or with only occasional verbal prompts, but needs almost complete help with everything else. This often applies to individuals with impulse-control issues.
- The disabled person needs help with both ADLs and IADLs. This usually applies to people who deal with both physical and mental/developmental disabilities. Family members often provide help and support, but 24/7 PCAs make life better for everyone.
In a few instances, because of the extent and severity of the disabilities, at-home care may not be the best solution; residential care, in which nursing care is available, may be the best choice, but only as a last resort and not necessarily as a permanent solution.
It is important not to make assumptions about a person’s level of disability, their appropriate level of care and amount of independence. A person may be confined to a wheelchair but may be perfectly comfortable living independently with little or no help. By the same token, a person may not look like they have a disability when not moving but may have balance, coordination, articulation, walking, and/or strength issues that make it necessary for them to have help.