Levels of Care 101

Entry into the family caregiver role is different for everyone. Some families ease into the world of caregiving - they dip a toe in when a parent has a minor procedure or short illness. They experience the altered life of a family caregiver but then the antibiotics kick in and strength returns. Everyone breathes a sigh of relief and goes back to caring for children and spouses with the knowledge that mom and dad can take care of themselves after all. Snapshots of friend’s parents we knew growing up come to mind, examples of older adults that needed care. But we’re not “there yet.” 

Some families are thrown into the deep end. A stroke or a hip fracture steals the dream of independence in a moment. Everyone is left reeling, wondering how the plan went awry and when normalcy will return. Lives are upended and busy adult children are in the impossible situation of choosing who to neglect - their parents or their children. It’s the Sophie’s Choice of Gen X. 

Aging in 2026 is an intensive activity, highly tested and regulated. Families and friends of older adults need to understand the language to advocate for the appropriate Level of Care. 

“Level of Care” is where your loved one fits on it care spectrum. The higher level of care, the more help the person requires. The skill and education of the person providing the care will also increase with the level of care. It essentially categorizes the amount of care and support needed, ranging from minimal assistance to high-intensity care around the clock by a nurse. People requiring low levels of care are more independent than those needing a higher level. 

Considerations of level of care include: 

1. Cognition - is the person able to remember to eat, take their medication at the right time? Turn off the stove when done cooking? How about wandering in the street or neighborhood?

2. Physical ability - can they get to the toilet and take care business? Dress upper and lower body? Stand long enough to cook a meal? See well enough to safely handle their medication?

3. Safety awareness - are they a fall risk with unsteady gait and forgetting limitations? 

In my role at HelloCare as an RN Care Manager, the level of care assessment is one of the most important. 

The best way to accurately determine the Level of Care is to spend the day with your loved one and observe their routine. Do they prepare meals and medications competently? Do they ask questions repeatedly? It might seem kinder to overlook the shortcomings in their self-care routine. But it is much crueler to place a loved one that needs care in a community that does not provide it. 

If you have questions about the level of care you or your loved one requires, reach out to any member of Portland Elder Care Council from our website - https://www.portlandeldercarecouncil.com/contact

Written by: Helen Ande