Choosing a Long-Term Care Facility
An Informed Decision
Are you considering a move to a long-term care facility for yourself, or for your spouse,
parent, other family member or friend? If so, you will feel more confident in your choice if
you know about your options and what you and your family can expect after the move.
Whether you are considering just one long-term care facility, or are trying to choose from
among several facilities, your decision should be an informed one. This means understanding
what level of care is needed in your particular situation and making sure the facility you are
considering is a good fit.
You might start by using the Nursing Home Compare tool on the Medicare.gov website. A
geriatric/aging life care manager, hospital discharge planner or social worker can also help
with the decision. But nothing takes the place of an in-person visit. Taking the time to visit,
observe, and ask questions not only lets you make the best selection, but also prepares you
and your family to take full advantage of everything the care facility you select has to offer.
Level of Care
The level or levels of care a facility offers is the first thing to ask about. A person about to be
discharged from a hospital and admitted to a nursing facility for a short period of recovery
before returning home has one set of medical, therapy, and social needs. A frail or chronically
ill person who requires ongoing, around-the-clock nursing and personal care has another set
of needs. Someone with severe dementia has yet another. Ask whether the facility you’re
looking into offers the level of care appropriate for the situation of you or your loved one.
Paying for Care
Another thing to check on is cost and who will pay. The rates facilities charge their residents
vary, and it may be important for you to know which services are covered in a basic daily
or monthly rate, and which ones have to be paid for as extras.
Not all facilities participate in Medicare and Medicaid. So, if one of these programs covers you
or the person you are helping, it is important to verify that the facility you have in mind is
certified to receive that type of payment.
Similarly, a growing number of managed care plans, like HMOs, have payment contracts with
particular long-term care facilities. It is worth asking about this, as well. If you have long-term
care insurance, check your policy’s payment provisions to see what is covered.
Things to Watch For
Visiting a facility you are considering is always a good idea. While you’re there, these are some
of the important things to look for:
Do the residents appear comfortable and well cared for? Are they appropriately dressed and
Do the facility’s employees seem knowledgeable and well organized in the tasks they are
performing? Are they courteous and attentive to the residents (for example, knowing and
using a resident’s name, and knocking before entering a resident’s room)?
Are they wearing name tags? Are they groomed appropriately?
Do they seem happy and engaged in what they are doing?
Are the residents’ rooms clean and comfortable? Do lighting, ventilation, and space seem
adequate? Are the bathrooms equipped with non-skid surfaces and grab bars? If rooms are
shared by two or more people, is privacy respected as much as possible?
What is the dining room like as a meal is being served? Do things seem calm and organized?
Is the food appealing? Is it served hot?
Does the facility offer a variety of activities and outings? Does it keep residents informed and
personally active as much as possible? Are calendars, posters, and photographs displayed?
Building and Grounds
Is the facility well maintained? Are there walkways or a courtyard for outdoor visits in good
weather? Do stairways and hallways have safety rails?
More Questions to Ask
Many important characteristics of a facility are not immediately apparent. Don’t be reluctant
about asking more questions. For example:
Choice of Doctor
Does your regular doctor see patients at this facility? If not, which doctors do?
What sort of written contract does the facility use? Ask to see a copy.
Find out about visits, availability of support groups, and participation in care conferences and
All long-term care facilities are regularly inspected (“surveyed”) as part of their license
renewal or in conjunction with their certification as a participant in Medicare or Medicaid.
The facility’s most recent survey results are always available for you to see. Were there any
Facility Policies and Procedures
What does the facility ask of each resident—its “rules and regulations”? What is the policy
on smoking? On noise? On protection of resident belongings?
Long-Term Care Selection Checklist
Here is a checklist you can use as you consider the merits of a particular facility.
- Services and capabilities match needs
- Participates in Medicare and/or Medicaid
- Rates are competitive
- Residents appear to be well cared for
- Staff appears to be knowledgeable and dedicated
- Residents’ rooms are comfortable
- Residents’ rooms have adequate light and ventilation
- Activities programs are interesting and varied
- Meals are appetizing and served in a comfortable setting
- Building and grounds are well maintained and functional
- Admission agreement is reasonable and easy to understand
- Family involvement is encouraged and supported
- Recent survey results show no major problems
- Facility policies and procedures protect quality of life
- Facility policies and procedures protect privacy
Copyright © IlluminAge AgeWise, 2015
© 2015 IlluminAge Communication Partners | All Rights Reserved
The millions of employed family caregivers in the United States lose a considerable amount of money when they take time from their jobs to care for their aging parents, and spend a good deal of their own funds to do so.
The MetLife Mature Market Institute released a study, “The MetLife Study of Caregiving Costs to Working Caregivers: Double Jeopardy for Baby Boomers Caring for Their Parents,” which found that as of 2011, employed caregivers in the U.S. lost an estimated $3 trillion in wages, pensions and Social Security benefits over a lifetime if they left the workforce prematurely. The average losses were $304,000 per person. That does not include additional out-of-pocket expenses related to caregiving, such as travel costs, contributing to the parents’ household upkeep and purchasing items needed by the care recipient.
The study offered 10 financial planning tips for family caregivers:
1. Think twice about leaving your job to provide care, as it will impact your lifetime wealth and future employment prospects. In addition to losing a paycheck, you also could be missing out on years of service required to become vested in a defined benefits pension plan, to receive matching 401(k) funds or to build Social Security benefits.
2. Check with your employer to determine what benefits are offered and how you would replace them, should you curtail your employment. Your employer may be able to provide workplace accommodations, such as flex time or family and medical leave, so you can stay in the workplace while caring for your relative.
3.Take stock of what you have and your expenses for caregiving. Consider your current costs for travel, home care and any other items you cover. Add up all your current out-of-pocket costs for caregiving and create a budget for these expenses.
4.Look into public benefits. Community services may be available for free or at a low cost and can offset out-of-pocket expenses. The Benefits Checkup website (www.benefitscheckup.org) from the National Council on Aging offers a free, confidential service that can help older adults find programs to help pay for some of the costs associated with prescription drugs, healthcare, utilities and other essentials.
5. Become knowledgeable about Medicare and Medicaid. Medicare is not all-inclusive and you will want to be aware of costs for premiums and deductibles. Some enrolled in Medicare also may qualify for Medicaid, which covers a range of health and long-term care services.
6. Calculate what it would cost to keep your loved one at home. There are many resources to enable an older person to age in place, such as meals-on-wheels, adult day care services, home care and home modification.
7. Consider enlisting a geriatric care manager. Geriatric care managers are usually social workers or nurses who assist with evaluation, referral and monitoring a plan of care for older persons. (Note: today, geriatric care managers are often referred to as “aging life care specialists.”)
8. Be aware of possible elder financial abuse. Older individuals, especially those with physical or cognitive impairments, can be vulnerable to exploitation, which may deplete their savings.
9.Discuss your loved one’s legal, financial and medical wishes. Investigate legal tools such as power of attorney, durable power of attorney and a living will.
10.Create a budget for your own future retirement expenses. Consider what portion of your income you’ll need to maintain your current lifestyle after retirement; experts typically place it at about 80 percent of current income.
“Legions of dedicated caregivers are making not only emotional and physical sacrifices, but also financial sacrifices for their parents,” said Sandra Timmermann, Ed.D., who served as director of the MetLife Mature Market Institute. “There are steps people can take to mitigate the hidden costs of caregiving, and there are programs employers can put into place to help support their employees.”
Source: The MetLife Mature Market Institute. Read more about the “The MetLife Study of Caregiving Costs to Working Caregivers” (https://www.metlife.com/mmi/research/caregiving-cost-working-caregivers.html) on the MetLife Mature Market Institute website (www.metlife.com/mmi/index.html), where you will find other studies that were created by MetLife to educate consumers on aging, longevity and the generations.
© 2016 IlluminAge Communication Partners | All Rights Reserved
Notice: The articles on this website, BrightStone ElderCare Solutions, LLC are for informational purposes only. It is not to be construed as medical, legal, financial or any other professional advice nor is it intended to be a substitute for professional advice, diagnosis or treatment. Always consult with a qualified professional with any particular questions you may have regarding your or a family member's needs.
The 6 Best Ways to Help An Older Adult Adjust to Assisted Living
As individuals age, many seek living arrangements that offer a safe, secure, stimulating environment but also one which provides for changes in mobility and health status. When it comes to making a decision about an assisted living community for a loved one, making a well-informed and timely decision is essential.
Let's face it, handing over the care of a parent or loved one when home care is no longer available is often a difficult step for anyone to take. The new housing arrangement will have to meet the daily life needs of older adults for today and the future. Keep in mind this type of move will likely be stressful for the older adult—it is best to not have to do it twice.
Older adults experience varying degrees of adjustment challenges—the need to downsize to a moderately sized apartment, adjustment to new dining routines, resentment in having to live with those that are more disabled, feelings of abandonment and a sense of frustration surrounding a perceived loss of independence.
It is also important to note that many older adults have no trouble making the transition to assisted living. Many older adults recognize at some point it may not be feasible to remain at home. They may acknowledge it is a relief to no longer have to manage and maintain the upkeep of their former homes.
Of most importance, check out housing options early because it takes time to find the right place to call home where your parent will be in a safe and supportive environment, receive the proper physical care and medical oversight, mental stimulation and companionship.
First, here is some guidance on doing an assisted living search.
When starting the search for the right assisted living community, you may find yourself looking into Continuing Care Retirement Centers (also referred to as CCRC) which offers several levels of housing arrangements depending on the resident's health status and ability to function independently. All levels are typically located on the same campus or facility site.
When you tour a facility, check to be sure the facility can truly provide the level of care advertised and ask about staffing levels.
A quality check is important as you research options. Contact the local area agency on aging or the long term care ombudsman about licensing or any quality assurance agency within the state. You may check with the Better Business Bureau to see if any complaints have been filed against a particular community.
You will find that it is helpful to talk to people who reside in these communities and their families.
For a comprehensive resource on various senior living options and all long term care options including Alzheimer's or Dementia, be sure to check with seniorguidance.org where you will find helpful information for your individual state.
Assisted living units are designed for individuals who may have limited mobility and need some assistance and supervision with daily living activities, such as bathing, dressing, toileting and other personal tasks. Units can be a single room with bath or a small apartments with bath and a kitchenette.
Advantages include balanced nutritious meals, housekeeping, supervision, activities and custodial care. Some facilities accept people with dementia.
The national median monthly rate according to the 2016 Cost of Care Survey by Genworth Financial Inc. for a one bedroom unit in assisted living in the United States is $3,628 or could be higher or lower depending on the area and services provided. The cost has been rising by an average of 4.39 percent during the past 5 years.
For more information on regulations and the residences in your particular area, contact the area agency on aging at eldercare.gov and the National Consumer Voice for Quality Assisted Living at assistedlivingconsumers.org which works in collaboration with individuals and groups to promote safety, choices and rights in assisted living.
Once you have identified and located the ideal assisted living community, here are the 6 best ways to help an an older adult make a sucessful transition to their home away from home.
1. Visit the Community Several Times before Moving In. There will be opportunities to attend meals and events. It is a a good time to become familiar with residents, staff and the layout of the community. Such efforts help to make the assisted living community and everyone who works there seem more familiar. It will help your parents feel more comfortable when she or he will eventaully move in.
2. Help Your Parent Personally with the Move. Find the time to become involved in the move by wrapping special household or sentimental items and addressing any concerns early. This personal attention will demonstrate your support of your parent or the older adult. Your engagement in this area will also be appreaciated and lift some of the stress of moving.
3. Provide Regular Positive Reassurance. This reassurance is of great importance during the first few days and weeks of the move. It will help your parents to think positively and to view the move as starting a new chapter in their lives rather than ending a life they have already known.
4. Bring Personal Items and Recreate Aspects of Their Former Home. Can you duplicate certain aspects of the livingroom or bedroom in the new living quarters? Find ways to decorate cherished items and organize furniture in the assisted living apartment or unit when possible to reflect a similar layout to their previous home or current preferences. Your loved one will appreciate a sense of familiarity and convenience and experience a feeling of comfort in the apartment. It is also an opportunity to create a safe environment where everyday fall hazards are eliminated.
5. Encourage Your Parent to Participate in Activities and to Volunteer. There is a wide variety of activities available at assisted living communities. Encourage your parents (s) to find the activities that appeal to them and to seek volunteer opportunities or to sponsor a club. Your parents will adjust better if they become involved in activities. In addition, they will experience the health benefits and social support of making some new friends.
6. Allow Your Parents to Remain Independent. Visit your parents regularly especially during the first few days and weeks to ensure that your loved one does not feel abandoned and to address any new concerns. As a long distance or local caregiver, you will at some point find a comfortable schedule that meets both your needs.
Do your best, however, to not feel as though you must be with them all day or every day. Avoid parenting your parent.
The goal is to reinforce any abilities and independence and encourage them to adapt well to his or her new home and to not feel abandoned or trapped in the new community.
"There is nothing more important than a good, safe, secure home." —Rosalynn Carter
© 2017 Kathleen Steamer │All Rights Reserved
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