Few people hope to spend time in a long-term care facility, but the reality is that most people will. Research indicates that about 70% of Americans over 65 will spend some time in a long-term care facility. Of those who do, about half will be in long-term care for over a year, while about 21% will be there for more than five years. Given these statistics, choosing a long-term care facility carefully is important; it may be where your loved one might be spending a significant portion of their later years.
While you might be evaluating long-term care facilities for your own future needs, it is more likely that you are looking for care for an aging parent or other loved one. In that case, you may be feeling the pressure of arranging care on a short timetable, and you might be unsure where to begin. In this blog post, we’ll raise some considerations you may want to take into account, and let you know where to get extra help if you need it.
Do You Need to Find a Nursing Home?
When you hear the expression “long-term care,” your first thought may be of a nursing home. Nursing homes are long-term care facilities, but that doesn’t mean they are necessarily the only place your loved one can get the care they need.
Think about whether your family member would prefer to remain in their home if possible (and under what circumstances you would no longer be comfortable with them remaining in the home). Involve them in the discussion if at all possible; after all, they are the ones who will be living with this decision.
If in-home care is a possibility, there are a lot of options available. Seniors can receive a variety of services, including nursing, assistance with activities of daily living, housekeeping, meal preparation, transportation, respite care to help out family caregivers, and more. These services may also be combined with other services outside the home, such as adult day care and congregate meals, which also provide seniors with activity and the opportunity to socialize. In many cases, a combination of in-home and outside services makes it possible for an older person to remain in their home for much longer.
What’s more, the MI Choice waiver program allows seniors who meet income and asset requirements to receive Medicaid assistance to pay for nursing home-type services in their own home. This can make in-home services that otherwise might be financially out of reach much more affordable. For those who are not enrolled in the MI Choice waiver program, PACE may be an option. PACE stands for “program of all-inclusive care for the elderly.” PACE organizations offer comprehensive service delivery systems and help with Medicare and Medicaid for qualifying individuals. An elder law attorney can help you learn more about these and other alternatives to nursing homes.
While most seniors would prefer to stay in their own home, for many, it is no longer possible, even with supportive services. In those situations, the analysis shifts from whether a person needs to be in a long-term care facility to what facility would best suit their needs. For instance, a senior with advancing Alzheimer’s or other dementia may need the structure and security of full-time care in a memory-care facility.
Factors to Consider in Choosing a Long-Term Care Facility
There are over 65,000 regulated long-term care facilities in the United States. How do you begin to go about choosing the right one for your loved one? Here are some factors to think about when choosing a nursing home or care facility.
Location of the Long-Term Care Facility
The first thing you need to think about is the geographical location where your loved one will live. Many seniors who must go into a long-term care facility prefer to remain in the same city or area where they have lived for years. That makes sense on many levels; depending on their health and abilities, they may be able to continue to attend services at a familiar house of worship, see old friends, and maintain relationships with trusted health providers.
However, it may also make sense to get the senior settled in a facility that is closer to family members, especially if they have no family currently living in their area. Doing so will allow family members to visit much more often, stay aware of their loved one’s needs and condition, and avoid the need for long-distance caregiving.
Level of Care Needed
For some seniors, living in their familiar home may no longer be a viable option, but they may not yet need a skilled nursing facility (nursing home). It’s often best to place an older person in a long-term care facility that offers the level of support they need while still encouraging as much independence as possible.
For some seniors, a continuing-care retirement community (CCRC) is an option. In a CCRC, an older person can start out in an “independent living” apartment with some supportive services, such as prepared meals, housekeeping, onsite medical and personal care services, and social activities. If their health declines, they may move into assisted-living care at the same location, which offers more care and support. Finally, they may need to move into the CCRC’s skilled nursing facility.
One advantage of a CCRC is that once a senior is living there, they don’t need to apply to be accepted to a higher level of care or find a different location. As the name suggests, there is more continuity of care at these facilities. If a CCRC is not available or affordable, a senior may need to go to an assisted living facility and transfer to a nursing home if and when that becomes necessary.
Beyond levels of care available, it is critical to assess whether a long-term care facility offers specific types of services that your loved one will need. As mentioned above, seniors with dementia benefit from memory-care services designed for their unique needs. Seniors who have had a stroke may need a facility that offers physical, speech, and occupational therapy.
In addition to specific medical issues, think about other things that will make a facility more comfortable for your loved one. Are the rooms or apartments home-like and cozy, or sterile and institutional? Is there room for some of your family member’s treasured photos and possessions? What are the opportunities for socialization? Does the facility create opportunities for residents to get out of their rooms and spend time with others, improving their quality of life?
Staffing is another important consideration. A facility that is inadequately staffed is more likely to have caregivers who are overburdened and stressed, and who may have time to provide only basic care rather than helping residents thrive as fully as possible. Check online reviews and if possible, references from other families to learn about issues like staffing, cleanliness, and safety violations.
Last but not least, cost is a consideration. Planning for the cost of long-term care is often the most stressful part of getting a loved one the care they need. However, this isn’t a burden you need to bear alone. An elder law attorney and their team can not only help you find the right care for your family member, but figure out how to pay for it.
To learn more about choosing a long-term care facility for your loved one, contact Estate Planning & Elder Law Services to schedule a consultation.