Planning For Long-Term Care

Moving from a home to a long-term care facility or nursing home is a big change. It certainly affects the whole family. One thing that can help is the fact that there are more choices in long-term care than ever before. According to the National Institute on Aging (NIA), options include:

• home health care
• adult day care
• transportation and nutritional services for seniors living at home
• assisted living and retirement communities
• traditional nursing homes
• skilled nursing homes which provide 24-hour services and supervision, including medical care and rehabilitation (Read about "Rehabilitation") for residents, who may be very frail or suffering from the later stages of dementia (Read about "Dementia")

What's important is to remember that it's never too early to start planning for the later years, both for ourselves and for family members. A doctor or healthcare provider may have suggestions. In addition, specially trained social workers or geriatric case managers can help people develop a long-term care plan and find appropriate services, especially if family members live a long distance apart.

NIA has some suggestions for those starting out on their research:

• Learn all you can about specific facilities in the geographic area you're considering. Start with doctors, friends and relatives, local hospital discharge planners and social workers, as well as clergy members. Your state's Office for Aging may also have information about specific nursing homes. Get recommendations. Talk to people in the community or local social service agencies to find out which facilities are well run.
• Decide what's most important in terms of location. Do you want to relocate to a place that's close to family members, even though that may mean moving away from friends and neighbors? Do you want a facility that can accommodate specific medical needs that may develop in later years? In cases where spouses have differing health needs, is there a facility that can accommodate both of them?
• Call the places that interest you. Ask basic questions about vacancies, number of residents, costs and method of payment, insurance issues and participation in Medicare and Medicaid. Also think about other issues, such as nearby transportation, meals, housekeeping, activities, special units for Alzheimer's disease or medication policies. (Read about "Alzheimer's Disease")
• Go to places in person and talk to the staff, residents, and, if possible, family members of residents. Set up an appointment, but also go unannounced and at different times of the day. See if you like the way the staff treats residents. Check if the building is clean and safe. Do residents seem to have enough privacy? Are they restrained in any way? Are social activities and exercise programs offered? Do such programs appear to be well run? How much personal property can residents keep with them? Is the facility safe and secure for people and their belongings? How are meals prepared? Is there a registered dietician on staff who understands the needs of older people? (Read about "Senior Nutrition") What type of training is required for employees?
• Review legal issues and be sure you understand the facility's contract and financial agreement. It's a good idea to have a lawyer look them over before you sign.

It's all a lot of work. But by gathering information in advance, and letting friends and relatives know what's most important, you can be better able to cope if an unanticipated event or emergency occurs.

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