Exploring Long-Term Care Options for Aging Family Members

By Nate Widom

Deciding whether aging family members should transition to long-term housing is a profoundly emotional and complex journey. It is a decision steeped in love, concern, and the desire to provide the best possible care for those who have spent their lives caring for us. Balancing respect for their independence with the necessity for enhanced support can be a tightrope walk. As we navigate this path, it’s crucial to approach it with empathy, patience, and a deep understanding of the various options available to ensure our loved ones find a place that feels like home, where they can thrive and feel cherished in their golden years. Let’s explore key factors when considering housing options for your aging loved ones.

1. What Does Your Loved One Need?

The journey begins by assessing your loved one’s situation – their capabilities and their needs. Spend time around them and call them; it shows that you care and helps you develop a thorough understanding of their quality of life. If you live far away, developing relationships with their doctors, neighbors, and friends can provide invaluable support and insight. Below are a few signs that they may need more care, per the National Institute on Aging:

• Consider if they struggle with daily activities or have mobility difficulties.
• Determine whether forgetfulness is negatively impacting their safety and quality of life. Memory loss is typical with age but can be experienced to varying degrees.
• Pay attention to things like poor hygiene, significant weight changes, confusion, falls, and loneliness.
• Check their home to see if it’s well maintained and ask if they take their medications as suggested.

Also, consider whether they need more medical attention or if it’s simply best for them to live closer to you. This will help determine whether your loved one needs extra care and the best type of long-term housing for them.¹

2. Types of Housing

There are plenty of options for long-term eldercare facilities. All have different amenities and programs, affecting price. Most focus on one level of the eldercare options below, with some offering multiple:^2,3

• Nursing Homes: Nursing homes will provide the most medical care. They include 24-hour supervision, meals, and more direct assistance for residents. Rehabilitation services are among the typical services offered.
• Assisted Living: Assisted living facilities won’t provide as much individualized care and supervision as nursing homes. However, residents will still receive some aid. Most have meals, security, and various forms of personal care. Residents generally live in their own rooms and can socialize in common areas.
• Board and Care Homes: Board and care homes are small, privately owned facilities where residents live in shared or private rooms. They generally receive care and meals, but nursing and medical services are not provided.
• Independent Living: Independent living is intended for reasonably healthy aging adults who don’t require much assistance. Residents live in their own apartments but frequently enjoy the social benefits of other types of facilities. They’ll still have meals, activities, security, etc. If needed, they can access care services through home health aides.
• Continuing Care Retirement Communities: These facilities offer many levels of care. According to the National Institute on Aging, they usually provide independent living, assisted living, and nursing. If someone eventually needs more care as they age, they can stay on the same property but move to a different section where the care they need is offered.

Don’t forget that having your loved one move into your own home is an option. They may also be able to stay in their current housing with home health aides.

3. Check Finances

Financing long-term care can be overwhelming and costly – the last thing you need when making an already difficult transition for a loved one. People pay in three main ways: personal funds, governmental assistance, and programs from the private sector.

Government assistance programs that can help with payment of long-term housing include Medicaid, Social Security, The Department of Veterans Affairs (VA), and The Program of All-Inclusive Care for the Elderly (PACE). Keep in mind that eligibility for these programs varies by situation and location. Private options include long-term care insurance, life insurance, reverse mortgages, annuities, and trusts.⁴

The National Institute on Aging provides detailed information on all these programs, their intricacies, and how to get in touch. Visit nia.nih.gov/health/long-term-care/paying-long-term-care to learn more.

Unfortunately, Medicare does not cover assisted living or long-term care specifically. Still, it does cover some health care services, doctors’ visits, and hospice care.⁴

4. Take a Tour

Once finances and needs are established, it’s time to check out options. After determining room availability and affordability, you can begin contacting facilities for tours. Make sure to speak to staff and research each home’s licenses. Below are questions to guide you from the National Institute on Aging:

• What care features does the facility have? Yes, we did cover the types of facilities earlier, but many offer services specializing in specific care. For instance, does the facility have physical therapy if your loved one has mobility issues? Do they have a dementia or Alzheimer’s care unit if they suffer memory decline?
• Is the facility inclusive? Is it easy for residents to get around? Is it safe, inside and out? Are there transportation options for residents to get groceries, visit the pharmacy, and see a doctor?
• What social needs can the facility provide? Are there meals, activities, and social events residents and guests can participate in? Are these features provided frequently? See if you can attend one yourself!
• Pay attention to staffing. Are there enough care providers per resident? Are there doctors? Is there a high turnover? Do staff interact well with residents?
• Plan a follow-up visit. If you’re serious about a particular facility and have already toured it, it’s suggested that you return—this time unannounced. See if the vibes are different. Are residents well-cared for? Is the facility well-maintained?

Also, include those you know in the process. When possible, ask people in your circle if they or their loved ones are happy with the facility.

http://www.LongTermCare.gov lists several services to help you with your journey. These include links to their eldercare locator, tools to find various agency data, and insurance and pricing information.

5. Look for Violations and Certifications

You’ll also want to know if the facility is certified and cited with any violations. Nursing homes are regulated at both federal and state levels, but assisted living communities are only regulated by the state.5 Therefore, data is found in different places depending on facility type.

• Nursing homes: To view data and ratings for nursing homes specifically, visit Medicare.gov/care-compare. Facilities are ranked on “health inspections, staffing, and quality measures.” The organization inspects only Medicare-approved nursing homes.
• Assisted Living Facilities: Due to assisted living being regulated by each state, guidelines and violation reports differ by location. A Place for Mom lists all the nitty gritty details, depending on where you live. Visit aplaceformom.com/caregiver-resources/articles/assisted-living-violations to learn more.

To view Delaware’s licensed and certified long-term care facilities, visit dhss.delaware.gov/dhss/dhcq/licfac.html. To see inspection and complaint reports, visit dhss.delaware.gov/dhss/dhcq/survreptsassistedliving.html.

A Takeaway and Resources

Clearly, many factors must be taken into account when seeking long-term accommodations for an elderly relative. It can be a draining endeavor, so it’s important to remember your well-being, too. Caring for a loved one is a noble and challenging task, and ensuring you stay healthy and supported is essential. You are not alone on this journey, and by considering these pointers and taking things step by step, you can find a solution that ensures your loved one is safe, cared for, and happy.

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References

1. nia.nih.gov/health/caregiving/does-older-adult-your-life-need-help
2. nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes
3. ncoa.org/adviser/local-care/independent-living/
4. nia.nih.gov/health/long-term-care/paying-long-term-care
5. americancaregiverassociation.org/2019/03/how-to-check-for-assisted-living-violations-2/