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Long term care: Early planning pays off
It's best to talk about long term care early — before the need for medical or personal care is imminent. Here's help understanding, choosing and financing long term care.
By Mayo Clinic staffLong term care is a general term used to describe various home and community-based services for people who need help taking care of themselves. If you're considering long term care options for yourself, a parent or another loved one, start the research and discussions early. If you wait, an injury or illness might force your hand — leading to a hasty decision that everyone may later regret. Instead, get familiar with long term care options now.
Understanding types of long term care
Understanding the various levels of long term care can help you choose the type that's most appropriate for you or your loved one. For example:
- Home care. Personal or home health aides may help with bathing, dressing and other personal needs at home, as well as housekeeping, meals and shopping. Home health nurses provide basic medical care at home.
- Day program. Day programs for adults offer social interaction, meals and activities — often including exercise, games, field trips, art and music — for adults who don't need round-the-clock care. Some programs provide transportation to and from the care center as well as certain medical services, such as help taking medications or checking blood pressure.
- Senior housing. Many communities offer rental apartments intended for older adults. Some senior housing facilities offer meals, transportation, housekeeping and activities.
- Assisted living. Assisted living facilities offer staff members to help with medications, bathing, dressing and basic medical care — as well as meals, transportation, housekeeping and activities. Some assisted living facilities have on-site beauty shops and other amenities.
- Nursing home. Nursing homes offer 24-hour nursing care for those recovering from illness or injury. Nursing homes also offer end-of-life care. Services may include help bathing, dressing and toileting, wound care, rehabilitative therapy, and help with respirators or ventilators.
- Continuing-care retirement community. Continuing-care retirement communities offer several levels of care in one setting — such as senior housing for those who are healthy, assisted living for those who need help with daily activities, and round-the-clock nursing care for those who are no longer independent. Residents can move among the various levels of care depending on their needs.
Choosing the right long term care facility
With all the options available, selecting a long term care service can be overwhelming. Ask yourself these questions to make the process easier:
- What level of service do you need? Do you or does your loved one need help with everyday chores? Nursing care? What does the doctor say? Determining specific care needs can help you decide what type of facilities to consider.
- What are your personal preferences? Would you or your loved one prefer a smaller facility, a certain location or certain living arrangements, such as a single room? Would you rather eat your meals in a cafeteria setting or in your own room? What amenities are most important? Also consider the rules. Can residents choose when to get up and go to bed? When are visitors allowed? What social activities are offered? Can residents continue to see their personal doctors?
- What can you afford? Get the details on prices, fees and services. Know what's included in the monthly fee and what costs extra.
- What's available close to home? Being close to friends and family can ease the transition to long term care. If vacancies are an issue, ask about waiting lists.
- What's your first impression? Schedule a tour of the facility. Does the facility seem safe? Does it smell OK? Is the temperature comfortable? Are the residents treated respectfully? Do they seem happy? Are there enough caregivers on staff? What are the rooms like? Later, make unscheduled visits to make sure your first impression was accurate.
- How does the facility compare with others? What have you heard about the facility? Call the Better Business Bureau to check whether any complaints have been filed against the facility, and use online applications such as the Nursing Home Compare tool on the Medicare Web site. Ask a long term care ombudsman — on official who investigates complaints against long term care facilities — about the strengths and weaknesses of specific facilities. To find a local ombudsman, use the Eldercare Locator, an online service of the U.S. Administration on Aging.
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References
- Long-term care. U.S. Department of Health and Human Services. http://www.medicare.gov/longTermCare/static/home.asp. Accessed Sept. 29, 2009.
- Types of long-term care. U.S. Department of Health and Human Services. http://www.medicare.gov/longTermCare/static/TypesOverview.asp. Accessed Sept. 29, 2009.
- Paying for long-term care. U.S. Department of Health and Human Services. http://www.medicare.gov/LongTermCare/Static/PayingOverview.asp. Accessed Sept. 29, 2009.
- Steps to choosing long-term care. U.S. Department of Health and Human Services. http://www.medicare.gov/LongTermCare/Static/Step4.asp?dest=NAV%7CSteps%7CStepsOverview%7CStep4#TabTop. Accessed Sept. 29, 2009.
- Garavan R, et al. When and how older people discuss preferences for long-term care options. Journal of the American Geriatrics Society. 2009;57:750.
