Click here to read Silver Senior Alert Part 1– When Do My Loved Ones Need Senior Care?
Once again one may blend the adult day care program with personal in-home care to achieve the required level of care. Adult day care centers exist that specialize in care for those suffering from dementia issues. Many people ultimately chose full-time, out-of-home care. It may be an evolutionary process involving all of the situations cited previously. As you probably guessed by now there are even more options to explore. The two basic categories are skilled nursing and assisted living.
Residence at a skilled nursing facility is most similar to what you senior loved one may refer to as “being placed in a nursing home.” However, today’s skilled nursing facilities bear little resemblance to that description. They are designed to provide skilled clinical care on a 24-hour basis.
Likely candidates for long term care in that kind of location may have significant issues such as severe breathing difficulty requiring a ventilator or perhaps requiring a feeding tube for nourishment. Other medical factors may be involved. Skilled nursing facilities often provide short-term rehabilitation following an acute care hospital stay for such things as surgery or stroke recovery.
Hospitals provide a form of out-of-home care. Generally the stay in the hospital is rather finite, depending of course on the reason for hospitalization. The purpose for mentioning hospitals in a long-term care article is that there are several such facilities offering special consideration for seniors. They may have a senior-specific care division within the building itself with specially trained staff and providers. They may even have a Senior Care Program designed to assist patients experiencing mental, emotional or behavioral needs.
Many of the residents that would have formerly been described as living in an “old folks’ home” now live in assisted living communities. Assisted living communities provide care for seniors with needs for activities of daily living. Those activities include such things as grooming, dressing, bathing, meal preparation, cleaning, among others. The residents generally live in a smaller apartment or bedroom that may be a companion arrangement similar to a dorm room.
Within the larger community one finds common areas for dining, activities, and general socialization. These communities vary in the levels of care that they provide. Some communities provide specialized memory care for those with dementia. There are a few that are dedicated specifically to memory care residents, such as the Barton House in Sugar Land, Texas. It is incumbent on you to visit the communities that you are evaluating to see if their care provisions meet you loved one’s needs.
Many families suspect that this type of long-term care will ultimately be necessary but do not actually visit communities until a physical or emotional trauma forces action. Keep in mind that the best time to evaluate communities is when you do not yet need them, so that you can remove emotional stress from the criteria. Trust your instinct when evaluating communities. Ask such questions as, “Would I want to live here?” You will generally find a place that just feels right.
The final piece of the long term care puzzle involves end-of-life care. Professional assistance is available for families dealing with this issue. It is called Hospice Care. Hospice organizations also subscribe to the process of employing specifically vetted and highly trained individuals experienced in handling the unique factors encountered in this most difficult of times.
Hospice Care is however somewhat different because the care can be delivered in a variety of settings. One may move their loved one to a special in-patient Hospice facility. Additionally, care can be provided right in the home or even at a long-term care community such as skilled nursing or assisted living. Once again your geriatrician is a great resource in finding this type of care.
The task of evaluating professional options for care may seem quite daunting. It is, but you can find help. Revisiting the discussion of the experience the geriatrician that you selected offers you one avenue for help. Also Geriatric Care Managers are professionals skilled in exactly this sort of evaluation process. You can search for one near you at Care Manager. As well there are organizations for on-line matchmaking for you and a community such as A Place For Mom .
They know the communities from personal visits and can get you pointed in the right direction based on care needs and family budget. Another vital resource is an elder law attorney. A broad spectrum of legal and estate issues loom when evaluating long-term decisions. A good attorney with strong experience in dealing with estate planning is invaluable.
The big questions still looms. How does one pay for the care? Long-term care is far from inexpensive, but the alternative of perhaps seeing your loved one cited on the electronic billboard can be a strong counter-argument to care costs.
- In-home professional care averages $10-$25 per hour. Some negotiation can be effected for 24-hour care.
- Adult Day Care runs $50-$80 daily. Assisted living costs vary: $2,000-$8,000 monthly depending on the care needed and the specialization of the community.
- Skilled nursing facility costs run $6,000-$9,000 monthly.
Medicare may pay for some short-term rehabilitation costs in a skilled nursing facility, but covers no cost for long-term care in any setting. Medicare will also pay for in-home Home Health services, but not the non-medical home care costs. For the most part these costs are paid directly by families. Also Medicare does provide funding for Hospice Care. As you would expect Medicare does provide coverage for most services at a hospital.
If there is veteran status of your senior, either as self or spouse, then the Veterans Administration has a program called Aid and Attendance that may provide anywhere from $1,000-$2,000 monthly, dependent on cost of care and financial need. See the VA web site at www.va.gov. Also the elder law attorney can provide assistance with the VA issues. Some of your senior loved ones may hold long term care (LTC) insurance policies. These policies are designed for exactly this kind of need.
However, many older LTC policies were written when there really were only “nursing homes” available. When you investigate your loved ones paperwork you may want to consult a professional such as attorney or your own insurance agent to verify coverage concerns. At a minimum call the issuing company to get clarification. By the way, those of you gasping at the care costs cited might want to consider purchasing a LTC policy for yourself.
Many families decide to sell their senior loved one’s property to help pay for care. Often the house has full equity value since the mortgage has been paid. Indeed, it has probably enjoyed a dramatic rise in value since purchased. Thus, the asset base created from the sale may last a long time. This is a good option for those would have only one surviving spouse living at that former homestead.
If both of the senior couple are still living you can still exercise the property sale option, but you must realize that one person may not require care. They could potentially move in with you or another loved one. Additionally, there are some assisted living communities that can accommodate a couple. As with most anything else there is an increased price with two people involved. A final payment option rests with Medicaid funding. This is heavily based on financial need.
Frequently, all assets must be liquidated prior to application for the approval process. Generally, there is a significant waiting list for care provision from authorized Medicaid providers. You should check with your local county or state officials.
Care considerations can appear overwhelming. Remember to approach your fears for the safety and well-being of your senior loved ones in deliberate fashion. It is always important to consider what is best for the loved one in need. Emotional and financial considerations may impact your progress, but progress itself is very important. The most significant lapse in the entire process occurs when loved ones know that a problem exists, but avoid taking any action to help the situation.
Family meetings may prove necessary. Discussion of that subject requires an entire saga of its own. Suffice to say that the well-being of the one in need should be paramount in any deliberations. Just remember that electronic billboard, “Searching for missing elderly…’ and keep that from becoming your loved one.
The author, Steve Andriko, has been involved with care for seniors, both health-related and long-term for a couple of decades. He currently performs a marketing assignment at a specialized memory community.