10 Tips to Choose Long Term Care Options

You've put off the decision to move to a nursing home for so long...and who can blame you? No one wants to leave home. But is this going to be a permanent move or just a temporary, short-term rehabilitation?

But don’t get caught trying to make a decision at the last minute! There are plenty of things you can check out ahead of time to be sure you’ve made the right decision about where you could be living.

1.     How Far Away?
You want to be sure that your new home is located close to friends and family. If it’s convenient, it’s easier for family members to pop in for frequent visits and for friends to remain close.

2.     See It For Yourself
You didn't buy your house sight unseen, did you? This is going to be your home, potentially for many years, so make sure you thoroughly check it out in person. Do the rooms seem homey and comfortable? How are they decorated? Be sure to meet the staff, talk with some residents, walk the grounds, and check out the facilities. Perhaps you'd like to have a nice quiet reading room, or a place to play backgammon outdoors when the weather is nice. Be sure the facility will fit your lifestyle and interests, today and tomorrow. Ask if you can stroll around on your own - without an official guide giving you the standard sales pitch.

3.     What Is Your Budget?
Paying for a long-term care facility is complicated. Remember that Medicare only pays for temporary stays at a facility (usually after a hospitalization.) Medicaid will pay for about half of a long-term (or permanent) stay...but with a number of caveats, including shared rooms and fewer choices of location. It's important to understand the financial aspects, and realize you may not be able to afford the height of luxury. Planning - in order to stretch those dollars out - is the key to avoiding unexpected (and unpleasant) results later.

4.     Understand Your Care Needs
Facilities offer a wide range of care – from skilled nursing care to specialized care to general assistance. Do you need help getting dressed? Do you need to be reminded to take your medication? What about in the future? Don't be afraid to ask questions about help you may need in the future, even if it doesn't apply to you today.

5.     Research - Research - Research!
Your kids (and their kids) love to use the internet....so make them do some homework! Medicare has a website (www.medicare.gov) that allows folks to find and compare facilities. Every state also has a long-term care ombudsman available. They can help you discover if your selected nursing facilities are in great shape!

6.     Is There a Doctor in the House?
The facility's doctor will likely take the place of your primary care physician once you become a resident. Since they'll be providing most (if not all) of your medical needs, learn as much about them as you can. What levels of medical care can the doctor and the facility offer, and are they capable of meeting your needs into the future? What kinds of emergencies are they trained - and equipped - to handle? How often will the doctor meet with you?

7.      What is the Staff-to-Resident Ratio?
This is a very important number, since it's an indicator of the amount of attention you can expect to receive. Patients with certain conditions should make sure that the staff-to-patients number is higher than in a general assistance facility. For example, one staff member to four Alzheimer's patients is considered a good ratio. Residents who are lucid and reasonably healthy generally require less care (usually 1-to-8). Be aware that staff-to-resident ratios are typically lower during the night.

8.     Get a Taste
When you visit facilities, ask if you and your loved ones can join the residents for dinner. You’ll want to get a sense of the quality of the food – and whether staff is available to assist those residents who have trouble feeding themselves. Are there plenty of choices at mealtime? What about dietary restrictions, or the availability of healthy foods? Are snacks available throughout the day? This will be your home and satisfying meals are important to your comfort.

9.     Volunteers Can Make a Difference
Do volunteers work in the facility? Are they screened ahead of time? Places that are open to outsiders may indicate that the facility places importance on open interaction with the community at large - a great benefit to active seniors. On the other hand, some facilities may also manage dementia or Alzheimer's patients, and need stricter controls on access to prevent injury to residents.

10. Time for Fun!
Since this decision is all about your future, you’ll need to know what kinds of activities the facility offers. Many facilities have Activities Directors...so find out how often they are on site. What types of events are routinely planned, and do residents have a say in what they'd like to see and do? Is there variation in the 'daily fun' routine?