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How To Evaluate Long-Term Care Solutions
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Business New Haven
11/11/2002
By: Karen Singer
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They've been called the "sandwich" generation.
Baby boomers with children making long-term care decisions about aging – and ailing – parents. It's a daunting responsibility to be sure.
But these days, a growing number of options afford more flexibility than ever before. A greater number of services are available within a local community, and often at home, where many parents would prefer to stay and maintain some semblance of independence and dignity.
Long-term care solutions are increasingly being viewed as part of a continuum ranging from relatively simple help with such daily activities as dressing or medication reminders to more complex health and safety issues. How they're solved depend on the degree of need and economic status of older adults and their families.
Wending your way through the labyrinth is the tough part, particularly in a crisis situation.
Ideally, parents and their children should try to sort out some of the issues before a crisis, but more often than not that doesn't happen.
Whatever your situation may be, the diversity of choices can be extremely frustrating. Don't be shy about getting help. Long-term care experts recommend seeking advice from a variety of sources.
To get a sense of what services and programs you should explore, start with general queries to a local agency on aging or continuing care department at local hospital, then zero in on what you think you will need.
Be sure to figure out, in writing, an honest evaluation of your parent's status, including daily living and health requirements, as well as how much income and other resources, such as savings or sale of a residence, you can spend on care. Wherever possible, include mom or dad in the discussions.
Boomers who may assume Medicare or other government agencies cover most long-term care expenses are in for a rude awakening. Medicare will generally pay for a hospital stay, and for a period of time in a nursing home, as well as some rehabilitation after an acute episode. But Medicare typically covers only a small percentage of expenses for those in need of intense nursing or home health care services. Independent and assisted living facilities costs are almost always the responsibility of the individual or family members.
Elder care attorneys can help you navigate these thorny matters, and other legal issues such as power of attorney and living will. They also may be able to provide advice on living arrangements.
Long-term care insurance also may be an option worth exploring.
In recent years, some employers have begun offering access to long-term care or other types of assistance as part of their benefit package. They're not just being magnanimous. Companies can lose megabucks when employees miss work trying to handle these problems.
For older adults in reasonably good health, requirements may entail the services of a homemaker or companion, adult day care center or assisted living facility. In recent years independent and assisted living facilities, as well as continuing care communities, provide far more than basic necessities. Many have daily activities aimed at stimulating the physical and emotional well-being of residents. And some even resemble fancy hotels or stationary cruise ships.
Some assisted living facilities have a mini-continuum of care, ranging from housekeeping services to an emergency response system. But be aware that as more advanced care is needed, there may come a point where health and safety issues may necessitate a change of venue, perhaps to a skilled nursing facility.
Once you have a better sense of what might work, evaluate your options:
- Interview admissions coordinators at all the facilities or agencies matching your criteria. Find out what levels of care they offer, and what funding they accept. Pin down what's included in the basic daily rate, and what extra services cost.
- If it's a live-in facility, ask about food, staffing, daily activities and safety and security issues.
- Visit your top choices. Then drop in unannounced to get a sense of what the place is really like.
- Find out from program participants or residents what their gripes are about the place.
- If a nursing facility is needed, look for evidence of cleanliness, resident care, good food and friendly competent staff.
- Above all, remember that caregivers can suffer physically and emotionally, too. So do your best to take care of yourself.
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