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How to Find the Right Long-Term Care Facility – Richmond, VA

- Monday, February 08, 2016

Making a decision to move a loved one into a long-term care facility can be tough enough. Sometimes even more difficult, is finding the right facility.

It’s better to do some investigating even if you have to do it quickly,  so you have fewer surprises in the end.

Identifying needs

Before selecting a long-term facility, you should know about the types of long-term care available and what kind your loved one needs.

  • Assisted living

There are lots of options in assisted-living centers, which are generally less expensive and less restrictive than most nursing homes.

Services can vary considerably, but most provide meals, housekeeping, laundry, transportation and social activities. They also often offer assistance with eating, bathing, grooming and personal hygiene.

Many provide some nursing care, including help with medication dispensing.

  • Skilled nursing, including short-term rehabilitation

Nursing homes provide 24-hour care with nursing, social services and activities staff, and serve people with more medical services than are usually given with other care options.

Yet nursing-home care doesn’t automatically mean a long-term stay; more than half of the people who go to nursing homes stay for three months or less.

  • Memory care

An estimated 5.3 million Americans have Alzheimer’s disease.

Alzheimer’s, dementia and memory-care services are often provided in a secure assisted-living or nursing-home setting, usually in a separate floor or wing. Residents might live in semiprivate apartments or private rooms and have structured activities.

The goal is to let people live at the highest level of independence that you can.

Many family members are inclined to pick a more-restrictive setting than a loved one might need or want in order to keep them safe.

Allowing the older adult to have some control in the choice is important because people tend to be happier and do better when they have a stake in the decision.

If you need help determining the proper placement, consider a long-term-care consultation.

The agency will make home visits to review a person’s needs and circumstances.  Consultants — most often a nurse or social worker — will meet with you and other family members for a free assessment of the current situation and future options.

They will explain the available services, eligibility requirements and the financial resources to meet your needs and wishes. Anyone can request a consultation.

Getting started

Once the type of facility that best suits a loved one is determined, the search begins.

Ask doctors, friends and relatives for recommendations.

Community social workers, hospital-discharge planners and residents and family members already living in the facilities you’re interested in can also be helpful.

The fuller picture you get of a place, the better.

Think about whether the center is a comfortable traveling distance from family and friends. And look at the quality indicators compiled by state and federal sources.

When examining the quality indicators, pay particular attention to services that matter most to you.

A facility that has low satisfaction with patient care and is repeatedly cited for medical errors might be a bad choice for a resident who is confined to a bed and in failing health.

On the other hand, a facility with high resident satisfaction that has many activities might be the best fit for a person who is active and sociable.

Whatever you do, don’t look at the quality indicators in a vacuum.

Don’t make quick decisions based solely on these ratings. They’re important but should be viewed as just one piece of the puzzle.

Assessing costs

Long-term care can be expensive, and more than two-thirds of people 65 and older will require some long-term care during their lifetime.

Assisted living generally runs from $2,500 to $4,000 a month, depending on the size of apartment and level of assistance required, said Peters, who works mostly with elderly clients.

Be aware that costs can vary with the residence type, apartment size and services needed. At some places, the basic rate covers all services; others charge extra for special services.

Nursing homes, meanwhile, usually cost between $4,000 and $8,000 a month. Alzheimer’s care ranges from about $3,000 to $7,000 a month.

Unfortunately, where a person ends up often depends on their ability to pay.

People generally have three ways to pay for their long-term needs: personal funds such as a pension, savings or retirement funds; the state Medicaid program, which pays for health care of low-income residents; or long-term-care insurance.

A nursing-home stay can quickly deplete a retiree’s financial resources to the level of poverty, at which point they might become eligible for Medicaid.

Many people used to buy long-term-care insurance because they were scared of the potential costs, he said. But sales of the policies have declined as insurance companies have raised rates and cut benefits, making more people question their value.

Setting priorities

Perhaps the single-most important thing you can do, experts say, is visit the centers you’re considering. There’s no substitute for seeing things firsthand.

Inspect at least three facilities if possible, and stop by each more than once — so you get a sense of the place during meals, at a shift change and at different times of the day and night.

Watch to see whether the staff is friendly, patient and respectful when interacting with residents. Note whether they call residents by name and know the activities each likes or dislikes.

Look for warning signs, such a lot of people crowded around the door, trying to get out.

Other red flags include loud overhead paging, staff members clustered around the nursing station not paying attention to residents, and patients dressed inappropriately for the weather or left unassisted in front of their meals.

Pervasive odors, unclean rooms and unwashed linens might also be signs of an understaffed facility.

Use all of your senses as you walk around.

As much as possible, you want a place that feels like a home — not a hospital or institution — where your loved one will look forward to each day.

It takes your head and your heart to make the right choice. For more information on assisted living facilities, contact Spring Arbor.

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