Choosing Assisted Living Options Wisely
Here’s how to deal with rising costs and caregiver shortages.
Assisted living has become a popular alternative for elderly people in recent years, compared to staying in their homes. They can remain in a comfortable home environment while receiving the services they require, such as assistance with bathing and dressing while avoiding the institutionalized atmosphere of a nursing home.
Finding the proper place to live, on the other hand, might be a difficult task. For one thing, the price is high: according to Genworth, a long-term-care insurer, the median rate for a private one-bedroom soared to $48,000 per year in 2018, up 6.7 percent from 2017. Although some households qualify for Medicaid, the majority of residents pay out of pocket. (Long-term-care services are often not covered by Medicare.)
Furthermore, determining the kind of care, that your loved one will receive might be challenging. According to state long-term-care for ombudsmen, several residents have complained about caring shortages. (Under federal law, every state is obligated to have an ombudsman who advocates for people receiving long-term care services.) That’s why, before you sign up, you should ask a lot of questions and conduct some research; more on that later.
Understaffing and delays in responding to pleas for assistance were the most common complaints, according to a Consumer Reports poll of state long-term-care ombudsmen performed in 2017. Complaints regarding assisted living have grown 10% in recent years, according to ombudsman data.
Lori Smetanka, executive director of National Consumer Voice for Quality Long-Term Care, an ombudsman advocacy group, says, “Many more people moving into assisted living facilities today have high care needs.”
Rather than focusing on the mechanics of caring, many assisted living facilities prefer to highlight their amenities, such as restaurant-quality meals, beautiful lobbies, and cultural event calendars. According to David Grabowski, a professor of healthcare policy at Harvard Medical School, such marketing technique recalls the origins of assisted living, which came out of the hospitality business.
Grabowski explains, “The assisted living sector originally targeted healthier older folks with hotel-like services. However, given the increased prevalence of chronic illness and medical complexity among its residents, some in the business are adopting a new paradigm that emphasizes the need to provide both health care and hospitality services.”
Questions to Ponder
Families looking for assisted living for a loved one have options for finding a facility that provides exceptional care in a welcoming environment. According to Amy O’Rourke, an aging-life-care expert in Maitland, Fla., and a member of the board of directors of the Aging Life Care Association, a nonprofit membership association for care managers, the key is to conduct thorough research.
Begin by considering the following five crucial questions:
1. What kind of assistance is needed?
It’s a good idea to have your family member evaluated by a doctor so that you can have a clearer picture of the degree of care needed and how it can vary. Then you’ll be able to know if the facility will be able to meet your loved one’s long term needs.
Consider the type of assistance you or a family member requires now and in the future, according to O’Rourke, based on the professional’s advice. Maybe your loved one might benefit from greater social interaction, or maybe they’ll need more medical attention or memory aid. Different facilities provide different degrees of care—not all, for example, have memory units. The social events differ as well, so investigate whether reading groups or excursions to the symphony are something your loved one might enjoy.
You can start looking for assisted living facilities after you know what to look for. Eldercare Locator, a program of the United States Administration on Aging, is a terrific place to start. You might ask one of their local aging-life-care specialist for some advice.
2. What Is the Care Quality?
Examine the property’s license and inspection records to discover if there are any red flags. You might be able to obtain this information online depending on your state; contact your state’s Area Agency on Aging for more information. You can also inquire about the facility’s complaint history with your state’s ombudsman. (Go to ltcombudsman.org and utilize the map tool to identify state-specific links.)
You should also inquire about the presence of a registered nurse on the premises. Bobbi Kolonay, R.N., an aging-life-care manager in Pittsburgh, says that if the facility doesn’t have one, your loved one may end up traveling to the ER more frequently.
Make several trips to the facility to acquire a sense of the quality of life. Go at mealtimes and on weekends when there are fewer people on duty. Also, inquire about the inhabitants’ and their families’ experiences.
3. What Are the Real Care Costs?
As previously stated, the average cost of care is considerable. Add-on fees could drive up these expenditures even more, stretching or beyond many seniors’ budgets. (For more information on how to pay for assisted living, see this article.)
Make sure you acquire a documented list of the residence’s fees and charges, and double-check that they’re included in the contract. Some facilities offer an all-in fee for lodging, board, and a specific level of care, while others use a point system or charge à la carte. Find out what circumstances may result in higher prices, such as requiring assistance walking to meals or becoming ill for a week or more.
Given the high costs, hiring an elder law attorney who is familiar with local facilities to analyze the contract provisions can be a wise decision.
4. What Is Best For Your Loved One?
One of the most serious dangers for assisted living clients is that their health demands may change, necessitating care that surpasses the facility’s capacity to give it—for example, cognitive deterioration or a loss of mobility. Moving to a facility that can meet their needs would be the best option. The resident may face an involuntary discharge or eviction if this transfer is not scheduled ahead of time.
Find out ahead of time what circumstances would necessitate a release and whether you could hire private aides if more care is required—in certain cases, the person may be able to remain in their current residence with additional assistance. Inquire about the facility’s ability to assist if a move is required.
Some nonprofit facilities, for example, may assist a low-income person in qualifying for Medicaid, which may pay for nursing home care or finances to allow your loved one remain in their home.
5. Are There Any Care Gaps?
It’s critical to have relatives and friends visit your loved one once you’ve selected a place for them to live. You’ll be able to detect any care gaps sooner, which is especially crucial if your family member is ill or confused and unable to speak for herself.
If you or your family is unable to visit on a regular basis, try hiring a caretaker or asking a friend who lives nearby to do so. Early detection of problems may help to avoid more costly difficulties later. And letting the assisted living management know that you’re keeping a close eye on your loved one can help to guarantee that they’re getting the best care possible.
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