Choosing the Right Long Term Care Facility

When your loved one can no longer safely live at home and is ready to trade in the responsibilities of a homeowner, an assisted living facility or a nursing home may be the best option. These two types of senior living communities are often categorized as "long term care facilities" as most residents live and receive care in them for many months or years.

Since your loved one is going to live in an assisted living facility or nursing home for an extended period, it can make the decision seem even more daunting. Fortunately, you can narrow your search with a few quick considerations and then spend more time touring and researching places that already meet your preferences, optimizing your time and ensuring you have confidence in the decision you make.

Remember, it's never too early or too late to begin looking at assisted living or nursing home options. In fact, it is much easier for your family and your aging loved one to have a future plan in place that includes senior living. This way, you don't feel pressured to make a quick decision during a health crisis.

Narrow Down Your List

A quick internet search for "assisted living near me" or "nursing homes near me" can yield hundreds of results, which can leave you feeling instantly overwhelmed. First, let's narrow your list by eliminating senior living communities that don't meet your base qualifications and preferences.

By Type of Care

Choosing the right facility begins by understanding that they do not all offer the same type of care. Assisted living facilities are designed for older adults who need support with no more than two activities of daily living, or ADLs. ADLs are the tasks we all do to care for ourselves each day, such as:

• bathing
• continence
• dressing
• eating
• toileting
• transferring

Assisted living facilities have caregivers available around the clock to support residents with these ADLs and respond in case of emergencies.

Nursing homes, sometimes called skilled nursing facilities, are long term care facilities that provide skilled care to residents. Skilled care is given by licensed professionals, such as nurses or therapists. Examples include:

• wound care
• IV care
• pain management
• complex disease management
• feeding tube or catheter care
• medication administration

Nursing homes have both certified nursing assistants and nurses available around the clock, making it a more clinical environment than an assisted living facility. And, while not all residents require skilled care, they typically require assistance with more than two ADLs.

Not sure if your loved one needs skilled care or how many ADLs they need support with? Talk to your loved one's physician to better understand their abilities.

By Location

Now that you have narrowed your list by the type of care provided, you can eliminate more by your desired location. You may consider a convenient location for family members, such as an assisted living facility or a nursing home near a main highway. Or you might prefer to find a place within a favorite or familiar neighborhood.

Long term care facilities can cost more depending on their location. For example, a facility in an affluent neighborhood of a big city might cost more than a community tucked in a rural town. Keep this in mind when determining your desired location.

By Payor Source

Finally, narrow your potential options by how you will be paying for care. Assisted living facilities can be paid for out-of-pocket, which means residents use their retirement funds or money from selling their home to pay a monthly fee that covers room and board, care, and access to amenities.

Nursing homes can also be paid for out-of-pocket, but they are significantly more expensive. Medicare covers skilled nursing at 100% for 20 days and then at 80% for days 21 to 100 annually as long as the resident is eligible and has a three-day qualifying hospital stay.

Residents may be able to offset the cost of a long term care facility if they are eligible for Veterans Aid and Attendance benefits, if they have long-term care insurance, or if they are Medicaid-eligible and the facility accepts Medicaid payment.

During Your Tour

Now that you've narrowed a list of potential assisted living facilities and/or nursing homes to a manageable amount, you can begin researching them and setting up tours. A tour is a wonderful opportunity to meet with key staff, ask specific questions, and get a peek at daily life, how the team interacts with residents, and how the residents look.

Cleanliness and Atmosphere

When touring a facility, observe if it is clean. Does it seem well-kept? Does it feel like home, and is it welcoming? Is there plenty of natural light, or is it dark and dreary?

Staff Interactions

Take a look at how the staff interacts with one another and with residents. Are team members smiling and helpful, or do they appear rushed and frustrated? Does it seem like they know residents well? Are they having positive interactions with the residents they are around?

Meals and Activities

When possible, time your tour around mealtime so that you can see what the dining experience is like. How does the food smell? Is it presented well? Are residents chatting with one another at their dining table?

Observe activities you see happening during your tour. Is the activity something that looks interesting? Are the residents engaged and participating?

Reviews and Recommendations

Finally, consider finding out what others think of the assisted living facilities and nursing homes you are touring. Begin by asking friends and neighbors if they have any experience with senior living communities and if they have any recommendations or poor reviews. Take their experiences seriously, but also remember that each situation is unique. You should also note if there is new leadership at the facility compared to when their experience occurred.

Online reviews can also be a good way to find out initial information. Do your best to give less weight to the best and worst reviews. The reality is always somewhere in the middle. However, if you note that online reviews show a pattern of concern about food quality, for example, add more questions about food and the menu to your list when you make a follow-up call.

Final Considerations

When possible, invite your loved one to participate in the senior living community decision-making process. It will be their home, after all! Invite them to assist you with research, attend tours, and make a list of their own questions and concerns.

You can also take more than one facility tour. You can even ask to attend a meal or an activity with your loved one to get a better idea of what life is like there. Take as much time as you need to make a confident decision.

Good luck!