As seniors, the choices we have for long term care can enhance our quality of life in the best of worry-free environments. Whether you’re a senior or a family member of a senior, there may come a time when one may need to make a decision on choosing long term care options.
With the generation of baby boomers fast approaching their need for long term care, the industry’s environment will change to accommodate the high-tech life they have lived. We will need to adjust facilities and services which not only meet their needs, but will have the capabilities and desire to ensure a quality of life that one expects to enjoy.
Depending on one’s needs and level of care, the choices are varied. Generally, there are different levels of care available in many different settings. Provided services include activities of daily living (ADLs) which are assistance with bathing, dressing/grooming, toileting/incontinence care, transferring, turning/changing position, ambulation, and eating/feeding — these services are available in all levels of care. Nursing needs may be provided in all different settings — at home, in independent living residences, assisted living facilities, nursing homes and rehab centers.
INDEPENDENT LIVING RESIDENCE
This is where seniors may enjoy living in suites or apartments without the worry and hassle of maintaining a home, both inside and out. Typically, all utilities except personal telephone are included in the monthly rate. Other services may include a meal plan, housekeeping, guest rooms, private catered luncheons/dinners, a beauty salon, on-site laundry facilities, personal laundry services, maintenance to the building and grounds, exercise room/equipment, computer/internet media room, shopping trips, social activities and private-duty services. Pets may be allowed. Residents enjoy continued independence in a setting with neighbors who grow quickly to become “family.” Payment options are generally private pay. Independent living may be a transitional step to assisted living and/or nursing care when the need arises. Services from personal care agencies, home health and hospice agencies are available in this setting.
IN-HOME CARE
Local personal care agencies can provide non-medical personal and respite care which is RN-supervised aides assisting with ADLs. They assist with self-administered medications, meal prep/clean-up, housekeeping, making/changing bed/bath linens, personal laundry, errands, and accompaniment to medical appointments and shopping. Other assistance may include help with, errand services, live-in companion, and calling 911 in an emergency. Payment options may be paid by private pay from the client or family, third-party insurance programs, and/or Veterans’ Administration and Medicaid. Doctor-referred home health and hospice services are also available in one’s home
ASSISTED LIVING FACILITY
Licensed by the Virginia Department of Social Services, long-term and respite care are available typically in a home-like setting with payment options from private pay, third-party insurance programs, and/or Veterans’ Administration and Medicaid. Nurses’ aides, registered medication aides and optional professional nurses are on duty around the clock. Services include, but are not limited to:
»Assistance with ADLs
»Assessing and preparing an individualized service plan coordinated by a licensed health care professional with the resident and family
»Medication administration and chart maintenance
»Three nutritious meals and snacks daily with dietary supervision
»Bed/bath linen and housekeeping services»Daily social activities
»Arranged transportation
Assisted living facilities partner with home health agencies and hospice agencies to provide nursing services for residents who then are able to remain in that facility and “age in place.”
NURSING AND REHAB FACILITIES
Licensed by the Virginia Department of Health, these facilities are for those who have a medical need for around-the-clock professional nurses in a medical setting to provide care to meet the needs of the patients. Services include but are not limited to:
»Nursing services by professional nurses and aides
»Physical, occupational and speech therapy
»Assistance with ADLs
»Bed/bath linen and housekeeping services
»Medication administration and treatments
»Three nutritious meals and snacks daily
»Social activities
What should you look for and ask about when inquiring about any type facility? Make sure to tour the facility, including visiting the resident/patient rooms, dining room and kitchen, living room, activity room, and nurses’ station. Talk with the residents/patients and staff. Ask to see their most recent state licensing inspection report, health department report and fire marshal’s report. Ask to see their mission statement. Ask for the rate sheet and any additional services rate sheet(s). Is any deposit or last month’s rent required upon admission? And what is their refund policy?
Ask about the types of staff available daily, for example: management, nurses, floor staff, activities director/coordinator, beautician, housekeepers, dietary, and maintenance. What are their credentials?
What is the staff to resident/patient ratio on each shift? What is the percentage of staff turnover? Were there any offensive odors? Remember that dealing with incontinent residents and patients is an ongoing challenge that requires additional staff efforts on every shift, every day. Are there any additional charges for incontinence supplies — briefs, pull-ups, wipes, underpads, barrier creams, etc? Or can family bring in the supplies?
What kind of call bell system is in place? Is it easily accessible to the resident/patient in their room? What ancillary services are accessible —home health, hospice, PT, OT, mental health day programs, among others.
Do they accept payment from Medicare, Medicaid, Auxiliary Grants (in Assisted Living), third party insurance, or Veterans Supplemental Program benefits? Would they consider a rate waiver for one whose monthly income falls below the current private pay rate?
What type of medication delivery system do they have? Do they accept medication from the Veterans’ Administration for veterans or from a pharmaceutical mail order center? If so, is there a charge to repackage meds to meet the requirements of their current system? Look at the monthly activities calendar, and does it reflect the lifestyle, family values and fun-loving activities that your loved one would enjoy, if participating?
Look at the current monthly menu. Ask if they can accommodate a doctor-ordered special diet. Any charge for it? Can any special food be brought in for your loved one? Ask about a regular residents’ council meeting and/or a family meeting with management to voice opinions and offer suggestions.
Pay attention and listen to the staff’s interaction with the residents, patients and with each other. Were they patient, knowledgeable and caring? Are they a staff who can relate to the generation for whom they are caring? Was the person giving you the tour hospitable? What was your first impression? Then what was your final opinion?
Remember that it’s not just about the chandeliers or furnishings; it’s all about the care given to your loved one in a clean, comfortable, safe setting. Residents/patients have the right to be treated and cared for in a professional and dignified manner.
RESOURCES FOR FACILITY INFORMATION AND HELP WITH MAKING A DECISION
»Go to the facility’s website
»Contact the local area board on aging for referrals
»Contact a Certified Senior Advisor (CSA)
»Contact the local Department of Social Services for a listing of licensed assisted living facilities in your area
»Contact the local Department of Health for a listing of licensed nursing home and rehab centers in your area.