WHAT TO KNOW ABOUT LONG-TERM CARE BEFORE YOU NEED IT

By Rachel Tate, MSW

When it comes to looking at options for care in a nursing home or residential facility, the task can be daunting. Often, this isn’t even a consideration by most of us until we or our loved one has a medical emergency and decisions about care need to be made quickly. Planning and understanding the types of care that are available in advance can make a stressful situation much easier to handle.

For most individuals considering a facility, whether short or long term, there are two main types: skilled nursing facilities and assisted living facilities.

Understanding the difference in levels of care can be the first step to ensuring a good fit for placement.

Skilled Nursing Facilities

A skilled nursing facility (SNF) provides 24-hour skilled nursing and other rehabilitative services which can include, but is not limited to, physical therapy, occupational therapy, and speech therapy. Individuals are admitted under the care of an assigned physician and the facility is required to develop an individualized plan of care with the resident (or their representative), the physician, and facility staff. The care plan should include elements necessary to help the individual attain or maintain their highest feasible level of functioning. This includes plans for recreation and social activities!

WHAT DOES A NURSING HOME COST?

Medicare only covers a skilled nursing facility stay for a very limited time. Most skilled nursing facilities accept Medicare, Medi-Cal, private pay, and other insurances. It is important to understand what types of payment the facility accepts prior to admission. The cost of skilled nursing care can be high. And, even if you or your loved one do not qualify for Medi-Cal at time of admission, choosing a facility that accepts Medi-Cal could prevent having to move again at a later time.

Assisted Living Facilities

Assisted living or board and care facilities are licensed as residential care facilities for the elderly in California. They can range from small six bed private homes to large multistory high-rises. These facilities provide care and supervision in a non medical environment. Ideally, these facilities are best suited for individuals who cannot live on their own, but do not require 24-hour nursing care. Importantly, Medicare does not cover the cost of assisted living and most individuals pay privately or through long-term care insurance. Some buildings accept SSI payments for those who qualify. While the type of care and payment are important, it’s important not to lose sight of how you or your loved one will feel living in this type of facility. One that is close to home could allow for more frequent visits from family and friends. A personal visit to the location is critical. Request a tour of the facility and make sure to be on the lookout for activities, interactions between residents and staff, and the suitability of the overall environment. Consider if the location seems comfortable, homelike, and safe. Does the facility offer things that are important to you or your loved one?

WHILE THESE ARE COMPLEX DECISIONS, YOU ARE NOT ALONE. THE WISE & HEALTHY AGING LONG TERM CARE OMBUDSMAN PROGRAM WEBSITE PROVIDES INFORMATION AND A FACILITY LOCATOR TO HELP MAKE SEARCHING FOR FACILITIES EASIER. PLEASE VISIT: WWW.WISEOMBUDSMAN.ORG

OMBUDSMAN REPRESENTATIVES ARE ALSO AVAILABLE FOR FREE AND CONFIDENTIAL CONSULTATION AT: 800-334-WISE (9473).