Finding the right place for Mom or Dad is both an art and a science. You have to do your research and trust your gut.
Assisted living facilities are widely available to help take care of older adults who need help with bathing, dressing or other daily activities. When that is no longer enough, a nursing home can provide 24/7 healthcare. Either way, it is important to research facilities to determine which one seems to give the best care.
COST
Before deciding on a live-in facility, make sure that is the option you want to pursue. Include the older adult when considering other care options. A major factor can be cost. In 2020, the Genworth Cost of Care Survey documented median annual costs for five options. (These numbers are not reflective of higher costs in more expensive areas.)
• Nursing home (private room) $105,852
• Nursing home (semi-private room) $93,072
• Assisted living $51,600
• Home health aide (full time) $54,912
• Adult day care $19,236
Check if your parent has long-term care insurance. Generally, it will cover assisted living, but most health insurance plans, including Medicare, do not. It may not cover the full cost of care, either. Read the policy carefully. Medicaid may be an option for those with limited assets or your state may offer some other assistance. Contact Hawai‘i’s Medicaid agency through medicaid.gov to find out more.
Veterans may be able to get help through the Aid and Attendance benefit (va.gov/pension/aid-attendance-housebound). Check with Hawai‘i’s VA pension management center at benefits.va.gov/stpaul. Learn about VA pension benefits at va.gov/pension.
SIZE
Facilities may have just a few patients, or house more than a hundred residents. Each has benefits and drawbacks. A small group home can have a great staff-to-patient ratio where caregivers know every person’s preferences well. They are often located in neighborhoods.
WHERE TO GET A LIST OF FACILITIES
Trying to determine what your options are can be daunting. Here are options you can check out to locate facilities in your area:
• Area Agency on Aging: usaging.org
• Yellow Pages website: yellowpages.com
• Aging Services Directory: leadingage.org/find-member
• Find Senior Housing: directory.alfa.org
• Ask neighbors, friends, doctors and other professionals for recommendations.
SERVICES
Larger facilities can offer more amenities such as libraries, music rooms, gyms, and swimming pools. They are sometimes set up to care for residents who start off in independent living and then transition to assisted living and/or memory care units that specialize in people with advanced dementia. They may also provide transport to stores or to obtain health care. Some may have doctors who make house calls and an in-house hair and nail salon.
Basic services usually include housekeeping, laundry, medication management support, wellness programs and meals. Some facilities may even offer specialized care for those with health conditions.
Consider your mother or father and what activities she or he may be interested in doing. Does the facility offer gardening, art programs, musical outlets, church services or reading material? What about activities for those with impaired sight or hearing? Is assistance available for those who need help eating? Is hospice care available?
Also, check to make sure that the facility will provide additional help to your parent as their needs increase over time.
THE FACILITY
AARP has developed a comprehensive, printable checklist of what to look for in a care facility:(assets.aarp.org/external_sites/caregiving/checklists/checklist_assistedLiving.html). Here is a modified list of the basics to ask about and verify when you visit:
• Cleanliness
• An emergency generator or alternative power source in case of an outage
• Enough common areas, such as living rooms
• A floor plan that is logical and easy to follow
• Rooms adequate for your loved one’s needs
• Rooms/bathrooms with handrails, call buttons
• Safety locks on doors and windows
• Security and fire safety systems
• Services such as banking, a beauty salon, a café
• Well-lit stairs, hallways with well-marked exits
You will want to visit prospective facilities several times before making a final decision. Visit on the weekend when it is likely to be busier. Join Mom/Dad for meals to see if they like the food. Do residents in the dining room appear happy?
TIPS FROM A CAREGIVER
A former caregiver recommends finding out the average salary of the certified nursing assistants (CNAs) and comparing it to other places you are considering. The higher the salary, the happier the help and the better care the residents receive. Ask how many residents are they usually caring for on a shift and if they like working for the facility. You may have to talk to CNAs without any supervisors around to get honest answers.
THE CONTRACT
Don’t sign anything without taking it home and giving the contract a close review. You can hire an elder law attorney (naela.org) to review it. Have other family members go over the document, as well. Check for an arbitration clause
(consumerreports.org/elder-care/putting-the-assisted-living-facility-contract-under-a-microscope), which requires you to give up your right to sue.
Do your research, visit, ask questions and make your decision based on the answers and your gut feeling. Do residents and staff seem happy? Does it smell good? What does your parent think? Can you afford it? The answers will help you find the best facility for your loved one.
CSA (Society of Certified Senior Advisors)
We support specialist in aging dedicated to improving lives of older adults.
1-800-653-1875 | csa.us
Blog posting provided by Society of Certified Senior Advisors, July 17, 2022
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