Long-Term Care Facility – A Conversation Nobody Really Wants to Have…

 In Senior Care
Aged set of hands, folded on a knee.

No one ever says, “Oh, boy, I can hardly wait until I can move into a long-term care facility.” It’s a pretty safe bet that living in long-term care is probably not on your bucket list. Nor would anyone say, “Gee, Mom, don’t you think moving into assisted living would be fun?” or “Dad, I’m going to find a stranger to come into your home and help you take baths.”

We all want to stay as independent as possible for as long as we can, but we may need help when safety and health are at risk. For some, long-term care is a welcome safety net but, needless to say, the move to a long-term care facility is not an easy subject to broach with a loved one. Before you do, it’s important to understand the options.

What is long-term care?

Long-term care includes in-home care, certified family homes, and assisted-living and skilled-nursing facilities. Each provides a variety of designated services to people who can no longer live independently and need assistance with daily living activities.

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The facilities give continuous assistance, social services, and medical care to people with chronic health problems and general vulnerability.

  • In-home care is provided by a service company or individuals hired for a designated number of hours a week to give assistance with bathing, dressing, managing medications, or other needed services.
  • Certified family homes (CFH), overseen by Health and Welfare, provide a family-style living environment for adults who need some assistance with the activities of daily living. Usually there are one or two adult residents in a CFH.
  • Assisted-living facilities(ALF) are residential facility for people with chronic conditions or disabilities. The facilities provide a group living environment and typically offer help with bathing, dressing, eating, medication management, and some medical assistance.
  • Skilled-nursing facilities (SNF) are residential nursing homes that provide 24/7 supervised nursing care or rehab services.

Staying at home

Most of us would rather stay in our own homes, make our own decisions, and take care of our ourselves. But sometimes we need help. In-home care by an agency or individual may provide enough help to keep a person living safely at home.

Family caregiving can be rewarding and stressful. Respite care at a facility for the loved one provides an opportunity for socialization and individual time for the caregiver. In-home care is an additional respite option for family. The Area Agency on Aging is a source of information about available services.

When is a long-term care facility needed?

A move to a facility is usually precipitated by failing health, dementia, or general vulnerability. Families often feel guilty even thinking of putting their loved one in long-term care. Promises have been made and now must be broken, but no one knew how difficult caregiving would be. No one knew the time, attention, energy and unlimited patience needed to keep their loved one safe and cared for.

There may come a time when the care needed is more than can be given by family members or even an agency. It’s then that a move to long-term care is the best solution. Long-term care facilities give continuous care night and day by trained staff.

How do you choose a facility?

Advertisements are meant to grab your interest and may not be nearly as interesting when you show up at the location. Your local Area Agency on Aging and the Ombudsman can provide a list of facilities. Facility visits are a must.

Make a list of questions to ask and things to look for. Talk to management. Ask about services and any other important features.

  • Levels of care and costs
  • Charges for personalized services
  • Medical services and medication management
  • Facility transportation for shopping, banking, etc.
  • Community involvement
  • Available activities
  • Laundry services
  • Anything else you can think of

Have a look around.

  • Is staff friendly and interacting respectfully with residents?
  • Housekeeping: Is the facility neat, clean and comfortably furnished?
  • What do the individual rooms look like?
  • Are the grounds and building well cared for?
  • Talk to residents. Are they happy with the food, staff, services?

When do you begin planning for long-term care?

When you start thinking about it is the time to start planning. It’s never too soon to plan, even if the plan changes over time. Visit or call your local ombudsman (a great source of current information), visit facilities, and make a folder of information. Gathering information and planning is essential, and best done before the situation becomes critical.

Grappling with reality

Even when families make every effort to care for their ailing loved ones, conditions change. Placing a loved one in a facility is difficult and is often accompanied by guilt, hurt and anger, even when it’s the best decision.

If the situation becomes critical and you must make all the decisions, do your homework. Visit several facilities, gather information, include your loved one as much as possible, and continue to offer positive, loving support as your loved one makes the transition to long-term care.

by: Jan Noyes Associate Ombudsman, Area Agency on Aging

Jan Noyes holds a degree in education and has used her teaching skills in public schools, adult education , workshops and seminars for church and civic groups, and corporations. Jan has been an ombudsman with the Area Agency on Aging for ten years, recruiting and training new ombudsmen. Jan also acts as an ombudsman, visiting facilities and advocating for their resident rights, quality of care and quality of life.

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