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Choosing a continuing care facility

When the time comes for you or an elder relative to choose a continuing care facility, there are many options, and many things to consider – cost, location, type of care, and maybe most importantly, the emotional toll it will take. Deciding to leave your home can be very difficult, and sometimes an outside opinion can be very valuable.  Here at Traphagen Financial Group we offer a life-cycle of services, which includes planning for retirement and beyond. Contact us today to see how we can help with this life transition.  

What Kind Of Care Are You Looking For?

In-Home Care

There are generally three categories of in-home care. Housekeepers will take care of basic household tasks like laundry, dusting, cleaning etc.  Homemakers will assist with more in-depth household management including meal preparation, personal care services, and medication management. The third type of in-home care is a health aide or visiting nurse, who assist’s with personal care, dispenses medication and report’s back to the elder’s primary nurse, therapist or doctor.  Medicare may cover the costs of an in-home aid or nurse if it has been ordered by a doctor, for a limited amount of time.

Adult Day Programs

Adult day care programs provide respite for families who have an elder living with them, but have to work during the day. There are programs that emphasize social interaction, and programs that fulfill medical needs.

Independent Living Facilities

Independent Living Facilities provide elders with a community of others in similar circumstances, while still providing them with the opportunity to live independently.  They generally have social and recreational activities, and sometimes transportation services. There is not usually any health care services or assistance with daily activities. 

The cost is generally comparable, or a little higher, than rates paid to live in regular apartments. Medicare does not assist with the costs of independent living facilities.

Assisted Living Facilities

Assisted Living Facilities offer residents help with daily activities, while also offering an essentially independent living arrangement. Recreational and social activities are available, as is access to personal care workers. Elders will generally occupy their own unit or apartment from which they can come and go as necessary.

Costs for assisted living facilities reflect local market prices, and are adjusted up or down depending on the nature of services the facility agrees to provide. Monthly rates may vary from less than $4,000 a month to over $10,000 a month.  Payment is generally out of pocket using private funds.

Nursing Homes

Nursing homes are the option that many families decide on if their elders need round the clock care. Residents will be cared for by licensed professionals and will stay in a room that may or may not be private. Nursing homes are considered “all-inclusive” –      housekeeping, laundry services, meals and care are generally provided.

Costs vary depending on the degree of care required and the area of the country the facility is located in. Nursing homes are federally regulated, and may be covered by Medicare if residents are eligible.

Dementia Care Facilities

This type of facility specializes in the care of elders with Alzheimer’s or other forms of dementia.  These facilities provide assistance with daily living, have skilled nurses on site, and may offer a range of social and community activities. Fees are generally paid through a combination of private and Medicare funds.

Continuing Care Retirement Communities (CCRCs)

Continuing care communities offer the widest range of care, generally including all or most of the types of care listed above.  Residents live privately and care is offered a la carte - from basic assistance with daily living activities through to skilled nursing care. These facilities are suited to most elders, especially those with progressive conditions that will cause them to decline over time. Costs vary greatly, and are generally paid through private funds.

Find A Community

Start by contacting the Area Agency of Aging in the area you want to live for a list of CCRC’s in your area.

Once you have made a list of a few facilities, start making phone calls to see if they have vacancies, what they charge, and if they provide the type of services you need.

Take a tour and have a meal in their dining hall. Ask lots of questions! To check up on the facility, call the state long-term care ombudsman and use the Medicare nursing home comparison tool.

What Questions Should I Ask?  

  • What is the provider’s background and experience?
  • Are all levels of care licensed or certified by the state?
  • Is there an entrance fee, how much is it, and can it be refunded based on length of stay?
  • What is the monthly fee?
  • What happens if the fee goes up and I can no longer afford it?
  • Do the fees change if my level of care changes?
  • What is included in my regular fees?
    • Meal Services
    • Special diets/tray service – Can I eat in my own room?
    • Utilities
    • Cable TV
    • Furnishings – Can I bring my own? Can I redecorate?
    • Unit maintenance
    • Laundry
    • Housekeeping
    • Recreational activities
    • Physician services – can I choose my own doctor?
    • Dental and eye care
    • Personal care services
    • Drugs, medication and medical equipment
    • Emergency call system
  • Who decides what care I need, and on what grounds?
  • What are the staffing levels?
    • Will there always be someone available for my personal care?
  • If I need assistance with personal care, will I be able to set my own schedule or will it be decided for me?
  • How are disputes handled?
    • Either between residents and other residents or between residents and staff
  • Is it a Medicaid facility?

Can I afford it?

This is the big question.  Can you afford the ongoing costs of the level of care you need. Do you have a trusted accountant or financial advisor? Have you planned for retirement? Contact us today to discuss your options, and how to design a safe and comfortable financial plan that will account for all eventualities.

 

More Resources

http://time.com/money/4579934/continuing-care-retirement-communities-cost/

http://www.nextavenue.org/advice-on-moving-to-a-continuing-care-retirement-community/

https://www.seniorliving.com/article/eight-questions-ask-choosing-continuing-care-retirement-community