Aging parents. We want to honor them. We want them to be happy. We want them to be properly cared for. We want them to be comfortable. What if they want to stay in their own home? What if they are not able to care for themselves, yet they insist on staying in their own home? What if they need some medical assistance, but do not have the financial resources for that care? Should you move them into your own home? Should you try to find in-home care?
These are just a few of the issues you might encounter, as you wrestle with this complex situation. We obviously cannot answer these questions for you, but we can shed some light onto some of the resources, and options available to you, so that you can make an informed decision for your family.
Aging at Home
All of us want to live independently in their own home…right? “Aging at Home”, is the first and most palatable option for most seniors. If your parents have a supportive community close by, can make some modest modifications to their home, and can afford to bring home health care professionals into their home if needed, this can be a feasible option.
If Independent living is no longer appetizing, the next least invasive option is called “Assisted Living”. These are facilities that provide a wide menu of services, as well as housing in an apartment or community environment. Services can include meals, exercise, limited housekeeping, laundry, beauty and hair services, entertainment, and even transportation. Medical assistance is typically very limited. Assisted Living facilities come in a wide variety of formats including apartment units and even single-family homes within a compound community.
If your parents need skilled nursing and a high level of medical care, in addition to the services typically found in an Assisted Living facility, then a “Nursing Home” is the next level care that would be appropriate. These are full scale, 24/7 facilities available in single or shared room formats. This is what people traditionally think of when they think of Senior Living facilities….whether the image is positive or negative. It is not uncommon for Nursing homes to also offer “Memory Care” as an option for those suffering from one of the many forms of dementia.
Continuing Care Facilities
Within the last 20 years, a new format has emerged that is gaining traction…. For those that are ready to sell their home, and simplify their lives, the “Continuing-care retirement communities”, (CCRC) are gaining in popularity. These properties have independent living, assisted living, nursing home care, and memory care all within the same facility. These are popular, because as your parents age and matriculate they can remain on the same property without losing access to their social community. The key differentiator with CCRC’s is the fact that there is typically a substantial financial commitment required which is largely then refunded back to the family when your parents vacate the facility. The other two facilities are simply a “pay as you go” format.
Questions to ask
So…if you….or your parents are ready forgo “Aging at Home”… and select an Assisted Living, Nursing Home, or CCRC, how does one go about selecting the right facility? Here are some things to think about:
- What is the monthly cost of the facility? Is there a deposit required? Is it refundable at 100%?
- What is inflation history of the monthly cost?
- Is financial assistance available?
- Are meals included? How many? Can the meals be tailored?
- What amenities are provided? Is there a cost to any of these amenities?
- Are pets allowed?
- Is transportation to doctor visits included?
- Is a health screening performed upon admission?
- What is the proximity to the medical district? Shopping centers?
- What is the proximity to your support community?
- What is the social environment? What activities are included? Is there a social director?
- Is there a contract? What are the rules?
- What is the training for the staff? Are there background checks?
- What is the security?
- Is Housekeeping included?
- Is the facility properly licensed and accredited?
- Are there visitation rules or limits?
- What is the available of medical assistance?
- What types or resources are available 24/7?
- What is the ownership structure of the facility? Is it privately or publicly held? Is it solvent?
This is just a starter list of questions you will want to ask as you vet the right facility for your parents. Whether your parents decide to “Age at Home”, or select Assisted Living, Nursing, or a CCRC, I hope this has helped cut through some of the terminology and confusion of this stressful, yet pivotal decision. If you have any questions, or want to drill down deeper on any of these topics, feel free to give me a holler!