Be aware that figuring out care for the long term
isn't easy. Needs may change over time. What worked
6 months ago may no longer apply. Insurance coverage
is often very limited and families may have problems
paying for services. In addition, rules about
programs and benefits change, and it's hard to know
from one year to the next what may be available.
A Need for More Care
At some point, support from family, friends, or
local meal or transportation programs may not be
enough. If you need a lot of help with everyday
activities, you may need to move to a place where
care is available around-the-clock. There are two
types of residential care:
- Assisted living arrangements are available
in large apartment or hotel-like buildings or
can be set up as "board and care" homes for a
small number of people. They offer different
levels of care, but often include meals,
recreation, security, and help with bathing,
dressing, medication, and housekeeping.
- Skilled nursing facilities --"nursing
homes"--provide 24-hour services and
supervision. They provide medical care and
rehabilitation for residents, who are mostly
very frail or suffer from the later stages of
dementia. Sometimes, health care providers offer
different levels of care at one site. These
"continuing care communities" often locate an
assisted living facility next to a nursing home
so that people can move from one type of care to
another if necessary. Several offer programs for
couples, trying to meet needs when one spouse is
doing well but the other has become disabled.
Finding the Right Place
To find the residential program that's best for
you:
- Ask Questions. Find out about specific
facilities in your area. Doctors, friends and
relatives, local hospital discharge planners and
social workers, and religious organizations can
help. Your state's Office of the Long-Term Care
Ombudsman has information about specific nursing
homes and can let you know whether there have
been problems at a particular home. Other types
of residential arrangements, like "board and
care" homes, do not follow the same Federal,
state, or local licensing requirements or
regulations as nursing homes. Talk to people in
your community or local social service agencies
to find out which facilities seem to be well
run.
- Call. Contact the places that interest you.
Ask basic questions about vacancies, number of
residents, costs and method of payment, and
participation in Medicare and Medicaid. Also
think about what's important to you, such as
transportation, meals, housekeeping, activities,
special units for Alzheimer's disease, or
medication policies.
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