How to Choose a Long-Term Care Facility


When the time comes for an aging adult to find a place to receive long-term care, exploring the options can be a bewildering experience. The choices for living arrangements vary greatly, as does the cost of the services. In this article, our elder law attorneys at BRMM discuss the factors that the elder and their loved ones should consider during the process of finding the place best-suited for the individual’s long-term care needs and wishes.

Understand the Available Options

The array of choices for long-term care is broad and seems to be constantly expanding. Whether you are a senior choosing long-term care for yourself, or you are helping a loved one make a choice, one of the initial considerations should be which options to consider. You can narrow the suitable choices, based on the senior’s needs and wishes.

Numerous in-home care services are now available and may provide the necessary care, if the elder would prefer to stay at home. Home health services and care management, as well as meal services, in-home chore services, and respite care can be used to provide essential care services separately or in combination. Even home repair, maintenance, and security services for aging adults are now available.

Supplemental services outside the home, such as adult day care and congregate meal services, can be combined with specific in-home services. Community services can also help a senior maintain independence in the community.

Under the Michigan Choice Waiver Program, eligible adults may receive Medicaid benefits for some nursing home services in their own home or in another community residential setting. Exploring available benefits is an important part of evaluating the options available for long-term care.

Housing options are as broad as in-home services. The choices include senior citizen apartments, assisted living, adult foster care (AFC), homes for the aged (HFA), and nursing homes. Each option provides a different level of service. As with in-home services, evaluating whether benefits are available throughMedicaid is an important consideration in choosing a housing option.

Choose a Location

After you have established which options provide the best solution for living arrangements, the next step is narrowing the geographical area. You want to find a location that eases the elder’s transition to long-term care. That usually means staying close to friends and family and remaining within driving distance of familiar places and services.

Evaluate the Care Services

Individual facilities provide different services and levels of care. For each facility you consider, make sure it provides all the necessary services, from assistance with personal care and everyday activities to skilled nursing care and physical, occupational, or speech therapy. Evaluating individual facilities on this basis may help you narrow down the viable options.

Assess the Credentials and Quality of Care

Licensure and reputation are crucial factors in evaluating a facility. If Medicare or Medicaid provides funds to a facility, state surveys evaluating the facility should be available. Public information available online can be helpful in determining the reputation of a facility.

Quality of care provided at a facility is equally important. In part, staffing at the facility bears on this concern. Find out what professionals are present and in charge, and what specialties the medical professionals have. Look for appropriate levels of nursing care and supervision, including the availability of nursing assistants to help with personal care. If the elder has Alzheimer’s or another form of dementia, memory care is a very important service to evaluate.

Determine the Suitability of the Environment

Looking beyond the level and quality of services, evaluation of a living arrangement should include determining whether it provides an environment that suits the individual’s needs. A home-like environment helps ease the transition to long-term care.

Availability and quality of meals and snacks should be evaluated, along with the arrangements and alternatives for dining and sharing mealtime with other residents. Whether a facility provides customized nutritional services and a dietician also may be an important factor.

The privacy of living quarters and ability to have personal effects and furnishings may be a consideration. Community spaces like recreation rooms and outdoor spaces where residents can gather may also be relevant. Organized recreational activities for personal interests and community events should also be taken into account.

Evaluate the Cost

After you narrow down the choices, the central question will be whether a facility or living arrangement is affordable. In making that judgment, all costs, fees, and services should be taken into account, whether they are included in a monthly fee or are charged separately. This difficult part of the process also includes assessing what resources are available to pay for the long-term care, including potential Medicaid benefits.

Get Help Throughout the Process

Many resources are available to help you through the process of choosing a long-term care facility. Your localArea Agency on Aging is a good starting point. TheMichigan Long-Term Care Ombudsman Program provides specific resources relating to long-term care options.

Talk with our BRMM Elder Law Attorneys

Long-term care planning andMedicaid planning are important parts of the assistance our BRMMelder law attorneys provide to seniors and their families. Our compassion, credentials, and commitment set us apart. Call us at 248-641-7070 to talk with us about matters relating to long-term care planning or other areas of concern. We serve clients in Troy, Oakland County, and surrounding areas, as well as out-of-state clients.

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