Finding care that is right for you and your family.

Living options for the elderly. Independent Apartments Congregate Properties Assisted Living CCRC’s Nursing Homes Personal Care Homes In Home Care

Options to Pay for care? Private Pay –From resident or families cash reserves. Medicare (short term only) –Will pay for care in some facilities for rehabilitation. Medicaid –For elderly who meet the income requirements for need. Will cover all of nursing home expense minus a monthly stipend. Long Term Care Insurance –If resident has purchased insurance it may cover their expenses in different facilities depending on the need of the resident and the facility.

Independent Apartments For those with an active lifestyle who need little outside support. Can do most Activities of Daily Living (ADL’s) without assistance. May get outside help in apartment if needed. Most all apartments are private pay. May or may not be rent subsidized ie: HUD

Congregate Properties Can do most Activities of Daily Living (ADL’s) without assistance. Offer some supportive services for the elderly. May have meeting rooms and planned group activities. Mostly known as Aging Communities or naturally occurring communities. Most properties are private pay.

Assisted Living Range in care based on size and level of care provided but are licensed by the state. Offers services including, medication management, prepared meals, laundry, housekeeping, transportation, etc. Offer planned activities as well as group meetings. May offer Hospice Services. Most are private pay, a few have a minimum number of beds available for Medicaid, but most have a waiting list, may be possible to get funding from the state (Community Based Alternatives).

Continuum Care Retirement Communities (CCRC’s) Offer services ranging from independent apartments, assisted living, and nursing care. May be a “buy in” or “Life Care” program, where you pay an upfront fee to live in the facility and some may offer a return on your investment. Allows resident to “age in place” May allow residents to adjust easier to changing levels of need. May offer Hospice Services, Most CCRC’s are private pay but there are some who have assistance programs.

Nursing Homes For residents who require 24 hr nursing supervision. Residents receive meals, assistance with personal care, supervision of medication, social services available, as well as a chance for socialization and activities. Licensed by the state. May be used for short term rehabilitation, but many residents become permanent. Can be private pay, Medicaid, or may be Medicare, but for limited time.

Personal Care Homes A home in the community with 3 or less unrelated people. They are not licensed by the state. Similar to room and board or board and care homes. Offers services including medication management, help with ADL’s, prepared meals, laundry services, etc. May be paid privately or through some state funding (Community Based Alternatives Program).

Other Things to Consider How to pay for care? Where to look? What type of facility? Does my loved one or myself have Advanced Directives?

Where to look for a facility? Area Agency on Aging – TAHSA / EIA – Friends and Peers Church Location

What type of facility? For Profit –Revenues are divided among shareholders and investors of the long term care facility. Non Profit –Revenues and dividends are reinvested in the care and the residents of the long term care facility.

Non Profit Benefits Provide more hours of care per patient per day. Invest more resources in resident care. Non Profit providers had 34% fewer deficiencies than for profit nursing homes. (Deficiencies are citations from the licensing organizations for less than perfect care) * Information Taken From AAHSA Document.

Advanced Directives Living Will Directive to Physicians Do Not Resuscitate (DNR) Out of Hospital DNR Legal Guardian –Power of Attorney (healthcare/financial) Have a “caring conversation” with your loved ones about their wishes for a “good death” and share your wishes too.

Making a Decision Make a decision together. Plan ahead if possible. Consider alternatives. When your loved one is confined to the hospital, request a social service consultation for planning purposes. Ask Questions!!!!!

Questions to ask a Retirement Community. What type of lease is required? Is it a monthly or lifetime lease or purchase? What is included in the rate? Are maintenance, transportation, meals, laundry, parking, utilities, and housekeeping included? What services are included at an extra charge? Is there an emergency response system available? What type of meals are offered? Can you be a guest at a meal? What type of wellness and/or health care services are available? Does the community offer recreational programs?

Questions about Nursing Homes. Does the facility offer the level of care and services you need? What type of medical and therapeutic services are available? Is the family involvement encouraged? How? Is there an active volunteer program, and are there interesting activities for residents? Is the facility clean, well maintained, and free of odors? Do the residents appear clean and well-groomed? Are residents encouraged to create a homelike environment in the resident’s rooms?

Continued Does the food look/smell good? Are there provisions for special diets? Does the staff appear attentive and caring? Do they encourage residents to eat their meals in the dining room? Does the person you talk with give you honest, straightforward descriptions of the services offered? What are the visiting provisions? Is their a private area for visits? What is the ratio of staff to residents? Does the facility have a current state license? Is the facility Medicare or Medicaid Certified? What kind of special care does the facility provide for people with Alzheimer’s?

Questions about Resident Activities. Is the Bill of Rights posted and a copy available? Is there an active residents’ council? Are special events held at the facility? Are special excursions planned for those able to participate? Do all residents have access to the outdoors? Do volunteers assist with residents’ recreational activities? Are daily activities available to meet individual needs? Are religious services conducted?

Questions about Community Services? What services does the agency provide? Is the agency licensed by the state? Are services provided by the agency sufficient to meet your needs? Who will manage the care and who will supervise the caregiver(s)? How much will the total cost be for all services provided? Are services covered under Medicare or other third party payor?

Before Placement Considering Utilizing Existing Alternatives. Home Health Services Transportation Services Adult Day Care Respite Care

Caring for the Caregiver Ask for help! Try to reduce stress, some suggestions: –Get adequate rest and good nutrition. –Exercise regularly. –Get away. –Allow others to help. –Talk about your frustrations. –Go easy on yourself. –Set personal milestones you can achieve. –Reorganize your work.

Internet Resources Senior Housing – Department of Health Suggestions – Texas Medicaid Eligibility – sing/index.html TAHSA –