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Entering Assisted Living: What You Need to Know About Determining Long-Term Care Needs

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Guest Post by Hal Salazar,

Many people begin preparing for life in a long-term care facility early in their golden years. Even if you or a loved one happens to need care suddenly and unexpectedly, choosing a place may be more difficult but not impossible. The first steps for finding a good fit are identifying what level of care is needed and how to pay for it. Life coach, speaker, and author Coach Win presents ways to determine your long-term care needs below.

Evaluating the Level of Care

Assisted living facilities allow residents to maintain their independence. Individual apartments or suites provide privacy, with staff around to help with housekeeping and daily activities. Nutritious meals, social activities, and transportation are typically available. Residents can receive help with medication, but nurses don't provide around-the-clock oversight.

Nursing homes provide a much higher level of care. In an intermediate care facility, residents receive 24-hour supervision by certified nursing assistants or licensed practical nurses. Skilled nursing facilities have registered nursing staff on duty at least eight hours per day and an RN or CNA working the other 16 hours. Federal regulations are vague about how many RNs, LPNs, and CNAs should be on staff, saying that the number should be "sufficient" for resident safety and well-being based on individual residents' needs and other factors.

Every facility should have policies regarding other health care as well. Residents should be able to get dental care, mental health care, and eye care. Access to a local hospital is also important. Some people want to continue to see their own doctor, but this can depend on whether the doctor is willing to visit the facility or if there is reliable transportation. Also, different facilities offer different types of therapy. A person who has had a stroke and needs occupational or physical therapy should learn whether the facility can meet these needs.

Some skilled nursing facilities are dedicated solely to memory care for residents with dementia. Buildings and wards are secure to prevent wandering, with layouts designed to reduce confusion. Staff have training in dementia care, with a high ratio of staff to residents. Residents enjoy mentally stimulating activities and therapies and are typically able to maintain skills longer as a result.

Finding the Means to Pay for Care

As explains, average monthly rates for long-term care across the US range widely. The type and level of care, the area, whether a room is private and other factors affect cost. Some people rely on long-term care insurance, an annuity, or Medicare to pay for care. Medicaid is one of the most common means of payment, but states have different income limits for eligibility.

Aging Care suggests that those who own residential real estate or have only a small mortgage may consider a reverse mortgage if a spouse or another co-borrower on the loan lives in the home. This converts equity into cash payments without requiring the sale of the house.

Selling the home may be another option. However, even in a seller's market, the expected value of the home may not be what the owner receives. The seller is usually responsible for realtor commissions, fees, repairs, taxes, and closing costs, as well as the mortgage payoff if there is one. Some of these costs are negotiable, though, and the average sale prices in the area make a difference.

In addition to finding ways to afford the care you need, be sure to budget for other essentials that are part of this transition. This includes any necessary repairs at home, purchasing moving supplies and hiring movers. When surveying your options for movers, compare national moving companies to local professionals, and don’t be afraid to call independent businesses; you might get a better deal. When vetting moving companies, be sure to confirm that they belong to The American Moving & Storage Association, and that they are licensed, bonded and insured.

With these matters settled, you can narrow down a list of facilities to those that provide the services needed and are financially feasible. Choosing a care facility that's comfortable, safe, and welcoming for you or a loved one can be a challenge, but it's worth taking the effort to find the right place.

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