Guide to Senior Care

Guide to Senior Care

As the average life expectancy of our population increases, more people are finding themselves having to make decisions about care for an elderly parent or loved one.  Decisions often need to be made about housing, medical care, and other needs for the elderly person.  Here is some information to help you assess the needs and find the available resources.  We have also provided a list of Internet search terms that will help you find other information and resources.

Assessing Daily Activities

One of the first steps is to assess the daily activities of the person to determine their level of function and independence.  Are they able to take care of themselves and stay safe and healthy? Do any changes need to be made to their home to make it safe? Would they recognize danger if they smelled smoke or had a stranger come to the door? Determine how well they do the following things:

  • Make meals and eat
  • Bathe, groom, and use the restroom
  • Dress themselves
  • Walk, move around and go up and down steps and stairs
  • Pay bills and manage money
  • Drive or navigate public transit
  • Take their medications
  • Do household chores
  • Use phones and computers

Assessing physical health

Another step is to assess their physical health. Encourage regular medical checks and consider accompanying the person to their medical appointments. The primary care physician of the elderly person is a good resource of information.  Here are some questions to consider in assessing an elderly person’s physical health:

  • Does the person have trouble with balance? Are they steady when walking and navigating steps and stairs?
  • Do they have incontinence problems?
  • Do they have hearing problems? If they have a hearing aid, are they using it?
  • Do they have vision problems or need vision aids?
  • Do they experience persistent fatigue or sleeplessness?
  • Are they experiencing unusual weight loss or gain?
  • Do they have swollen feet or legs?
  • What medical conditions do they have that require treatment and/or regular monitoring?

Assessing mental health

We expect that as people age their mental abilities may slowly decrease.   They may have trouble remembering someone’s name or where they left an item in their house.  However, there are changes in behaviors that could be a sign of a more serious problem, such as Alzheimer’s disease or dementia. Signs of Alzheimer’s disease or other dementia may include:

  • Memory loss, especially of recently learned information, such as important dates or events, asking for the same information again and again, to the extent it disrupts daily life.
  • Confusion about where they are, how they got there, or how to get to a familiar location. This might increase in the late afternoon or after sunset.
  • Difficulty doing daily tasks at home or in leisure activities.
  • Withdrawing from social activities, hobbies and recreation due to trouble remembering how to do them.
  • Decreased attention to grooming and keeping themselves clean.
  • Misplacing or losing things and having trouble retracing their steps to find them
  • Difficulty having a conversation, struggling with words, or repeating themselves often.

These signs may require a caregiver to seek a medical evaluation for the person.   See the elderly person’s doctor for a referral to a mental health specialist or neurologist.  The caregiver may also need to locate other services.

Helpful Internet search terms:

  • Alzheimer’s Disease
  • Dementia

Helpful Internet Resources:

Housing alternatives for seniors

Finding the right place for an elderly person can be challenging and stressful, both for the caregiver and the elderly person.  It is important to assess their abilities and needs to determine the right option.  Keep in mind that the person’s abilities and needs may evolve over time and the most appropriate senior housing option may change.  The key is to find the right option that matches their health, lifestyle and financial needs.   Here are some housing alternatives available to seniors:

  • Living independently at home. Consider home modifications to make it easier for the person to continue living at home.  These might include raised toilet seats, handrails and grab bars, and security systems and emergency call buttons.
  • Home care services. This may include home-delivered meals, unskilled caregivers (housekeeping, non-medical supervision, companionship, etc.), skilled caregivers (if requiring bathing, dressing and feeding, injections or catheterization, physical occupational therapy, etc.) or some combination.
  • Adult Day Care. These programs may include structured activities, lunch, transportation, health services and occasional outings.  There are both public and private, profit and non-profit adult day care centers.
  • Assisted Living Communities. This option usually provides utilities, meals, transportation and activities in an apartment-style facility.  They may also provide various levels of care such as bathing, dressing, grooming and other personal care needs.  Secured Alzheimer’s and Memory care may also be available options. Assisted Living Homes.  These options are in residential communities and have a smaller number of residents.They offer a high level of care for the elderly who are no longer able to function in a larger community and may need 24-hour supervision.
  • Skilled nursing facility. These facilities offer a high level of medical care with 24-hour nurse or doctor coverage. This may be required due to an injury or disease, or because the person requires an IV or ventilator.  This is usually the most expensive option..

Helpful Internet Resources:

https://www.medicare.gov/your-medicare-costs/help-paying-costs/pace/pace.html

Tips for Selecting a Senior Care Facility

Finding the right facility for a loved one is an important decision.   Some questions to ask include:

  • What is the staff to resident ratio?
  • What experience and training does the staff have?
  • What facilities and services are available?
  • What fees and expenses are involved and what is the payment policy?
  • What safety and security measures are in place for the residents?
  • What activities and events are available for residents?
  • Is transportation available and how far will they take the resident for a medical appointment?

It is important to visit the facilities being considered.  Here are some things to look for when visiting the facility:

  • How clean is the facility and how does it smell?
  • How friendly is the staff and how to they interact with current residents?
  • How is the food that is served? If possible, eat a meal at the facility.
  • Do the current residents appear clean and well-groomed?
  • Get feedback from residents and their family members.
  • What social and recreational activities are available for residents?

Options for Paying for Assisted Living

The costs for senior housing can vary dramatically, depending on the level of care needed.  The elderly person and their caregivers should evaluate the costs of the appropriate housing options and consider the resources available to pay for those options.  Some options to pay for the costs of senior care may include:

  • Income from Medicare, social security and other pensions
  • The sale of the family home and other investments
  • Reverse mortgage for those living at home
  • Personal retirement savings
  • Benefits from long-term care insurance
  • VA Aid and Attendance Program
  • The withdrawal of cash from a life insurance policy
  • Medicaid may be available to some income-eligible seniors
  • Choosing to share your apartment with a roommate
  • Benefits from governmental or non-profit organizations
  • Hospice Services, which may be covered by Medicare

Helpful Internet search terms: 

  • Medicare nursing home compare
  • Local Area Agency on Aging
  • long term care facility
  • assisted living
  • retirement communities
  • adult day care
  • estate planning

Planning for the Future

The odds of needing long-term care increase as one gets older.  When planning for the future it is important to think about what care you might need as you age and how you will afford to pay for it.  Maintaining a healthy lifestyle will improve your ability to live independently later in life. Long-term care insurance is an option to consider that can cover some of the costs of long-term care in the future.  Estate planning lawyers can draft legal documents to allow others you choose to make important decisions for you in the event of disability.   Planning for long term care now will put you in control of lifestyle, medical, financial and legal choices in your future.

We would like to thank Debbie Rosness, Elder Care Planner, for providing her professional input for this Guide.

DISCLAIMER: This guide is provided only for informational purposes and is not intended to be a substitute for legal or other professional advice. This guide does not contain nor is it intended to provide legal or other professional advice for any specific situation and readers should not take action or refrain from taking action, based only on the information provided in this guide. Goldberg & Osborne has attempted to provide accurate and current information in this guide, but cannot and does not guarantee that the information is accurate, complete, or up to date. This guide may contain links and/or search terms that will lead to external websites as a convenience to the reader, but Goldberg & Osborne is not responsible for the content or operation of any website other than its own website. The presence of a link or a search term does not imply and is not an endorsement by Goldberg & Osborne of the website provider or the information contained on any linked website or on any website contained in search results from a search term provided in the guide.