Choosing a Long-Term Care Facility for Your Aging Parents
Making the decision to move a loved one to a long-term-care facility is never easy. Finding the right facility can be even harder. If you have a loved one with Alzheimer’s, dementia, or other disability, that person might someday need to move into a long-term-care facility. Before you can select a long-term-care facility for a loved one, you must know what sort of care he or she needs. There are several levels of care that senior-care properties provide:
- Assisted living for those who need help in one or two activities of daily living, such as dressing or bathing.
- Skilled nursing for those who need the attention of a nurse every day, who are bedridden or have more complicated behavior issues.
- Memory care for those with dementia or Alzheimer’s disease.
Some properties provide varying levels of care under one roof. That can be a good option for people who want to move to a senior-care residence when they’re just starting to require help, then stay in place (by simply moving to another wing or floor) as their needs progress. In addition to considering the level of care, people need to think about where their loved ones would want to be. That is, would they prefer living downtown or in the suburbs? In the same city where they currently live or closer to family in another city? Do they need a place that allows pets or accommodates special dietary needs, such as a kosher diet? These questions need to be addressed before you start your search in earnest.
Create a list of properties that best meet your loved one’s needs and wants. Make sure each is licensed by checking with your state’s health and human services department or Medicare.gov. Use the Eldercare Locator site to get contact information for your local long-term-care ombudsman, then ask him or her if there have been any citations at those properties. Nothing will ever be perfect, but you don’t want to see significant lapses in patient care, such as serious injuries because of neglect or errors in medication management.
Health insurance and Medicare do not cover this sort of long-term care. If you’re a veteran, you might be able to get help paying for long-term care from the Department of Veterans Affairs. Medicaid rules vary by state, but in general the government program does pay for long-term-care services (primarily nursing-home care). However, your loved one basically has to deplete his or her assets to become eligible as Medicaid is a needs-based program and has asset requirements.
Finally, internet and phone research can only get you so far. To know whether a facility is right for your loved one, you need to visit it. Try to inspect at least three. Make an appointment to tour the residences during the week and speak with administrators. Then you should plan to make an impromptu visit to each on a weekend to see how the facility operates when the administrator isn’t there. While visiting facilities consider the following:
- Pay attention to overall cleanliness. Does it meet your expectations of what “clean” should be?
- Follow your nose. Are there strong, offensive odors in common areas or emanating from residents’ rooms?
- Watch the residents. Make sure they are in common areas and are active. If not, ask where they are and what they’re doing.
- Watch employees. Do they smile and say hello? Do they look like they enjoy their jobs? How do they get residents to participate in activities — by command or social invitation? Are nurses behind their stations, or are they engaged with residents?
- Observe an activity. The residence should have a list of daily programs posted. Make sure those programs are actually occurring.
- Look at the physical setup. It should look like a residence, not a hospital. That means it should allow residents to bring their own furniture or other belongings to make their rooms or apartments feel more like home. And make sure that the property is secure so that residents can’t wander off. If it’s a memory-care facility, the layout should be simple — such as a single hallway that encircles a common area — so that residents don’t get confused or lost.
- Look for life, such as fish tanks, caged birds, potted plants and a garden — something to give residents a reason to smile.
Bertie: Did you know that Canadian Geese are protected by federal law?
Spring has officially sprung, and with that you have probably noticed the return of Canadian Geese…and lots of them. Soon there will also be lots of little fluffy goslings trotting along behind their parents or pecking through grass in search of yummy bugs. These geese tend to inhabit highly populated areas and it is not unusual to see them crossing major roadways and interfering with traffic. While this can be aggravating for motorists, it is important to know that these birds are protected by federal law and it is a crime to kill them.
Migratory birds, including Canadian Geese are protected under four bilateral migratory bird treaties the United States entered into with Great Britain (for Canada in 1916 as amended in 1999), the United Mexican States (1936 as amended in 1972 and 1999), Japan (1972 as amended in 1974), and the Soviet Union (1978), more commonly known as the Migratory Bird Treaty Act (MBTA).
So remember to slow down and be aware of wildlife sharing the roadways and allow them to cross. And of course don’t forget to enjoy the sight of all the precious little goslings. There will be no judgement regarding audible gasps about their cuteness. I mean, who doesn’t go crazy for baby animals?!
Rachel H. Snead
757-399-7506 | 252-722-2890
Rachel Snead is an associate attorney with Hook Law practicing primarily in the areas of estate planning, estate and trust administration, guardianship and conservatorships, dispute resolution, and fiduciary litigation. To date, she has litigated and settled over 50 matters. She enjoys the diversity of work that elder law provides, and the challenges presented by litigation just as much as she enjoys helping people with creating their unique estate plan and navigating the complex administration of estates and trusts.
A graduate of the University of Richmond School of Law and Virginia Commonwealth University, Rachel is admitted to the Virginia State Bar. She is also a member of the Virginia Bar Association (VBA), the Hampton Roads Estate Planning Council, the Virginia Academy of Elder Law Attorneys (VAELA), and the Virginia Trial Lawyers Association (VTLA).
In 2022 she became a licensed health and life insurance agent and attended the prestigious National Trial Advocacy College at the University of Virginia School of Law where she received intensive hands-on advocacy training.
She has taught multiple continuing legal education courses including, “Getting Started in Elder Law,” “Virginia Probate from Start to Finish,” and “Guardianships and Assisted Decision-Making in Virginia,” and has facilitated sessions for VAELA including “Medicaid & SSI When a Client Owns a Business.” She has also been published on various platforms including T & E Magazine, WealthManagement.com and Age in Action, a quarterly newsletter published by the Virginia Center on Aging and Virginia Department for Aging and Rehabilitative Services.
- Estate Planning
- Estate & Trust Administration
- Guardianships & Conservatorships
- Litigation & Dispute Resolution