Is a Nursing Home the Right Solution?

continuing care retirement community

One of the most difficult decisions facing seniors and their families is where they will best be cared for in later life. A study of 8,000 seniors reported in the Harvard Health Blog found that fully two-thirds of those individuals over the age of 65 needed help doing one or more daily activities (activities of daily living (ADLs) include moving, feeding, dressing, bathing, and personal hygiene). And, as we age, those needs only increase. Even knowing that, many of us will understandably put off the work of considering alternatives and planning for that eventuality.

We shouldn’t. If the experience of these past months of living through a pandemic has taught us anything, it is that it’s important to understand the benefits and potential limitations of different care options. The time to learn about our options and do the necessary planning is now, when we have the luxury of time to make an informed assessment and decision; putting this off until later can result in having others make the decisions for us, while simultaneously eliminating what might have been attractive options.

Residential care options for seniors are many, ranging from assisted living facilities to continuing care retirement communities (CCRC). Here are just a few:

  • Assisted living facilities help residents with one or more ADLs. While residents can be supported through transportation or assistance with medication management, an assisted living facility does not provide the level of medical care available at a nursing home.
  • Nursing homes also help with ADLs and have the added services of 24-hour supervision and a higher level of medical care.
  • Continuing care retirement communities (CCRCs) include multiple levels of living options including independent living in addition to assisting living and nursing home level of care. CCRCs provide many recreational and onsite amenities, and typically feature a variety of private residence options for those residents able to live independently. CCRCs offer the opportunity to “age in place,” with a full range of medical and support services if assistance is needed in the future.

When considering your options for various living and care arrangements, three key elements are need, resources, and timing:

  • What will be your or a loved one’s needs in the future? While the full scope of needed support can be difficult to predict, the current health and requirement for assistance with ADLs can help.
  • How will you fund your care option? Long-term residential care is expensive. Costs vary widely among different options and between facilities, even depending on what state you reside in. In addition to your assets, understanding the role various government programs play (and don’t play) in long-term care along with possible insurance options will be key. For detailed, up-to-date information that is specific to New Hampshire, download our guide to Understanding New Hampshire Medicaid Rules for Long-Term Nursing Home Care here.
  • Availability of your preferred option and facility when you need it is not guaranteed. In fact, some facilities have waiting lists that may be many years long. Establishing a relationship with your preferred facility and starting the enrollment process can provide tremendous peace of mind.

And there are other advantages to starting the determination process early. Even before the pandemic, many nursing homes that the Centers for Medicare and Medicaid Services (CMS) found to have serious ongoing issues related to health, safety, or sanitation were not publicly disclosed. With the advent of COVID-19, those systemic issues proved devastating for many residents. Proactively researching facilities you’re considering can help in making a well-informed decision.

Additionally, early long-term care planning will be essential, especially if you’re interested in the idea of the “tiered” care model and the many amenities of a more expensive CCRC option. The sooner you put a plan in place, the more likely you will be able to take advantage of the full range of care options.

 

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