In the United States, nearly 70 percent of individuals age 65 and older will require long-term or post-acute care at some point in their lives. And with the population of older Americans expected to more than double to 92 million by 2060, the growing need for skilled nursing care will be experienced by families from coast to coast.
However, for many families, starting a conversation about aging care and options with a loved one is very difficult and emotional. By beginning a care conversation early, families can talk openly and honestly about aging, senior care, medical needs and their loved ones’ desires. Using simple steps to start a conversation, you and your loved ones can plan for the future and ensure care needs are met every step of the way.
Do start the care conversation early
Despite the growth in the number of older Americans, long-term and aging care is still a very sensitive subject. For many families, discussions about aging and mortality are swept under the rug, tucked away as a conversation for a later date.
Starting the conversation is often the hardest part. According to 2011 market research commissioned by the American Health Care Association (AHCA), the nation’s largest association representing long-term and post-acute care providers, nearly 60 percent of adults were not having conversations with families and loved ones about plans for aging or long term care needs.
Many of us avoid care conversations because we assume loved ones don’t want to discuss sensitive matters. These perceptions may not be reality. Loved ones may want to talk and the process may be easier than we think. We simply won’t know until we try, so it is vital to push past initial reservations and commit to taking action. When embarking on a care conversation, remember to address the who, where and when; be flexible; take the right approach; ask specific questions; and remember, it is not about you.
Do know your loved one’s care needs
There are several important steps to take when planning care for a loved one. It is crucial to recognize the signs--including the mental, emotional, social, physical and medical signs--that a loved one may need additional assistance, or that your loved one may require a more customized care solution.
Having care conversations with a doctor and other care providers before a crisis situation occurs will allow an individual to determine his or her own wants. But it also aids in determining which type of facility is best, based on a loved one’s medical condition.
One of the biggest challenges is understanding the medical needs of a loved one. This will largely influence the type of care facility that will best suit a person in times of need. Care needs can change, so it is helpful to familiarize yourself with various short-, mid- and long-term options.
Do plan and prepare for care
It is essential to make decisions based on medical needs and evaluate the types of care providers--such as in-home care, adult day care, assisted living care and skilled nursing care--that can best meet those needs.
Families should ask questions of various facilities and observe different types of care, as well as discuss costs and finances associated with each center. Learning about payment methods and government assistance programs, such as Medicare and Medicaid, also can guide a decision about the type of facility that is best for an individual.
It is critical to consider various ways of evaluating care, not just online surveys and ratings. While many resources are available to check a facility’s ratings, oftentimes these reports do not paint the full picture of a facility. It may be helpful to talk with other family members of residents at a facility to understand the quality of care provided.
Do visit care centers and know what to ask
Visiting a facility is the best way to compare facilities. If you are able, take time to tour facilities in the area where your loved one will reside. Many individuals have misconceptions about what long-term care facilities are like, how they function and the services offered.
It is also important to know the right types of questions to ask when an individual is exploring choices and options. Questions about the facility’s history, special care programs, how complaints are handled and what emergency plans are in place can help shape a family’s thoughts on a particular facility.
Do prepare for the transition
Transitions are usually easier to manage when you know what to expect and how to help a loved one feel more at home. As you and your loved one prepare for a move from the home, take some time to plan out the hours after you leave the center on moving day. Maybe your loved one will want company or maybe he/she will want to be alone. Be prepared for different options. Understand what you can expect during the first day, week and month after a transition.
Do not leave your loved one out of the conversation
The right mix of people, place and timing will help set the right tone for a pleasant, productive care conversation. Because care conversations are likely to affect everyone, it is worth trying to involve everyone. While it may seem tough to find a quiet moment amidst the hustle and bustle of busy lives, try to find a place and time when people are likely to be relaxed and receptive.
If a family sits down together prior to a crisis, many of the difficult decisions will have been made, ensuring that the family knows the desires of their loved one and can be prepared when a crisis situation does develop.
Do not ignore your emotions
According to research conducted by AHCA, adult children often experience strong emotions of guilt when it comes to caring for their parents. Additionally, aging Baby Boomers do not want to place a burden on their families. This can develop into a difficult choice for families to decide what type of care is best. For many families, there is a challenging balance between emotions and action.
Experiencing a health crisis is a stressful situation, and attempting to develop a care plan for your loved one can be an overwhelming situation for many individuals. Choose a time when your family can focus on the conversation. Some may be upset about the news and that is okay. Allow them to have their reactions and don’t take their reactions personally.
Do not believe that in-home care is always the best care
For many families, in-home care is often the first type of care considered. However, in-home care is not necessarily the right type of care needed for an individual. Considering the medical needs of your loved one should be the main driver of the selection of a care center. If a current care solution is not meeting your loved one’s needs, it is time to explore different options. Oftentimes, different relationships or circumstances require a different approach.
Do not forget to consult a doctor
Consulting with primary care doctors prior to a medical crisis can provide insight as to the types of skilled nursing and post-acute care centers most appropriate for a family member or loved one.
Do not think that today’s care centers resemble nursing homes of the past
Over time, skilled nursing care centers, like all areas of health care, have advanced in terms of clinical practices, resident rights, quality improvement, and the overall approach to the needs and wants of residents and patients. Yet, even today, many misconceptions about nursing homes (called skilled nursing care centers) do exist.
Separating fact from fiction will help you stay open to all of your care options. It is essential to experience a care center firsthand to understand that nursing homes are not what they used to be in the 1940s and 1950s. This is a new era of healthcare and senior living.
After conversing with a loved one’s doctor or care provider and determining what type of care center is most appropriate, a family can explore options within their community that fits their budget and care needs.
Speaking with an elder care advocate, such as Elder At Home, can help families navigate through the process of selecting a facility for their loved one. It is important for families to grasp what to look for in a facility, to understand the elements of care that are important to them and their loved one, to know the key questions to ask when visiting a facility and to appreciate the rights of all patients.