Long-Term Care: Choosing the Right Place (cont.)

These places supply 24-hour services and supervision, including medical care and some physical, speech, and occupational therapy, to people living there. They might also offer other services such as social activities and transportation. As a rule, the rooms are for one or two people. Some places want residents to bring some special items from home to make their rooms more familiar. Some even allow a pet or make it possible for couples to stay together.

Both assisted living and skilled nursing facilities sometimes offer special areas for people with dementia. These areas are designed to meet the special needs of these people and to keep them safe from wandering.

How to choose

Ask questions. Find out about what is available in your area. Is there any place close enough for family and friends to visit easily? Doctors, friends and relatives, local hospital discharge planners and social workers, and religious organizations may know of places.

Also, each state has a Long-Term Care Ombudsman. They have information and may be able to answer questions about a place you are considering. The ombudsman is also available to help solve problems that might come up between a nursing home and the resident or the family. To find your state long-term care ombudsman, contact the Administration on Aging's Eldercare Locator at 1-800-677-1116 or www.eldercare.gov.

Is the person in need of long-term care a military veteran? They might be able to get help through the Department of Veterans Affairs programs. You can check by going to www.va.gov, calling the VA Health Care Benefits number, 1-877-222-8387, or contacting the VA medical center nearest you.

Call. Once you have a list of possible places, get in touch with each one. Ask basic questions about openings and waiting lists, number of residents, costs and methods of payment, and their link to Medicare and Medicaid. Take a few minutes to think about what's important to you or your relative, such as transportation, meals, activities, connection to a certain religion, or special units for Alzheimer's disease.

Visit. Make plans to meet with the director of nursing and director of social services. Medicare offers a nursing home checklist to use when visiting (see Help in Planning). Some of the things to look for include certification for Medicare and Medicaid, handicap access, no strong odors (either bad or good ones), contact between staff and current residents, volunteers, and the appearance of residents. If the nursing home is a member of the Joint Committee on Accreditation of Healthcare Organizations, ask to see that group's review of the home. Ask yourself if you would feel reassured leaving your loved one there.

Visit again. Make a second visit without an appointment, maybe on another day of the week or time of day, so you will meet other staff members. See if your first thoughts are still the same.

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