Long Term Care

Introduction

You or a loved one might need long term care for several reasons. From injuries to complex medical needs to long term disabilities, there are many factors to consider. Our guide covers includes everything you need to know, including who requires long term care, services, cost of care, and how to evaluate facilities.

What is Long Term Care?

Long term care is a range of services provided for individuals who have become unable to take care of themselves. The reason long term care is needed spans from an accident to an ongoing chronic issue. Often long term care can be used for rehabilitation for a variety of conditions and may take several weeks or even months.

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Chapter 1: Who Needs Long Term Care?

What is Long Term Care

A few examples of patients who can benefit from long term rehabilitation include patients who: 

  • Have complex medical needs, requiring 24 hour medical care and/or monitoring to maintain health and well-being
  • Are recovering from serious or debilitating medical events, including stroke, heart attack or cardiac surgeries
  • Are recovering from injuries, such as hip fractures
  • Are recovering from joint replacement procedures or other orthopedic surgeries
  • Have temporary or long term disabilities that interfere with mobility
  • Have temporary or permanent physical impairments that affect their ability to manage basic activities of daily living, such as bathing, dressing or toileting, for instance
  • Have difficulty managing necessary household tasks, such as grocery shopping, meal preparation, cleaning and maintenance, keeping up with bills, and more
  • Need help to manage medications appropriately or have difficulty keeping track of or getting to medical appointments
  • Have Alzheimer’s disease, dementia, or other cognitive issues that impact safety or quality of life

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Chapter 2: Long Term Care Services & Options

Long Term Care Services
Long Term Care Services

While long term care services might be provided in different settings, all are aimed toward helping individuals maintain their highest level of independence.

The services offered in many long term care facilities or from home care agencies include: 

  • Personal Care Services – Includes assistance with bathing, dressing, grooming, toileting, eating, mobility, and other tasks according to individual needs.
  • Home Care – Assistance with housekeeping, meal prep, laundry, shopping, transportation and other household tasks.
  • Using Medical & Adaptive Equipment – Assistance with acquiring and learning medical or adaptive equipment.
  • Therapy Services – Includes physical, occupational and/or speech therapy.
  • Medication Management - In residential or nursing facilities, management or supervision are typically offered.
  • Alzheimer’s or Dementia Care – Commonly offered in skilled nursing facilities, nursing homes, and some assisted living centers.
  • Nutritional Care – For those with specialized diets, such as diabetes or heart disease patients.
  • Around the Clock Personal, Nursing and Medical Care – In nursing homes, skilled nursing facilities, and other residential/inpatient long term care settings, these services are generally offered as part of basic long term care. 

Again, services may greatly vary depending on the type of facility. Nursing homes and skilled nursing facilities often provide more services than an assisted living center, which might offer some but not all of the previously mentioned services.

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Chapter 3: Experience & Skilled Nursing

Skilled Nursing
Why Experience is Important

Experience plays a vital role in long term care. While many who are seeking long term care services for themselves or a loved one typically search for things like overall quality of care, the comfort and atmosphere of the facility, and staffing details, there’s more to it.

Essentially, experience for a skilled nursing facility means that they’ve been in business for a while and has earned a good reputation in the community. 

This also means its management and staff, have become familiar with local medical facilities and providers, along with pharmacies, medical supply establishments, senior centers and many other resources, developing solid working relationships throughout the community that allow them to make the most of these resources for their patients. 

An experienced facility will also have years of experience navigating Medicare, Medicaid and various insurance policies/contracts to make the most of coverage for patients.

Finally, staff should be seasoned professionals who are not only technically proficient in the tasks they manage every day but have the practical knowledge that comes from years of hands-on patient care experience.

Seeking a Skilled Nursing Facility 

As you search for a skilled nursing facility, consider that no two facilities will be exactly the same. Consider these three qualities as you search for the right facility for a loved one:

Above Average Staffing

While all skilled nursing facilities are required to abide by certain regulations and staffing requirements, there are only a few that are truly committed to providing high-quality care. Look for things like 24-hour RN coverage, on-staff physicians and specialists, and highly skilled staff, who are capable of managing specialized medical and therapeutic needs.

Emphasis on Therapy & Rehabilitation

Particularly for long term care, this is a crucial element to evaluate. Whether managing a disease or disability, intensive rehabilitation treatment can be helpful for maximizing function, independence and quality of life. 

Family and Patient Involvement

Lastly, it’s often seen that patients see the best outcomes when patients and families are involved in the treatment and care process. Quality skilled nursing facilities are aware of this and will welcome them as an important part of the healthcare team.

Outside of these vital elements, also evaluate things like cleanliness, comfort, how residents and families are treated by staff, visiting policies, and how well the staff communicates.

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Chapter 4: Cost of Long Term Care

Cost of Long Term Care

Another key consideration as you search for long term care is cost comparison. While the quality of care should be top priority, patients and their families cannot ignore this step in the process. Here are a few considerations:

  • Ask About the Basic Daily and/or Monthly Rates – In addition to knowing these rates, ask what is covered. You might also need to ask for a breakdown of costs for specific care or services.
  • Request a List of Fee-Based Services & Costs – As we said, since many services or care costs might not be included in the basic rate, so it will be important to know how much each costs so you can compare for different facilities.
  • Calculate and Compare Costs – Once you’ve gathered the information above, you can calculate any fee-based services or care along with basic rates to compare and determine which facility will work for you or a loved one.
Do You Need Long Term Care Insurance?

Another question that will probably come up is – do you need long term care insurance? The answer varies for each patient, but here are a few of the basics you might need to know.

Specifically, we’ll explore long term care coverage in Alabama. Here are a few areas to consider.

Medicare

Medicare offers some assistance when it comes to a somewhat brief stay in a long term care facility. Typically, this includes patients who are recovering from an illness, injury, or other acute medical incident. Coverage is not typically provided for those with an irreversible chronic condition or those who need personal, rather than medical care.

Medicaid

This is another option available for some as far as medically necessary long-term care. To be eligible for assistance, financial criteria must first be met. This can vary from year to year and can also depend on the age and marital status of the person applying to the program. As of 2016, this meant that a person's monthly income cannot exceed $2,199, and financial resources cannot be greater than $2,000. However, there are also exceptions to this rule depending on age and marital status.

Veteran’s Assistance for Nursing Homes

War-time veterans may be eligible for assistance from the Aid and Attendance Benefit, also known as the Improved Pension program. However, veterans must also require assistance to perform daily activities in order to be eligible. 

Long Term Care Insurance 

If you already have a long term care insurance policy, it might be a good idea to use this option, but benefits will vary by policy.

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Chapter 5: Choosing a Long Term Care Facility

Choosing a Long Term Care Facility
Questions to Ask About Long Term Care Facilities

Now that you’ve learned about a number of different factors when it comes to long term care, let’s explore a few key questions to ask as you begin the process. 

  • What is your impression of the residents? When visiting a facility, take notice of the residents. Do they seem happy? Do they seem to be well-dressed and groomed? How do they interact with the staff?
  • What is your impression of the staff? How is the staff interacting with residents and family members? Are they available to answer questions from residents or family members? Are they respecting resident’s privacy?
  • How do you feel about the facility’s environment? Lastly, how does the facility itself appear? Is it clean? Is it warm and welcoming? How accessible are different areas of the facility? Do meals appear healthy and nutritious?

These are just a few questions to start thinking about, consider a few of your own before you visit facilities on your list. 

Final Tips for Comparing Long Term Care Facilities 

Before we wrap up, we wanted to provide a few more tips as you compare facilities.

Use Medicare’s Nursing Home Compare

This site will allow you to find Medicare and Medicaid certified long term care facilities near you. You can gather your list of recommendations from your healthcare team, hospital social workers or discharge planners, friends and family, and review ratings for each facility. You’ll be able to see information about health inspections, staffing and quality measures, and more.

Contact Alabama’s Long Term Care Ombudsman Program

This program works to protect the rights of residents and insure that fair and quality treatment is being provided in long term care facilities. They also offer guidance for those seeking a facility.

Visit Facilities for Additional Comparison

Once you’ve done all of the research, compare the top facilities on your list by visiting in person. Consider touring at least three facilities for a good basis of comparison. In addition to asking the questions from the previous section, you can also us this checklist from Medicare.

If you’re interested in learning more about Rehab Select’s long term care services, click here for more information.

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