Table Of Contents

Table of Contents .............................................. 2

About The Author............................................. 11

Disclaimer ....................................................... 12

PART 1:  THE CARE YOUR LOVED ONE NEEDS AND WANTS ..... 13

Providing The Right Care For Someone You Love ... 14

Long–Term Care Choices ...................................... 15

Nurturing Independence ...................................... 16

Steps Toward Quality Care ................................... 17

What Is Long–Term Care? .................................... 19

Beginning The Dialogue ....................................... 20

When Does Your Loved One Need Help? .............. 21

Neighbor Alert.................................................. 22

Deteriorating Self–Care ................................... 22

Increasing Isolation ........................................ 23

Signs Of Falling ............................................... 23

Reduced Mental Capacity ................................ 24

Reduced Physical Capacity .............................. 24

Non–Invasive Solutions ....................................... 25

Other Alternatives ........................................... 26

Caregiver Burnout ................................................ 26

Temporary Measures ............................................ 27

Assessing Needs & Evaluating Alternatives ... 28

Kind And Quality Of Help ...................................... 28

Weighing The Alternatives ................................... 29

Doing Your Homework ......................................... 30

Keeping Independence ......................................... 31

Gaining Assistance .............................................. 31

Care At Home .................................................. 33

Live–In Caregiver ................................................. 33

Managed Home Care ............................................. 34

Home Health Aides ............................................... 35

Local Services ....................................................... 36

Financing Home Care ............................................ 37

Home Modifications And Repairs .......................... 38

Community Support .............................................. 40

Adult Day Care ...................................................... 41

Senior Centers ...................................................... 43

Transportation ...................................................... 44

Telephone Reassurance ........................................ 44

Emergency Response ........................................... 45

Subsidized Senior Housing & Independent Living ..... 46

Activities And Services ......................................... 47

Board and Care Homes .................................... 47

Assisted Living Facilities ................................ 49

Continuing Care Retirement Communities ...... 51

Nursing Homes ............................................... 53

Hospice ........................................................... 55

PART II:  WHEN A NURSING HOME IS REQUIRED ....................... 57

Does Your Loved One Need 24–Hour Assistance? ............. 58

When Capability Begins To Decline ...................... 59

When Accident Or Illness Takes A Toll ................. 59

Having The Conversation ..................................... 60

Your Next Step ..................................................... 64

What If Your Loved One Rejects The Decision? ................ 65

The Role Of Denial ................................................ 65

A Stranger In Your Home ..................................... 66

Understanding Why .............................................. 67

Offering Reassurances .......................................... 69

Emotional Impact: Family & Loved One ............... 70

Grandpa and Grandma's House ............................ 71

Guilt And Regret ................................................... 72

The Consequences Of Inaction ............................. 72

Talk: The Best Medicine ....................................... 73

Helping Your Loved One to Adjust ................. 74

Signs Of Depression ............................................. 75

Just Being There ................................................... 76

Keeping Channels Open ........................................ 77

Getting Your Loved One's Input ........................... 78

Choosing A Nursing Facility ............................ 81

Step 1: Research .................................................. 82

Step 2: Phone Calls .............................................. 85

Step 3: Narrow The Field ..................................... 87

Step 4: Schedule Tours ........................................ 88

Step 5: Gather Your Team .................................... 88

What To Look For When You Visit Nursing Homes ........... 90

Schedule A Tour ................................................... 91

The Nursing Home Tour .................................. 92

The Face Of The Facility ....................................... 92

First Impressions ................................................. 93

Preliminary Discussion ......................................... 94

In the Hallways .................................................... 94

Odor Problems ...................................................... 95

Residents' Appearance ......................................... 96

Accessibility & Availability ................................... 98

General Safety ...................................................... 99

Security Measures .............................................. 100

Residents' Rooms ............................................... 100

Personalized Spaces ........................................... 101

Resident Privacy ................................................. 102

Resident Activity Levels ..................................... 102

Personal Care & Staff Interaction ....................... 103

Recreation Facilities ........................................... 104

Therapy Facilities ............................................... 108

Dining Facilities ................................................. 109

Special Diets Accommodated ............................. 111

Food That Looks & Tastes Appetizing ................ 111

Special–Purpose Units ....................................... 112

Grounds & Gardens ............................................ 114

Questions & Answers ......................................... 115

Family Participation ........................................... 116

Pets & Daycare ................................................... 117

Employee Morale ................................................ 117

Resident Satisfaction ......................................... 118

Other Questions & Issues ................................... 118

A Job Well Done ................................................. 119

Financial Arrangements ................................ 121

Personal Resources ............................................ 122

Medicare ............................................................. 123

Medigap Supplemental Insurance ...................... 124

Medicaid ............................................................. 124

Long–Term Care Insurance ................................ 126

Compare Policies ................................................ 127

Policy Limitations ............................................... 129

A Sound Investment ........................................... 130

Further Information ............................................ 131

After You Choose: The Admissions Process . 132

Tell Them About Your Loved One ....................... 133

Your Loved One’s Plan Of Care ........................... 135

The Initial Assessment ....................................... 136

The Plan Of Care ................................................. 136

Deciding What to Take ....................................... 137

Organizing The Process ...................................... 140

Dealing With Indecision ..................................... 140

Packing Instructions .......................................... 141

Clothing ......................................................... 142

Personal Items .............................................. 145

Miscellaneous Items ...................................... 146

Assuring Your Loved One's Continued Welfare ............. 149

Your Loved One's Rights .................................... 151

Preventing Abuse & Neglect ............................... 153

Your Role In Prevention ..................................... 156

Nursing Home Inspections ................................. 157

Ombudsman Information ................................... 158

Visits & Activities to Share ........................... 160

Keep Visits Interesting ....................................... 160

Simple Outings ................................................... 162

Stay–At–Home Activities .................................... 164

Good Gifts for a Nursing Home Resident ............ 165

Life In A Nursing Home: Fact & Fiction ........ 171

Resources ..................................................... 176

Emergency Response System: Lifestation ..... 176

Long Term Care Insurance: Allianz or Genworth (formerly GE), John Hancock or MetLife ........................................................... 177

Medical Supplies: Quality Medical Supplies ... 178

Supplements: Life Extension Foundation ...... 179

Other Resources ........................................... 180

AARP .............................................................. 180

Alzheimer's Disease Education & Referral Center ................................... 180

American Association of Homes & Services for the Aging (AAHSA) .......... 181

American Assoc. of Retired Persons (AARP) . 181

American Geriatrics Society (AGS) ................ 182

American Health Care Association (AHCA) .... 182

America's Health Insurance Plans (AHIP) ..... 183

Assisted Living Federation of America .......... 183

AoA Administration on Aging ........................ 183

Centers for Medicare & Medicaid Services ..... 184

Commission on Accreditation of Rehabilitation Facilities............................ 184

FirstGov for Seniors ...................................... 184

Healthfinder .................................................. 185

Joint Commission on Accreditation of Health Care Organizations (JCAHO) (also referred to as The Joint Commission) ........................................ 185

Long–Term Care Living ................................. 186

Long–Term Care Ombudsman ....................... 186

Long–Term Care On Medicare.gov ................. 187

MEDLINEplus ................................................. 187

National Assoc. of Geriatric Care Managers ... 187

National Assoc. of Insurance Commissioners (NAIC).......................... 188

National Assoc. for Home Care & Hospice ..... 188

National Center for Assisted Living (NCAL) ... 188

National Citizens' Coalition for Nursing Home Reform ................................ 189

National Clearinghouse for Long-Term Care Information ............................ 189

National Hospice & Palliative Care Org. ......... 189

National Institute on Aging ........................... 190

Partnership for Long–Term Care .................... 190

Senior Outlook ............................................... 191

Social Security Administration ...................... 191

State Health Insurance Counseling and Assistance Programs (SHIP) .......... 192

U.S. Administration on Aging (AoA) .............. 192

U.S. Department of Housing & Urban Development (HUD)...................... 193

Veterans Administration ............................... 193

Online Tools .................................................. 194

American Health Care Assoc. (AHCA) ............ 194

Benefits Check–Up ........................................ 194

Care Planner .................................................. 194

Centers for Medicare & Medicaid Services (CMS) ....................................... 195

Eldercare Locator .......................................... 195

Glossary of Senior Housing Terms ................ 196

Handbook for Long–Distance Caregivers ...... 196

Home Care/Hospice Agency Locator ............. 196

Homecare Online ........................................... 197

Long–Term Care Planning Tool ..................... 197

Nursing Home Compare ................................. 197