Making the Decision

Options In Long Term Care

Making the Decision

The main advantage of living in some type of congregate housing or nursing facility is security. The presence of others provides continued monitoring of health care. For those with limited mobility, there are built-in social contacts and activities. Experts agree that social contacts increase satisfaction with life and have a positive impact on physical health. Older people are often happy to relinquish housekeeping tasks and other chores. Families report relief at knowing their relatives are safe. In cases of a nursing facility placement, the family knows that the patient is receiving a level of care that could not easily be provided at home.

When asked about their preference for receiving care, most elderly persons answer, “What I would really like to do is to stay on my own home.” The person’s own home represents security, familiarity and independence. To live at home, one must be able to perform the activities of daily living which includes personal care (toileting, bathing, ambulating, taking own medications, etc.) as well as the ability to drive a car, go shopping, cook, manage finances and do household chores. Many people lose one or more of these abilities as they grow older and may require the assistance of someone to be able to safety live in their own home setting.

Due to a number of reasons, residing safely in one’s home may not be feasible and a decision may need to be made to either obtain in-home support and assistance or find a setting that would be safe and provide a home-like environment.

A decision is not easy, and needs to be well coordinated/planned. In many instances, the kupuna or family members do not discuss what may need to be done when the need arises to obtain care, support and health care services for the kupuna. Planning needs to be done to:

  • Determine the wishes of the kupuna when and if they are no longer able to make decisions on their own behalf;
  • Where would they prefer to be cared for if such services are needed. Map out Plan A, B, C and so forth with different scenarios and situations;
  • Look at the finances of the kupuna and what they are able to afford, if they have long term care insurance, if the family is willing and able to supplement the costs. If the elder has limited financial resources, research the options for Medicaid assistance (keeping in mind a 5 year look-behind of finances);
  • Look at the various settings ahead of time, so at the time of need, and informed decision can be made if placement is necessary in a health care setting, depending on the needs of the elder; and
  • Reach out to credible agencies/resources for information for example:
    • City and County Offices of Aging
    • Senior Handbook
    • State-Executive Office of Aging