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Wednesday, April 3, 2019

Assisted Living – Part II: Questions to ask when selecting a facility and the financial aspect of living in an assisted living community.

            On March 14th our blog, “Assisted Living – Part I:  What is Assisted Living and how do I decide if it is the right move for me or my loved one?” discussed what an assisted living community is and gave five strategies for talking about and determining whether assisted living is right for you or your loved one.  In follow-up, today’s blog will present items to consider and questions to ask when selecting an assisted living facility.  We will also discuss how to plan for the financial aspect of an assisted living facility.

            By 2030, 20 percent of U.S. residents will be retirement age and because healthcare has improved and life expectancies have extended, more people are living longer after they traditionally have stopped working.  Due to the ever increasing number of retirees and the need for living facilities and care for such residents, the number of assisted living facilities is increasing throughout the country.  With so many new facilities opening each year that offer different levels of care, varying services, different room layouts, and each varying in cost; it can be difficult to decide which facility is right for you or your loved one.

When beginning your search it is important to visit each facility both for an unscheduled impromptu walk through and for a scheduled tour with the facility director.  When you visit a facility during an unscheduled walk through we suggest going during a meal time which will allow you to see and smell the food, as well as to see how the staff interact with the residents.  A scheduled tour with a facility director will allow for you to see more of the room layouts, staffing and amenities, as well as ask important questions.  Below are six suggested questions to ask when selecting an assisted living facility.

            Below, we have provided a list of items to consider and suggest six questions to ask when touring the different facilities in your area.

  1. What are my needs, what individual preferences and concerns do I have?  Begin thinking about what your loved ones current needs are and what needs they may need in the future.  This may help to eliminate the need for numerous moves in the future, which can preserve a higher quality of life, reduce disruption and help lessen the effect that a move can have on loved ones with dementia or Alzheimer’s.  Making a list of questions to ask that are specific or important to your loved one can allow for a level of comfort for them when choosing the facility.  For example, you may ask about bringing your own furniture or if any furniture is provided, if you are allowed to bring a beloved pet, or if there are any restrictions such as alcohol, smoking, or overnight visitors.
  2. How much will it cost? Asking about base rent or a daily rate, as well as asking about what is included in the different levels of care and how much each level costs per month, can help to create a budget and assist in determining your financial ability for such a facility.  Also, be sure to inquire as to whether such fees increase annually and if so by how much; if there is any upfront fees to move-in or a buy-in requirement; if there are any other a la care fees that are not part of the monthly fee; and, the difference in fees if you move to a different area of the facility, such as memory care.  Many facilities will gladly share a copy of their contract so that you can review it thoroughly.  Below we will discuss further a couple options for financial assistance to allow for your loved one to afford an assisted living facility.
  3. Where is the facility located in relationship to loved ones and friends?  Location to family and friends or even their familiar community, such as church, doctors, grocery stores, can be important to helping your loved one to maintain relationships and assist with cognitive stability. 
  4. What activities and amenities are available?  Each facility will offer different activities and amenities, such as outings to community events, shopping, facility events, and even how and when they offer meals and snacks.  If social activities or the availability of transportation to churches, stores, and community events are important to your loved one, be sure to ask about the availability and schedules that will keep them connected to the activities they enjoy.  Food is an important part of many people’s lives and how we enjoy our food or meals can be an aspect that is important to your loved one.  Many facilities will invite you and your loved one to join them for a meal at the facility during your scheduled tour so that your loved one can determine if the facility meets their dietary and dining needs. 
  5. How is health care delivered?  It is important to ensure that the facility health care services are right for your loved one and their future care needs.  Inquiring about the medical care your loved one will receive at each level of care is important, as well as inquiring about how the facility physician, nurses, and social workers interact with the residents and the residents’ personal physicians or caregivers.  Ensuring that your loved one can continue with their primary care physician or other specialists in the community is important for continuity of care and familiarity of providers can be important as well.  Asking if the facility has had a resident with the same or similar care needs as your loved one or if the staff is able to handle the care your loved one does (or will) require based on their condition, may also help determine if the facility is a good fit for your loved one.
  6. What differentiates this facility from all the others?  Each facility is going to show you the wow factors or those amenities that make them stand out from other facilities.  Asking how they stand out from other facilities in the area will allow you to see if these factors are important to your loved one and if these amenities will fit your loved ones needs and allow them to live in comfort.

“Can I afford to live in an assisted living facility?” is usually the first question everyone asks themselves when deciding on this next phase of their life.  Many find the financial aspect of the move to an assisted living facility the most difficult and daunting part of the decision-making process.  Facilities typically rely on private payments from their residents, which means, the resident’s income (or supplementing such income from their retirement savings) can meet the financial costs of the facility and the level of care they will need.  However, there are many benefits that are available to assist your loved one with this new financial decision.  If your loved one is a veteran, or the spouse of a veteran, they may be eligible for the VA Aid and Attendance benefit.  The VA Aid and Attendance benefit provides additional income to the veteran and/or their spouse to assist in paying for an increased level of care they receive.  This is a needs based benefit and therefore requires certain eligibility requirements to be met.  With VA Aid and Attendance the benefit is paid directly to the person and not the facility, therefore the benefit does not dictate the facility choice for your loved one.  A second benefit that may be available to your loved one is the Medicaid Waiver program.  This program is also a needs based benefit and requires certain eligibility requirements to be met.  However, this program differs from VA Aid and Attendance in that the choice of facility is limited to an assisted living facility that has been Medicaid certified by the State of Indiana.  If eligible, the State of Indiana Medicaid Waiver program allows for your loved one to pay for such care at an assisted living facility from their income, while Medicaid pays any remaining costs of the facility directly to the facility.  This helps your loved one to possibly pay for remaining expenses such as supplemental healthcare, food, or additional utilities depending on their remaining income.

The attorneys at Severns & Howard, P.C. specialize and are knowledgeable in both VA Aid and Attendance and Medicaid Waiver for assisted living.  Our attorneys review financial assets, healthcare needs, and discuss with you how you or your loved one can meet the eligibility requirements for one of these needs based programs to assist in paying for an assisted living facility.  Meeting with one of our attorneys to pre-plan for your future needs or at the time of need for a you or a loved one to discuss your options for long term care needs can alleviate stress and worry about how to afford and receive the care you need as you age.  To schedule an appointment with a Severns & Howard attorney to begin these important discussions, please contact our receptionist at (317) 817-0300 to begin the intake process.

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