Where should I begin?
When you are looking for any type of service for your loved on, it is important to determine what is actually available in your area. Churches, social workers, social services, or even your loved one’s doctor will often be able to provide guidance on what type of services are available and what type of services your loved one may need.
The Illinois Department of Healthcare and Family Services, the local health department, and the local agency on aging are great places to start if you are unfamiliar with what services are in your community as well.
While communities throughout Illinois have made great strides in developing alternative solutions to nursing homes and assisted living communities, not every program or service will be available for everyone. Once you have determined what level of assistance your loved one requires, it is important to find out what is available in their area.
Some of the alternative solutions you might have available to consider include:
Home health care-Home health care covers a variety of services that are brought to your loved one. This can include:
- Part-time nursing care;
- Part-time home health aides;
- Occupation, speech, or physical therapy;
- Medical supply deliveries;
- Nutritional counseling.
Home health aide-A professional therapist will visit your loved one, assess their needs, and provide services they deem necessary for the care plan such as bathing, dressing, laundry, light cleaning, and meal preparation.
Chore services-For chores that are heavier, such as snow shoveling, heavy cleaning, and yard maintenance, chore service providers may be available.
Meal delivery-If a loved one is unable to prepare their own meals a meal delivery service may be available to deliver complete and balanced meals once or twice daily. Most meal delivery services deliver only during the week, but some may be available on weekends.
Group dining-Group, or congregate dining is done outside the home, in places like schools or senior centers where your loved one can meet with others for social interaction and activities as well as for a meal. Often these services include transportation as well.
Group living-If a group of senior citizens are not able to live completely independently but can live together and provide companionship and help each other with daily tasks, they may wish to live in a group setting.
Adult day care-Adult day care programs aim to provide adults with impairments a chance to work on improving their ability at self-care through social, health, and therapeutic activities. Adult day care can serve as a stepping stone from a health care facility back to independence or when 24-hour care is not warranted.
Transportation services-When your loved one is unable to drive themselves or they cannot use public transportation, volunteer transportation services will help with getting to appointments, going shopping, and other social activities.
Telephone reassurance services-If your loved one is anxious about being alone or has ongoing health issues, a telephone reassurance service will allow them to call in at an agreed-upon time. If the call is missed, a family member or the police will be alerted.
Friendly visiting services-If your loved one is often alone or homebound, services may exist that match them up with a volunteer who stops by for a friendly visit and to ensure they are safe and well.
Protective services-If your loved one is unable to protect themselves legally or financially, services exist to ensure they are not being taken advantage of.
Special housing services-Many communities often have special housing services for those elderly and mentally challenged individuals who are low to moderate income.
Hospice services-If your loved one is terminally ill, hospice services will be available 24/7 either in a nursing home or at your loved one’s home to support the patient, their family, and to help control and relieve their pain.
Referral services-If you are unable to determine where you should turn for your loved one’s care, there are often referral services available to point you in the right direction. A quick internet search will often provide a list of available services in your area.
When does my loved one need long-term care?
While there are many services that can help your loved one remain independent and in their own home, there are times when only a long-term facility will be the answer. Some of the factors you may want to use to determine if your loved one requires long-term care include:
- Does your loved one require care with dressing, bathing, meal prep, and chores?
- Does your loved one require medical attention or procedures you and your family are unable to provide or unable to afford?
- Does your loved one suffer from cognitive decline that makes them a flight risk or puts them at risk for injuring themselves?
- Is caring for your loved one at home taking a toll on your physical and mental well-being?
You should also contact your loved one’s doctor, other family members, and if you are considering moving them from the hospital to a nursing facility, talk with the social worker at the hospital. They can offer outside insight that you may not have because you are so closely involved.
As hard as the discussion will be, you should also discuss your thoughts with your loved one. Explain your concerns and listen to theirs. Remember, it is still their life and this decision will completely change what they know and how they live.
Finally, do not feel guilty if after these discussions and contemplation that you decide it is time for your loved one to move to a nursing home. Sometimes there are no other options and as long as this decision is made with compassion and you’ve done your research on a good nursing home, there is no reason for guilt.
What options in long-term care do I have?
Just as there are a variety of options in home care, there are a variety of options in nursing homes and long-term care facilities. Some nursing homes focus primarily on personal care, some specialize in nursing care, and others will provide a full range of services from basic care to post-hospital medical care. When you are searching for a long-term facility, it is best to schedule a visit to the nursing home and discuss your loved one’s needs with the administrator.
When you discuss your loved one with the nursing home administrator, they may bring up terms such as “intermediate care facility” and “skilled nursing facility”. An intermediate care facility will provide services to those that need health services, nursing supervision, and assistance with eating, dressing, bathing, walking, and other personal care needs. These services may be paid for by Medicaid, but they will never be paid by Medicare.
A skilled nursing facility provides 24/7 nursing care to those that require it. If a doctor states that this level of care is needed and the application is approved, Medicaid will pay for this level of care. Medicare will only pay for 100 days in a skilled nursing facility if a patient has spent 3 days under hospitalization and a doctor certifies that skilled care is required. After 100 days, Medicaid will continue to pay for the care.
Most nursing homes are certified by both Medicare and Medicaid, but it is always best to check with the prospective home at this first meeting on what they accept.
There are other available options for nursing care for those that are developmentally disabled, such as sheltered care facilities, intermediate care facilities for the developmentally disabled, and community living facilities. Each of these facilities aim to provide care and aid in integrating a mentally disabled resident into normal society and helping them to avoid becoming too dependent on others.
