the language of long term care

So many terms… nursing homes, home care agencies, companion care, day care, assistive technology, assisted living. What are they? What should you know about them?

For many people, the first thing that comes to mind when hearing the words “long-term care” is a nursing home. Nursing homes offer skilled nurses (RNs, LPNs), certified nurse aides, as well as physical, occupational and speech therapies. A nursing home can meet the needs of even the most dependent people. Many people utilize a nursing home for short-term acute rehabilitation care via their Medicare benefit (following hip replacement, for instance). However, Medicare is limited in length and once that coverage is exhausted, nursing homes can be extraordinarily expensive: as much as $13,000 per month in Westchester and surrounding areas. Planning in advance of a long-term care possibility is always wise, but there are some last-minute strategies to protect some of your assets, if necessary. And if you truly cannot pay, Medicaid can help with the cost.

Another option for long-term care is assisted living, which typically provides some intermittent assistance with activities of daily living. Most assisted living communities offer one to three meals per day in a communal setting with activities and entertainment, as well as skilled nursing oversight like medication management. They also provide basics like housekeeping and laundry. Most of these communities have a base cost starting at about $4,000 to $5,000 per month; additional services are à la carte (e.g., if you need help bathing, a fee will be added to your monthly rate). Almost all assisted livings are private pay, so they’re not an option for everyone. (There is only one assisted living residence in Westchester that accepts Medicaid.)

Finally, there is long-term care at home which can be as simple as needing home-delivered meals or transportation for shopping. Adult day programs are an option for seniors, who may have some compromised functioning (cognitive or physical), to attend during the day. These programs provide a safe environment in a social setting for them to spend the day and furnish respite for a family caregiver. There is also assistive technology (using the internet) for monitoring people in their homes. The emergency button (I’ve fallen and I can’t get up.), cameras, medication management systems, and fall sensors are a few of the systems available.

The final component to long-term care at home is having a person come in to your home to assist you. It could be low-level such as a companion, who just comes in to take you to the hairdresser, the bank or to a doctor’s appointment. The next level is a home health aide, who can help with more personal tasks like bathing or dressing. They may come into your home from a few hours a week to 24 hours a day.

All of these care options cost money so investigate Medicaid eligibility with an expert to be certain you have a solid understanding of the requirements. Do not rely on advice from friends or neighbors.

Understanding these resources and how to best utilize them is critical for maintaining the highest level of independence and quality of life possible. A senior care expert will work with you and your family to assess individual needs, plan on how to meet current or future needs, and also how to finance the cost of this care. This may be through your own personal funds, long-term care insurance or through the New York State Medicaid Program.

Colin Sandler

Colin Sandler

Colin Sandler, LCSW, CCM, is owner of Medicaid Solutions, 2127 Crompond Road, Cortlandt Manor, NY. She has been providing advice on aging to seniors and their families for over 20 years. Email her at Colin@Medicaidsolutions.com or call 914-924-2566
Colin Sandler

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