As our population ages, elders and their families have multiple long term care choices. With so many options available, consumers today really need to do their research in order to ask the right questions so that they can find the most appropriate services for themselves or a family member.

Home Health:
Skilled nursing and therapy services ordered by the physician after hospitalization or to prevent a hospital admission from occurring. Care provided on a visit-by-visit basis (usually from 0.5 to 2 hours in length) is generally offered on a short-term basis. Medicare or a managed senior care program may pay for this type of care which includes skilled nursing, physical therapy, speech therapy, occupational therapy, medical social worker, and certified nursing assistant.

Personal Care, Support Services, or Private Duty:
These services are generally coordinated by a home-care company which provides the services of professional direct caregivers which can include personal care, light housekeeping, meal preparation, transportation, and companionship. Services are available from 2 to 24 hours per day. Some home-care companies offer live-in services. Care is provided on a fee-for-service basis and is paid by private funds or long-term care insurance. In Arizona the hourly cost of care is between $16-$19 per hour. Home-care providers can be found in the Yellow Pages under “Home Health” or “Nursing Services.”

Criteria for choosing a home care agency:

• Does the company provide the services you or your loved one needs?
• Does the company provide continuity of care?
• Will the same professional Caregiver or team be involved in your loved ones care?
• Is the individual and their representative involved in the development of the plan of care?
• Is someone available to assist you after regular business hours?
• Does the provider have a good reputation and positive track record?
• Ask the provider for a list of references from local physician, healthcare professionals, discharge planners and former clients.
• How long has the company been in business?
• ¨Is the company licensed and/or accredited by a healthcare accreditation organization? (This is not required in all states, and not required in Arizona.)
• All home-health provider services are required by law to be certified by Medicare.
  
  

  The agency you choose should be an extension of the physician's original plan of care for the patient. It is essential that the agency and Caregivers work well with the care recipient, her family and physician. Everyone's common goal for the patient's home care services should be a successful recovery.

Assisted Living:

Assisted Living is appropriate for individuals who no longer live in their home, need assistance with personal care needs, meals housekeeping, activities or transportation.

Assisted Living provides a residential apartment with 24 hour staffing, 3 meals per day, housekeeping, and scheduled transportation. In addition, assisted living provides an array of activities, opportunity for socialization and educational growth.

Many assisted living communities offer different levels of service and cost will vary depending upon the individual’s needs. Some assisted living communities offer secured apartments for those with advanced cognitive impairment. In Arizona, costs range from $2000-$5000 per month. Assisted living is paid for by private funds, long term care insurance or ALTCS (Medicaid). Each state has unique assisted living regulations. Check with the state Department of Health Services for the specific regulation and definition of assisted living.

Skilled Nursing Facilities/Nursing Homes:

Nursing home care is required for individuals who have complex care needs or skilled nursing services. Nursing homes provide 24-hour day licensed nursing services, certified nursing assistants (CNAs), physical therapy, meals, activities and scheduled transportation. Nursing homes which were traditionally used for most long-term care needs are now often used for post hospital stays and rehabilitation.

Medicare may cover the cost of nursing homes following a 3-day hospital stay when rehabilitation is needed. Long-term care which is classified as custodial care is paid for by private funds or long-term care insurance. In Arizona, rates may vary from $140-$160 per day.

Items to Check When Visiting a Long Term Care Facility:

• Visit the community on several occasions and at different hours of the day.
• Consider how close the community is to friends, family and hospitals.
• Read and ask about the state inspection reports.
• Ask about the staff-to-resident ratio.
• Inquire about the longevity of the staff.
• Talk to residents and their families, ask about their experiences in the community.
• Look at the overall appearance of the buildings, it is clean, odor free?
• Look at how residents are dressed and groomed and whether they are interacting with others.
• Listen for the content and tone of the staff as they speak with residents.
• Review the menu, ask to have a complimentary meal. Are special diets available?
• Get details in writing on living arrangements, services provided and additional costs.
• Ask if the services to be provided are covered by Medicare or Medicaid.

Regardless of where you receive care, the critical issue remains the same:
There is a critical shortage of trained, qualified, stable direct caregivers.

How To Select A Hospice Provider

When aggressive curative care is no longer desired by an individual, hospice offers service by providing compassionate care at home or in a home-like environment which addresses the unique personal, physical, spiritual and emotional needs of each individual. Hospice affirms life. It seeks neither to hasten nor postpone the end of life, but to assist persons to live fully until that time with individuality, dignity and maximum quality of life.

This is accomplished through coordination and delivery of the following services:

• Nursing services on an intermittent basis
• Physician services
• Medical services
• Spiritual and family counseling
• Prescriptions for pain relief and symptom control
• Medical supplies and durable medical equipment
• Physical, occupational and speech therapies
• Home health aide and homemaker services
• Bereavement services
• Volunteer services
• Short-term inpatient and respite care
• Continuous care during periods of medical crisis