Care Partner Information Sheet

Choosing Long-Term Care

The time may come when outside help is needed to care for an older adult. It may be okay to get help in the home. Or the person might need to move into a residential care setting such as assisted living, a group home, a nursing home, or a life-care community.

There are many choices to make for long-term care. Having the right information can help make the decision easier. Below are some steps to take to find the right care.

4 Steps to Help Choose Long-Term Care
Step 1
 

Make a list of care needs for the person.
What type of help do you and the older adult need?  For example, is help needed with bathing, dressing, preparing meals, eating, and/or medical needs? Will any of these needs change over time?
Step 2
 

Decide if care should be at home, a community center, or a residential setting.
Would someone coming into the home be enough help?  Could the older adult go to adult day care and come home at night? Or, does the person need to move out of the home and live somewhere else? 
Step 3
 

Decide how care will be paid.
What is paid by insurance can vary from state to state. Long-term care insurance, Veteran’s benefits, and Medicaid may only pay for some costs. Medicare does not pay for long-term care, except after a hospital stay when skilled nursing is needed. Some communities may have state or local support to help with payment. Check with the local area Agency on Aging to learn more.
Step 4

Visit several places before deciding. 
Look for the names of in-home care agencies, adult day care centers, and residential centers in the phone book, on the internet, or by calling your local Area Agency on Aging. Also ask friends, family, and health care providers for recommendations.

Ask the right questions.

It is important to be ready with questions when deciding if a care agency is a good fit.

  • Ask if they can deal with the care needs listed in Step 1 (on other side).
  • Ask how long they have been providing services, and how they hire and train staff. Ask if they do background checks on staff.
  • Ask how much they charge. Find out the cost of basic services, and ask if there are extra costs.
  • If the person will need care for the rest of their life, ask how the agency deals with end of life care.

Other questions depend on the type of care provided:

Questions for In-Home Care Agencies and Community Centers
  • Is care available at the times it is needed? 
  • Do they require a minimum number of hours of care?
  • Are they licensed by the state? Some services must be licensed, while others are not.
  • For in-home care, can you expect that the same person will come to the home each time?  What happens if the person doesn’t show up?
Questions for Residential Care
  • How many residents live there? 
  • How many staff are there for the residents? 
  • How many residents does each staff member care for?
  • What activities are offered for residents?
  • What happens if the person’s care needs increase?
  • What happens if there is a medical emergency?
  • How are the person’s care preferences respected?
  • Are families called if there is a problem?
  • Are there regular meal and snack times?

After visiting and asking questions, the most important thing to consider is comfort. Did the place feel warm and inviting? How did it smell? In community centers and residential care, did the people seem well-cared for and happy? It is okay to use instincts to answer this question. If the care agency does not feel right, it is not the right choice.

Written by: Deborah B Schaus, MSW, Exec Director, Alzheimer's Association Desert Southwest Chapter

Alzheimer's disease and Related Dementia ~ Care Partner Information
Edited by an interprofessional team from the University of Arizona Center on Aging, Alzheimer's Association - Desert Southwest Chapter and Community Caregivers

This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB4HP19047, Arizona Geriatric Education Center.  This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.