So many of us are facing the challenge of what to do with our parents or other loved ones when they can no longer live independently in their own homes. In the past the only option was a nursing home and the only real choice was which nursing home would be most comfortable…few options for those who had certainly earned the right to enjoy their twilight years.

I still remember my first trip to a nursing home many years (okay, decades) ago. I went with my Girl Scout troop, and it’s a memory that will stay with me forever…but unfortunately, not a good one. It was around the holidays and our troop leader thought it would be a wonderful opportunity to lift the spirits of the seniors at our local nursing home. To this day I remember the gray…the gray of that cold, damp November day, the grayness in the pallor of their loose, wrinkled skin, the lack of color in the halls where the lonely seniors sat in their wheelchairs all day; but it was the gray that you didn’t see but, nevertheless, felt..the sadness in their eyes, the loneliness in their hearts, the hopelessness of their spirits that remained with me for the rest of my life; it was the saddest place I had ever been.

Long term care options

Fast forward thirty (or so) years and, thankfully, there are more options for our aging population, each providing a different level of care.

• Home care - This includes medical care with visiting nurses but it can also include help around the home. Home health aides or personal care service workers visit regularly to help with personal grooming as well as housekeeping, meals and shopping. How often these services are needed depends on your loved one’s specific needs.
• Adult care - These programs offer social interaction and meals from one to five days a week, depending on the program. Some programs even provide transportation to and from the adult care center. Activities may include moderate exercises, trips, games, art and music. Limited medical services are sometimes offered, including help with medications or checking blood pressure.
• Senior housing - This is an option when your loved ones can no longer live in their house but they don’t need continuous long term care. Often these are rental apartments adapted for seniors, such as railings in the bathrooms, power outlets higher on the walls, and may include meals, transportation, housekeeping and various social activities.
• Assisted living - This is a consideration when you need more help than senior housing offers, but your loved ones still want to live as independent as possible. Assisted living staff helps with administering medications, bathing and dressing, and limited medical care. Some assisted living facilities even have on-site beauty shops and health services, such as a medical clinic.
• Nursing home - Offering 24-hour nursing care, nursing homes help elderly patients who are recovering from an illness or an injury as well as end-of-life care. Nursing homes are necessary for people who need more medical care than other long term care options can offer.
• Continuing-care retirement community (CCRC) - CCRCs offer many levels of care in one setting. The idea is to have your loved ones remain in one place for the rest of their lives, transitioning to different locations in the community when they need a new level of care. CCRCs can include a senior housing complex for the healthy and independent; assisted living arrangements when more help is needed, and a nursing home, when even more help is needed. A fee or endowment is usually paid, rather than paying monthly for rent and services.

Long term care funding

So now that that we have all of these long term choices, what are our funding choices? Unfortunately…not many. It became evident while researching this post, most of the dialog surrounding funding was either at the international (e.g., United Kingdom, Canada) or state level. According to Oregon’s Department of Human Services, long-term funding opportunities for those living in Oregon are:

• Spousal Impoverishment - If your spouse needs care in a facility, this law lets you protect some of your income and resources. Because of this law, your spouse can become eligible for Medicaid benefits without you becoming impoverished. Download the brochure (pdf)
• Long-term Care Insurance - Long Term Care Insurance can help pay for long term care costs. Some people do not need long term care insurance either because they will have enough money to pay for future long term care needs or because their income is low enough that they will qualify for Medicaid.
• Medicaid - Medicaid pays the long-term care costs for eligible, low-income individuals. If you satisfy eligibility requirements, a case manager in an Area Agency on Aging (AAA) or Department of Human Services (DHS) local office will help you find the appropriate care setting that will meet your need.
• Medicare - Medicare generally doesn’t pay for long-term care. Medicare also doesn’t pay for help with activities of daily living or other care that most people can do themselves. Some examples of activities of daily living include eating, bathing, dressing, and using the bathroom. Medicare will help pay for skilled nursing or home health care if you meet certain conditions.
• Oregon Project Independence - A special program available to Oregonians.

So what do you do if you don’t live in Canada, the UK, Oregon or any other state that provides long-term care assistance?

According to Karen Barton, Wells Fargo Reverse Mortgage consultant, for those who are 62 years of age or over, their home can be a source of extra income. According to Karen, “Seniors can use a Reverse Mortgage to supplement social security, pay unexpected medical bills, and even help fund their long term care needs. And it can be done while still living in their home and remaining the owner.”

For more on how a Reverse Mortgage can help seniors remain independent at home or help fund other long term care options, visit Karen’s Reverse Mortgage blog. It’s certainly worth exploring.

This entry was posted on Thursday, October 4th, 2007 at 2:00 pm and is filed under Family and Parenting. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.