It's never too soon
to start the conversation

It's also never easy, yet half of all Americans will need long-term care at some point in their lives. Planning ahead is vital in order to find the right combination of care, community and cost. Starting the conversation early can go a long way toward smoothing out the process. The process can be emotional, resulting in feelings of loss, anger, even guilt if you are moving a loved one out of their home. Making the decision mutual is key to finding a safe, secure, rewarding new home.

Remember these tips

  • Talk earlier rather than later, before you are pressed by need, health conditions, etc.
  • Take the initiative and do your homework so you have options at hand.
  • If you are helping a loved one, ask that person's permission to open the conversation. Timing is everything. Opportunities can present themselves around significant life events such as a death, an injury from a fall or a birthday.
  • In the case of a loved one, be ready for resistance. Stay positive and keep listening for the person's wants and needs. Don't go it alone. Include other trusted advisors such as doctors and/or other health care professionals in the decision process. They can "de-personalize" the issues and suggest care types and resources that make sense for the person.
  • In the case of a loved one, always remember that the decision to move to a retirement or assisted living community must be made by them. They must be comfortable with their choice.

Legal issues to consider

When the time is right — and while minds are sound — cover your legal bases. This is particularly critical if you are helping a loved one who is in the very early stages of Alzheimer's or dementia.

  • A Durable Power of Attorney — this document allows you (the principal) to give authority to someone else (your agent) to make financial and legal decisions on your behalf, even if you are disabled or incapacitated. A power of attorney for health care allows you to appoint a health care agent to make health care decisions for you in the event you can no longer speak for yourself.
  • An Advanced Medical Directive — this will make your (or your loved one's) end-of-life wishes known to medical providers.
  • Estate-Planning Documents — These should be reviewed to make sure beneficiaries, trustees and representatives are up to date while minds are sound. Consult your estate-planning advisors with any questions or concerns.
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Choosing your new home

Once you've determined how much care you (or your loved one) needs, you can begin to narrow down your choices. There are several points to consider. This isn’t a complete list, but it should get you started.

Location -- Do you want to stay near your current home, familiar surroundings and long-time friends? Do you want to move closer to family? Do you want to try somewhere completely new?

Activities and Interaction -- How much activity and interaction do you seek? Do you want to be very social in a large and active community? Or do you prefer a smaller, more low-key setting? Will the community allow you to be on the go all the time or, conversely, will the community allow you to relax and take it easy?

Food, Facilities, Living Areas and Atmosphere -- Is the food good, great, and are snacks available between meals? Are the facilities comfortable, clean and do the amenities fit your lifestyle? Are the living areas spacious, well-designed, convenient and secure? What's the atmosphere like? Are the residents and staff having fun, and are there good vibes all around?

Price -- Simply being expensive doesn't make a facility good. Carefully evaluate the quality of staff, condition of the facility, services provided and amenities offered. Costs vary widely, and fees are determined by room size, services provided, size and amenity level of the facility and more. Weigh the cost versus value so you can find the most affordable home for your needs now, and in the future.

Recommendations -- Ask friends, family, doctors and other trusted advisors if they have any recommendations. Explore your options on the internet by location, size, etc. You can also turn to a referral agency, whose fees are paid by the facilities. You can find some real help here, but remember that the agency will only refer you to a community with which they have a contract.

Once you have two or three or four solid prospects, VISIT, VISIT AND VISIT AGAIN! Drop in and have a meal or two at the facility you're researching. It's even better, and highly recommended, to do a trial stay for a day or two (most communities have an arrangement for this). Talk to residents and ask what they like, what they don't like, and how they got into the swing of things when they moved in. Take part in activities and try the transportation system. There's no substitute for first-hand experience.

Get an information packet, including contracts, from each community. Also request a copy of the most recent facility standards survey report, which will identify any complaints about the facility, and, if any, what the facility plans to do about the complaint.

When you think you have a leading contender, it's time to look very closely at the money. Most retirement and assisted living facilities accept only private funds or funds from long-term care insurance. You will likely have to pay a deposit to reserve space in the community, which may or may not be refundable.

It is highly recommended to have your attorney look over the contract. Make sure you completely understand what is required of both parties, now and in the future. Don’t take anything for granted if you don’t have clear answers.