Evaluating a Long-Term Care Facility

Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

Keep in mind that not all specialized Alzheimer's care is equal. When you visit a center, try to determine what makes it unique. For up-to-date information on the wide variety of options available and how to evaluate them, contact the Alzheimer's Association and ask for its guide (see "Resources").

When you visit a facility, ask plenty of questions, such as these:

  • How is the program geared specifically for people with Alzheimer's disease?

  • Are the caregivers trained in the treatment of Alzheimer's?

  • Is it a homelike environment?

  • Are residents engaged in meaningful activities?

  • Does the facility incorporate design features that can be helpful to those with Alzheimer's, such as enhanced lighting, color-coded hallways, and plenty of walking room?

  • Is the environment safe? How secure is it for people who wander?

  • How would an upset resident be handled?

  • How many people live there? What's the ratio of staff members to residents?

  • Can medical care be given on site if needed? Who provides it? Skilled nurses? Visiting physicians?

  • What personal items can the resident bring?

  • Are skilled professionals — including registered nurses, licensed practical nurses, and certified nursing assistants — on duty at all times?

  • How long and often may family members visit?

  • What's the cost? Does the facility require you to pay privately?

  • If the patient needs to change to Medicaid funding after a few years, will he or she be able to remain at the facility?

  • Under what circumstances would a resident be required to leave?

Because the average cost of long-term care is $34,860 a year for an assisted-living facility and $74,095 a year for a private room in a nursing home, you'll have to investigate payment options. Aside from Medicaid, there is no national government program that funds long-term residential care. Medicaid is administered at the state level and covers only those who are impoverished. It's not uncommon for people to pay for their own care, often until they use up their resources and then become eligible for Medicaid. In some instances, usually if the person with Alzheimer's is also suffering from an acute illness, Medicare may cover a short-term living arrangement for up to 150 days. Your local Alzheimer's Association chapter is an excellent place to start identifying possible sources of assistance (see "Resources").

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More than 5.3 million people in the United States are living with Alzheimer's disease, with a new person developing the disease every 70 seconds. Americans ages 65 and older with Alzheimer's and dementia pay three times as much in health care costs.