A Quick Guide To Care
If you’re in the position of investigating care options for a loved one or for yourself for the first time, the options can be overwhelming. Here is a quick reference guide of information to help sort out what’s offered. These resources are provided to help anyone who’s looking for information about memory support, assisted living, or skilled nursing and rehabilitation for seniors.
You want what’s the best fit, and we can help. When it’s your loved one or yourself, you want the best. We understand how much there is to manage when you’re investigating options. This quick reference guide offers basic information about memory support, assisted living, and skilled nursing and rehabilitation.
Medicare is a federal insurance program for people 65 and older and those who’ve been disabled for at least two consecutive years. There are several kinds of coverage:
- Medicare Part A covers comprehensive nursing care and rehabilitation services immediately following a hospital stay, limited to a period of 100 days per incident of illness. Part A also covers hospitalization, home health and hospice.
- Medicare Part B helps cover services such as outpatient therapy, durable medical equipment (DME) and other services.
- Medicare Part C provides Advantage Plans/Medicare replacement plans.
- Medicare Part D covers medications.
ELIGIBILITY FOR SKILLED REHAB
For the Medicare Part A benefit, the insured must meet these qualifications:
- Medicare is their primary form of insurance. They can have a secondary insurance policy, but can’t have coverage through an HMO/Medicare Advantage Plan.
- They’ve spent at least three consecutive inpatient midnights in a hospital within the last 30 days.
- They have a qualifying diagnosis and a need for daily skilled services, such as nursing or therapy services.
- Their doctor has written orders allowing them to be discharged from the hospital to a Medicare-certified comprehensive nursing care facility.
WHAT’S USUALLY COVERED
When rehabilitation services are needed, Medicare covers room and board, dietary counseling, medications, medical social services, medical supplies and equipment used, and ambulance transportation (when other transportation endangers health). And when needed as part of the insured’s health goals, Medicare also covers physical, occupational and speech therapies.
Alzheimer’s disease and other forms of age-related dementia are brain/memory disorders that adversely affect a person’s job or lifestyle. Dementia may be caused by stress, depression, nutritional deficiencies, Parkinson’s disease or other illnesses. Alzheimer’s is the most common form of dementia among older people; it involves the part of the brain that controls thought, memory and language. Progressive and degenerative, Alzheimer’s usually begins after age 60, and the risk rises with age. Nearly half of those over 85 show symptoms. Still, researchers frequently remind us that Alzheimer’s is “not a normal part of aging.”
WANT TO KNOW HOW TO SPOT DEMANTIA? Watch for these behavior and lifestyle changes, and when help is clearly needed, go with your loved one to seek a professional evaluation:
- Problems with walking, talking, eating, dressing, managing medications
- Uncharacteristic in appearance and personal hygiene
- Loss of short-term memory and diminished reasoning and task completion skills
- Stacks of unopened mail, unpaid bills
- Changes in appetite or sleep patterns
- Depression or abuse of alcohol
CHOOSING A DEDICATED MEMORY SUPPORT COMMUNITY
As driving ceases and other losses of independence occur in the progression of the memory loss, it’s time to explore the specialized memory support options offered in dedicated settings. In recent years, advances in programs and treatment have resulted in sophisticated residential programs that help residents live contentedly and engaged with their daily lives. When you’re looking for a new environment for your family member — whether it’s at a full-service senior living community, a free-standing assisted living or skilled care community, or a specialized memory care and Alzheimer’s community —keep these questions in mind:
- Is it comfortable and clean?
- Does it provide for safe wandering indoors and out?
- Are there colors or other cues to define areas?
- Is the overall lighting even?
- Are the bathrooms identifiable and safe?
- Do the furniture arrangements encourage interaction?
- Are there personal private places?
- Are there private places for the family to interact with the resident?
- Is the location convenient for you and your family?
- Is it specifically designed for people with Alzheimer’s or other forms of dementia?
- Are there opportunities for nurturing?
- Are behaviors accommodated without the use of restraints?
- Is there a full daily schedule for residents?
- What’s the philosophy of care?
- Who completes the initial assessment of your family member?
- How often are subsequent assessments done?
- What training does the staff receive?
- Are current residents active?
ASSISTED LIVING – The goal is independence — as much as possible. And when seniors receive assistance to accomplish the daily tasks like bathing, dressing and grooming, their sense of independence and individuality can grow.
HOW DOES ASSISTED LIVING HELP? The services offered within assisted living communities vary, but typically you should expect your loved one will have the following:
- Safety and security
- Personal care and assistance — especially with the activities of daily living
- Housekeeping and laundry services
- Meals in a community setting
- Social activities with an overall wellness emphasis
- Transportation services for shopping and medical appointments
- Health services, as needed — including medication management
How do you know if your loved one needs assisted living? Start with an honest appraisal of their competence with basic and ordinary activities, including bathing, dressing, toileting, getting in and out of bed, and feeding themselves. Have their health conditions worsened? Are they keeping up with bill paying, housecleaning, cooking, transportation and socializing? If not, it may be time to explore the area’s assisted living options.
SKILLED NURSING AND REHABILITATION
SKILLED NURSING – Long-term diagnoses call for long-term plans. When, for any reason and at any time, your loved one’s condition requires a licensed nurse 24/7 for days, weeks or even months, skilled nursing may be the answer. Anchor your search for skilled nursing for your loved one in a physician’s evaluation. The professional assessment of medical and daily living needs will help you know what’s needed next. If home care and/or outpatient care are inadequate to meet the demands presented by an acute illness, injury or post-op condition that doesn’t require hospitalization, you’re likely to discover skilled nursing is the right choice.
REHABILITATION – Many don’t know that rehabilitation is often offered within a skilled nursing setting, where staff, technology and services are ideally suited to delivering both long-term care and short-term skilled nursing — or “rehab.” When your loved one needs the right space for their body to heal and be its best — skilled rehab may be the answer.
Rehab is usually prescribed following an injury, surgery or illness that would heal faster or more thoroughly from new muscle memory, strength training, antibiotic IV therapy or other treatment. Ordinarily, rehab treatment can range from several days to weeks, and successfully concludes when all treatment goals are met and the resident is released to return home.
There are different care options available. No matter the setting, have a plan, make a checklist and plan to visit the community to make sure that it’s a good fit for you or your family member.