Choosing Care – Ah! Choices, Choices, Choices!

Choosing Care – Ah! Choices, Choices, Choices!

How Do I Choose A Carrier?Because we help many families file long term care insurance claims here at Mrs. LTC, we see a lot of different family situations.  Folks with no children, folks with only one child, folks with children that live far apart, folks with families that work pretty well, and many with families that don’t work well at all.  Mostly, though, we see people in severe stress because they are suddenly called to manage another person’s affairs and health decisions when they are not trained and/or already have a full life of their own they are trying to manage.  Yes long term care management for loved ones can be stressful!

So let me give you a few vocabulary items and a way to do triage on deciding about what type of care you should consider…

  •  Doctor’s orders: one thing most of us don’t’ think about is how powerful it is that a doctor “orders” care to be thus or that.  Insurance carriers and family members alike often ascribe more authority to the orders of the doctor than to any other source of information or recommendation.  And while I would also agree that doctors, more highly trained than the rest of us, have a very informed idea of the type of care that a person is most likely to need moving forward.  That said, the “order” of the doctor is really a strong recommendation.  You should heed it, but in the end the doctor will not be the one to make the final decision
  • Home Health Care (HHC) – often people think they will want to stay in their own home for care. The logic is sound:  most of us would rather be around our own things in our own nest where we feel safest and happiest.  Further, home health care can be less cost when the care needs are only a few hours a day or every other day.    So home health care should be considered if there are family members dropping by to check in, neighbors or friends who stop by to visit, and a trustworthy care giver to show to the home to provide the care.  But home health care does have a cautionary side.  Most notably if there is to be senior abuse, it is easiest to conceal in a private home where there is no one else to oversee the care.  Further, folks who are “shut-ins” with no visitors or family, or outside stimulation often suffer from depression and other mental challenges.  Mental health must be a part of your considerations as you weigh home health care.   Be sure you consider just how well served overall  the senior may be if they are cared for in a private home.
  • Assisted Living Facility (ALF) – Often people will opt for an assisted living community when their care needs exceed a few hours a day. For one, the cost of care in home health can escalate and eventually exceed the cost of an assisted living facility if the care requirements are more than 6 or 7 hours a day.  But a second reason to consider an ALF is because there is usually more stimulation than in home health care.  Assisted living communities pride themselves on creating community – they have activities (Super Bowl parties and poker, to name a couple…hey!  It isn’t all just bingo!), a feeling of “neighbors” and often amenities like barbers and salons that are harder to come by in a home care only environment.  Anecdotally, memory patients and those who have special dietary needs are often said to be happier and better take care of in a place where there are professional care givers to monitor and remind.
  • Nursing Home – usually this is the last place we go. Some of us will never end up in fully skilled care as we will pass away long before we get to this level of need.  However, if you do need a 2-person transfer, need regular transfusions or other medical treatments, it is possible that you would end up in a nursing home where you receive skilled care every day.
  • Adult Day Care – people often use these in the earliest stages of care where a senior is living with family who provide the care evenings and weekends but need someone to be with the senior during the day while the children work. This type of care can be less expensive than an all-day HHC or ALF or NH because it is done in a group environment yet is not 24 hour.


Types of Long Term Care continues to evolve.  One of the newer trends is an adult care home – a home in a neighborhood where 3 or 6 seniors are housed together and cared for by live-in staff.  There have been advancements in robotics even that indicate we may one day see at some care provided by machinery and software.  In the meantime, be sure you understand the physical and mental limitations of the person who needs care  — consult with the doctor or possibly an independent care assessor to be sure that you are choosing the right type of care that will best suit the need.


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