More often than not people choose long-term when they are in crisis mode. You know, mom or dad has fallen and is in the hospital. Now what? Nursing home, keep them home with help from the family, or maybe an Assisted Living Facility. Choosing long-term care is a very difficult decision. Not only are there numerous types of long term care, but literally hundreds of choices for each type. Whew!
Here are some simple steps that will hopefully help…
If you are in crisis mode, skip Step 1.
Step 1: Planning
It’s a good idea to get with an Elder Care Lawyer. They can help put together trusts or begin the process of applying for Medicaid (in Arizona it’s called ALTCS) or for VA Benefits. It’s a good idea to do these years in advance because many programs have a look back period on financial records. It’s also good to start documenting any type of care required or any diagnosis. Keep in Mind: MEDICARE DOES NOT PAY FOR LONG-TERM CARE. Medicare will only pay for skilled nursing services like physical therapy. They do not pay for caregivers.
Step 2: Assess the Needs
What type of care is needed? People often refer to these as Activities of Daily Living or ADL’s:
- Personal hygiene and grooming
- Dressing and undressing
- Self feeding
- Functional transfers (getting into and out of bed or wheelchair, getting onto or off toilet, etc.)
- Bowel and bladder management
- Ambulation (walking with or without use of an assistive device (walker, cane, or crutches) or using a wheelchair)
Other services that you might need include homemaker services: meal preparation, shopping, housework or laundry.
Although, you may need help with only one or two types of activities of daily living, like help with eating or bathing, it is important to make a list of the kinds of services you need and revise this list as your needs change.
Most reputable home care agencies will provide a complimentary, no obligation assessment to help you with determining the level of care required.
Step 3: Paying for Long-Term Care
- Family members
- Private Pay
- Long Term Care Insurance (costs might exceed original coverage amount)
- Health Insurance
- Trust
- VA Aid and Attendance Benefits
- Medicaid (financial and health requirements apply)
Step 4: Choose Long-Term Care
These are the most popular choices for long term care:
- In-Home Care Services – provides professional caregivers in your home to help with ADL’s and Homemaker
- Assisted Living Facility (often called Nursing Homes) – moves to facility where they provide meals and assistance with ADL’s.
- Group Home – Group home setting with multiple people living in one home.
The average cost of care for each is different.
I hope this helps and if you are in Phoenix, AZ or a surrounding community we can help.


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