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Making Choices Guide Essay

As we age our bodies and lives take on many different changes. Some of these changes are for the better and then there are changes that are not so much in our favor. Our health status is the one thing that can vary from time-to-time as we age, and for this we have to prepare ourselves for the many possibilities of needing long term care (LTC). Once the need for LTC is evident, there are many decisions to be made, and a long list of things to take into consideration. Finances, costs, demographics, and independence, are just a few variables to consider when choosing where you or a loved one will be spending the next chapter in life. Finances are the most important variable to take into consideration, mainly because plain and simple; the care is going to cost. Whether a LTC facility or a person’s home is going to be the place where the care is delivered, there will be some expenses accrued. Personal income, annuities, long term care insurance, savings, government programs (Medicare & Medicaid), Veteran’s Benefits, and reverse mortgages are just a few payment options available for LTC.

There are more payment options becoming available through new financial products as our populace ages. When it comes to the costs of delivering the care, and where it is to be delivered, a lot of things come into play. Residing in a LTC facility brings about a multitude of expenditures compared to staying at home or aging in place. In 2010, semi-private rooms averaged about $200 a day in a nursing home, and about $230 for a private room, and a one bedroom apartment in an assisted living facility averaged about $3,300 a month. Those costs are not all inclusive. There is usually a cost for added services such as private laundry, additional activities or programs.

According to LongTermCare.gov (n.d.), it is wise to think now about how your current residence and community will support your needs as you age and require long term care services. Staying at home or aging in place has its expenses too. A home owner’s expenses are a little less costly if they had their home built to their satisfaction to begin with. This eliminates having major work done on the home to accommodate the need for LTC. The adding of handrails and ramps, throughout the home is much cheaper than living in a LTC facility for a month. Another advantage of aging in place is the caregiver could be free of charge if it is a friend or relative. On the other hand, the cost of home health aides and homemakers range from $19 to $22 per hour. There are also programs to assist those who choose to age in place. One program is The Older Americans Act.

According to LongTermCare.gov (n.d.),The Older Americans Act is a Federal program designed to organize, coordinate, and provide home- and community-based services to older adults and their families. These services and programs assist the elderly and older adults in remaining independently in their communities. Local transportation services, in-home personal care, meals delivered for the homebound (and available in the community), and homemaker services are just a few of the programs and services available through the Older American Act. These services are also extended to Native Americans. Having the feeling of belonging where you are is a comfortable feeling. When making the decision on where you plan to live your next chapter of life, it is important to keep in mind to find somewhere comfortable and familiar to you. Nothing is more familiar to a person than where they are – home. . Here is where the demographics can come into play.

Most individuals are familiar with their communities and the people within them, so it is a little easier to locate services and programs in the area. Community-based programs are mostly targeted to help the elderly, disabled, and older adults to reestablish and preserve their optimal level of self-care, while preventing and prolonging unsuitable and unwanted institutionalization. According to Gibson, (1995 – 2014), these programs stress partnership with the participant, family, caregiver, primary care physician, and the community in working toward maintaining personal independence. An outstanding and reliable social support system can be a valuable asset, regardless of where your next chapter in life may take place.

Having family, friends, and the support of others (staff if in a facility) can have a positive impact and influence on the individual receiving the LTC. Regular visits and communication can also influence positive motivation. According to AHRQ (2006), social support and interaction within the facility also relate to quality of life satisfaction and reduced isolation and depressive symptoms, which is important for independent individuals.

Other variables that can affect a couple’s or individual’s choice on a LTC facility includes whether or not the facility is Alzheimer’s friendly. If the individual who is needing the care has Alzheimer’s, you would want to make sure the staff are properly trained to care for them. Other things to consider is whether or not there is a wing or ward for individuals with Alzheimer’s., or if the facility is safeguarded for these individuals to roam around indoors and out. .It is important to know the staff to resident ratio. There need to be enough staff to service the residents at all times. Visiting is a variable to be considered also. Not only having family and friends visit, but if the individual’s mobility is at a doable level, are they able to do an outing with a family member or friend? 

When the time comes to make the choice of where your next chapter in life is going to be spent, be sure to thoroughly research your options. Make sure that the services and programs you choose are not only available now, but also available for the future. There is an endless list of variables to consider. You would want to make sure the facility and staff are licensed and certified to provide the care needed. It is also important to know if the facility has full access to the medical care needed. A very important variable is behavior management. Knowing how the facility deals with various types of behaviors is significant to another resident’s safety.

Question the facility as to whether they use chemical or physical restraints, or if the individual is shut off from the main area. These are just some of the variables and questions to consider. Keep asking questions until you are fully satisfied and happy with the answers. When older adults and the elderly are devoted and participating personally in their care, they tend to be more satisfied with where they are and the decisions they have made to get to that point. 

AHRQ, (December, 2006), Factors Important to Consumers When Choosing Residential Care, U.S. Department of Health & Human Services (DHH), Retrieved from http://www.ahrq.gov/professionals/systems/long-term- care/resources/facilities/ltcscan/ltc5.html

Gibson, H., (1995 – 2014), Choosing Well: Long-Term Care Facilities, Today’s Caregiver, Retrieved from http://caregiver.com/channels/ltc/ articles/choosing_well_ltc_facilities.htm
LiveStrong Foundation, (n.d.), Assisted Living and Nursing Home Facilities, Retrieved from http://www.livestrong.org/we-can-help/managing-your-life-during-treatment/assisted-living-and-nursing-home-facilities/ LongTermCare.gov, (n.d.), Costs & how to pay, Retrieved from


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