Friday, January 25, 2008

Planning Ahead for Future Need

If you or a loved one becomes sick and need home health care, what agency should be called? If you or a loved one can't get around and do for yourself but can still stay at home, what kind of services do you want to help you with daily living? Most families don't know this information until the unexpected happens. Plan for the unexpected now and share your plans with family members, NOW.

Ask permission of your loved one to have the discussion. Having a conversation about the need for long term care is in the best interest of the entire family. Because the need for long term care is a challenging topic to discuss, some people might need more time to think and reflect on it than others. Asking permission assures your loved one that you will respect his or her wishes and honor them. Some ways of asking permission are:

- “There is something very important to me that I would like to speak with you about. I’d like to talk about your wishes and desires for the time when your health requires more care than you or I can provide at home.”

- “I would like to speak with you about the options and benefits of long term care. I don’t want to alarm you, but it will make me feel better if I know your wishes when it comes to your health in the future.”

Unplanned decisions are uninformed decisions, and in the heat of a crisis, they are rarely in anyone's best interest. Take proactive steps now:

• Create a "Rainy Day Folder" that places all of your directives in one place and share a copy with family members.

• Fill out a Living Will so everyone will know what you want regarding any end-of-life decisions

• Make a list of all your physicians and identify the hospital of your choice in the event of an emergency

• Choose a Durable Health Care Power of Attorney so a trusted loved one can make health care decisions when you're too sick to make them

• Choose a home health agency that will provide home health visits once in hospital or inpatient skilled care is no longer necessary. An agency that can provide private duty care if needed in addition to visits by therapists and nurses will help eliminate the need to deal with multiple agencies.

Getting your loved one to focus on and speak about this topic can be a very challenging process. A common response is, “I don’t need any special help.” Your loved one may not want to show signs of weakness or loss of control, which many people associate with long term care. Don’t be discouraged. Let him or her know you are concerned and that by discussing this topic, you are looking out for his or her best interests. Although you don’t want to pressure your loved one, be persistent and return to the topic over time.

Be a Good Listener
By listening, you can learn the wants and needs of your loved one.

It is important for you to understand what is best for your loved one when it comes to long term care, so spend most of the conversation listening. Your goal is to answer questions he or she might have and be able to provide insight on the topic. Here are some helpful tips:

Listen to his or her needs; what he or she is sharing is important.
Show respect.
Acknowledge your loved one’s right to make choices.

Provide Information

There’s a widespread misconception that Medicare pays for long-term care, but in fact, it only pays for very short term stays in skilled nursing. The average monthly cost of a nursing home nearly $7,000, and stays that exceed several years, it’s critical for people to start planning while they still have the ability to choose the long-term care service and finance options that are best for them.

It is important to realistically evaluate the costs associated with long term care and identify what is affordable in each case. On this page you can find a link to the National Clearinghouse for Long term Care, which provides helpful tools to support families in planning for future health care needs.