The Importance of Being Realistic About Care Needs

By Janice Martin, Senior Advisor / Family Liaison

It is human nature to want to downplay our care needs. When someone asks how we are, the automatic response is that we’re doing fine – even if we’re struggling. When a spouse takes their loved one to the doctor, they are often frustrated to hear them tell the doctor that there are no concerns. Rather, they have witnessed significant issues that are not being discussed and they’re afraid of saying anything.

Visitors to a senior living community will often insist that they want independent living. Instead, they may have arrived barely able to walk, require oxygen, have macular degeneration, and perhaps some cognitive impairment. Although their desire is to be independent, the reality is that some support is needed. If they did move to independent living, there is the possibility that they would have to move to assisted living in the near future. The goal is to be successful and happy with your decision rather than fail and be disappointed.

Being realistic is also true for those wishing to activate their long term care insurance. It is important to clearly communicate with your doctor about what your needs are so that they can be included in your medical records. Without this, the long term care insurance provider will not approve the need to receive your benefits, resulting in a lengthy delay until several months of documentation validates your request.

When moving to an assisted living community, a nurse will do an assessment to determine what care will be provided and how much it will cost as the care fees are separate from the room rate. Too often, people will not disclose or downplay their needs in the hopes that their fees will be lower. A follow-up assessment must be done 30 days after moving in to review if their initial expectation of care is accurate. If not, the care fees will change. Families will often become angry if it is increased. However, the frequency of falls, assistance transferring in an out of a chair, or assistance with dressing or toileting may not have been accurately disclosed.

I recently helped a family move their mother to assisted living. Their budget was limited and cost was a critical part of their choice. They visited two communities. The first community assessed that mom would be their highest level of care based on a thorough assessment. They explained that if her needs were less than they anticipated after 30 days, the level of care and fees would be reduced. It is often assumed that a community will not lower the fees because they want more money, but this is not true!

The second community asked the mother a few questions and did not ask her to demonstrate any of her abilities, such as how she was able to walk and get up out of a chair on her own. Based on this assessment, they determined that mom would be their lowest level of care. It was almost certain that her level of care cost would increase quickly once the community understood what was actually needed.

The better choice for this family was to agree to move to the community that fully understood the care needs regardless of the fees so they could properly budget. There would be no negative surprises and the family would not be disappointed that the proper amount of care they expected wasn’t done. Although budget is important, having an accurate assessment is the only way to ensure what the true cost will be.

If your loved one has some cognitive impairment, it is important to be with them when the assessment is done when moving to assisted living or to be approved for long term care insurance. As their advocate, you must put aside the fear that your loved one will be angry with you for disagreeing with them to ensure there is a full understanding of what is honestly needed.

My mother was living in assisted living and had an assessment to continue her long term care benefits. An interview was conducted without our participation or knowledge. She was asked if she needed assistance with walking or dressing. She happily reported that she was doing great and needed no assistance whatsoever! In reality, she needed extensive assistance, but the nurse never asked for a demonstration nor ask to see any documentation from the community. She was then denied her benefits because their assessment showed there were no qualifying needs. After an appeal, we had to wait for a second assessment during which time she received no compensation.

Hopefully, it is clear that the only way to ensure receiving the appropriate care that is needed and deserved depends on recognizing those needs, admitting them to yourself and others, and communicating them!

Janice Martin, president of Senior Liaison of Central Florida Inc., is available to answer questions and personally assist in locating an assisted living based on care needs, budget, and location. She is also the author of “The Complete Guide to Assisted Living” available on Amazon.com. For a free consultation, call 352-477-1866 or email SeniorLiaisonCFL@gmail.com. Please also visit our website at SeniorLiaisonCFL.com or on Facebook at Senior Liaison.

Senior Liaison of Central Florida

352-477-1866
seniorliaisoncfl.com
seniorliaisoncfl@gmail.com