Amy Miller, LCSW, is the Director of Family Services at the Alzheimer’s Association Colorado Chapter, where she meets with families and helps develop a plan of care to address short-term needs and long-term goals. Her background in working with older adults includes managing a Memory Care Unit at a Skilled Nursing Facility, as well as working with care managers & health clinics to provide information and support to older adults and their families.
One of the most common topics in family care consultations is how to go about choosing the right care community for a person with dementia. The process can be time-consuming and overwhelming, but having the right information will save families unnecessary time and disappointment. Here are the five steps for selecting the right care community:
Step 1: Determine what the person’s level of need is. Assisted Livings offer a lower level of supervision and medical attention than Skilled Nursing Facilities. The person might need Memory Care if they frequently try to leave and are at risk of wandering. Click here to learn more.
Step 2: Determine how you will be paying for care. Assisted Livings average about $3500 a month, but costs can increase quickly if you need to add on personalized services. Skilled nursing averages $7700 a month. Generally, a person can pay out of pocket, with a long-term care insurance policy, with VA benefits, or through Long-term Care Medicaid. Keep in mind not every community accepts Medicaid. If you need assistance determining how you will pay, the Alzheimer’s Association offers a free Legal and Financial Planning class.
Step 3: Call the Alzheimer’s Association Helpline (800.272.3900) to get a list of care communities in your area. Find the communities that work based on level of care, payer source accepted, and location. Call to see if there is a waitlist, and if you are paying with Medicaid check if the community requires you to pay out of pocket for a period of time first before you can use your Medicaid benefits.
Step 4: Tour three to five places. Use the following checklists from the ombudsman’s office when touring to get a feel for the community:
Once you have visited a few places, call the Area Agency on Aging and speak to the Long-Term Care Ombudsman to see if there have been frequent complaints or serious issues on their Health Department surveys.
Step 5: Tour the places that have passed your screening again. At least once arrive without an appointment, ideally during the evening or weekends when most of the management team isn’t there. Visit during a mealtime, and observe how staff are able to manage during their busiest time of day. See if there are visiting family members that you can talk to about their experience.
Trusting a care community to care for your loved one is difficult. It can be confusing to know where to start, but the Alzheimer’s Association is here to help. If you’d like more information on choosing a care community, you can contact the Helpline 24/7 at 800.272.3900 and speak to a counselor over the phone or set up an in-office Care Consultation to create a step-by-step action plan specific to your family’s situation.
Quick Guide To Helping Families Select A Care Community:
- Determine the level of need (ALF, Memory Care, Skilled) and how you will be paying (LTC insurance, VA benefits, private pay, Medicaid).
- Go through our list, finding places that will work in terms of location, payer source, and level of need.
- Call and ask about any waitlists.
- Tour 3-5 places once. Get a feeling for the community using our checklists of things to look for.
- Any contenders that are still in the running after the first visit: call the long-term care ombudsman to see if they have any frequent complaints from residents or families or serious deficiencies from the Health Department.
- Tour again, this time unannounced. Go during the evening or weekend, when most managers have gone home. If possible, go during meal time to see the staff when the demand on their time is highest, and see if they are still able to interact and take the time with residents that is needed.