Starting a Conversation About Long Term Care

Almost half of all Americans will need long term care at some point in their lives. In fact, one in five over the age of 50 is at a high risk of needing long term care within the next 12 months. Therefore, planning is crucial if you are to designate a facility that will be able to provide your loved one, relative or friend with the highest quality of care and quality of life in a safe and secure environment. Proper planning can help to diminish the feeling of loss or guilt that some people experience when they place a loved one in a skilled nursing center. In addition, such planning helps make the transition less stressful for the new residents, families and loved ones.

Ideally, all affected will be able to realistically evaluate both the current situation and how it may change in the future. Ideally, being proactive will help everyone arrive at a mutual decision that is the best solution. The first step in the planning process is having the conversation about a person’s long term care wishes.

Talk Sooner Rather Than Later

Have the conversation about long term care before the need arises. By planning ahead, you can find the quality of care and quality of life that you desire in a long term care facility for yourself, loved one or other person. Planning ahead will also make the transition easier because many important decisions will already have been made or at least discussed.

When considering long term care, a key advantage to planning ahead is that you will be better prepared financially.

  • While many people pay for long term care with their own funds, purchasing long term care insurance is an excellent way to prepare for these expenses.
  • Medicare, a government program for citizens age 65 and older, may cover the first 20 days of skilled care in a nursing center and may partially pay for the next 80 days, for a total benefit not to exceed 100 days, as long as the person qualifies.
  • Medicaid is a government program for those who lack the ability to pay for health care themselves.

Financial concerns can be the most challenging part when considering long term care. Cost is most commonly determined by the level of care needed, the setting where the care is provided and the geographic location. To ease the process, make sure your financial records are well organized.

Prepare Yourself

Take the initiative by doing your homework and offering options.
Before beginning the conversation with your loved one, it is important to know the basics of long term care. Being knowledgeable about the types of care available in your community will help you through the conversation. With this information, you will be able to lessen the fears of your loved one by providing educated answers to questions he or she might have.

Many people experience feelings of guilt when they consider long term care for a loved one. This is normal and, despite your feelings, you have to realize that you are looking out for the person’s best interests. There may come a time when your loved one is going to need more care or supervision than you have the knowledge or time to provide. Long term care gives professional caregivers the opportunity to provide the quality of care and quality of life your loved one needs and deserves in a safe, secure environment.

Ask your loved one’s permission 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.

Choose the Right Time and Environment
Look for opportunities that arise in conjunction with significant life events. The process of drafting wills, advanced health care directives or legal papers may provide a good opportunity to have the conversation. In addition, family gatherings may help get loved ones to focus on their wants and needs concerning long term care.

Choose a place to have this conversation where you know your loved one is comfortable. It should be a quiet place, free from distractions. Usually, a private setting is best.

Stay Positive
Understand that it is normal to encounter resistance the first time you bring up long term care. Don’t be discouraged, just plan to try again at another time.

Getting your loved one to focus on and speak about this topic can be an extremely challenging process. Your loved one may not want to show signs of weakness or loss of control, which many associate with long term care. Don’t be discouraged. Let the person 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 what your loved one wants and needs. It’s 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 the person might have and be able to provide insight on the topic. Listen to the person’s needs; what he or she is sharing is important. Be sure to show respect, and acknowledge your loved one’s right to make choices.

Include Others in Decision-Making
There are others who will be able to offer guidance on what kind of services your loved one will need and how to tap into community resources. During the discussion, it can be helpful to designate what is most important when it comes to your loved one’s care. That can include input from many different sources including your loved one, family members, the person’s physician or spiritual advisor, close friends or neighbors. These individuals may have an understanding of what type of care is necessary, and some will be able to help determine the facilities that best meet your loved one’s needs.

** Information from the American Health Care Association/National Center for Assisted Living was used in developing this content.