Help is available when you are faced with choosing a nursing home, assisted living, or home care.
We may take our independence for granted until we experience a health crisis or become primary caregiver for a friend or member of the family.  Suddenly, we are confronted by health insurance,  Health Maintenance Organizations (managed health care), the complex vocabulary of the long-term care industry, and the tension between choice and safety.  
A recent study commissioned by the American Association of Retired Persons, "Beyond 50 2003: A Report to the Nation on Independent Living and Disability,"  reveals that people age 50+ who have disabilities are highly motivated to maintain their independence.  And, as Judith E. Heumann has put it, "Independent living is not doing things by yourself, it is being in control of how things are done." (Co-Founder, World Institute on Disability)

If you or an elderly relative begin to experience a health care decline, or are finding it difficult to manage the increasing health care needs of a family member, do you know where to turn for information or assistance beyond what you can offer?   If they need a respite stay, rehabilitation, or ongoing care in a nursing home or other long-term care setting, can you help the senior choose wisely from the wide range of nursing homes and assisted living facilities?
Consider the scenario of Anna W., an 85-year-old widow.  Anna, who lives with her daughter, fell and broke her hip.  She was rushed to the hospital, and underwent surgery to repair the break.  After several days, the hospital discharge planner told Anna’s family that she no longer needed hospital care.  However, Anna still needed rehabilitation services and general assistance while she recovered from surgery and regained enough strength to walk and care for herself.
Experienced Long-Term Care (LTC) Ombudsman professionals offer free, objective assistance with complex decisions like this one  – identifying all the options and assisting with developing a selection process for choosing a long-term care provider that is best suited to meet the client’s needs and preferences.  LTC Ombudsman staff helps each person narrow the search to just a few facilities that meet their criteria.
Instead of “rating” facilities, we provide objective information and a context for the facility’s past performance as it relates to the needs of the individual seeking care.  Click here to locate your local LTC Ombudsman Program.  Your LTC Ombudsman Program can also refer you to other resources in your local area to address your specific needs.
Mark O’Keefe, Regional LTC Ombudsman from Southwestern Ohio, describes the value of advance planning:  “Obtaining input and guidance from the LTC Ombudsman Program during the planning and selection stage does more than help with this immediate decision.  The information we provide during the admission process helps shape the experience consumers have with long-term care, and we see the impact of this on a daily basis.”
O’Keefe explains, “Unfortunately, we hear frequently from callers who first learn of the Ombudsman Program when they have a concern about care and services, and are unsure of how to proceed with addressing this in the facility.  By this time, trust has often been violated, important details have been overlooked, and re-establishing productive communication is a challenge to all parties.  
When we can help consumers establish a good understanding of long-term care from the outset, we are often able to provide the information that improves their sense of well-being and equips them to address concerns directly with the appropriate decision-makers in the facility.  When the problem persists, they know that – with the client’s consent - a LTC Ombudsman can become involved in resolving the problem or can offer alternative strategies that reflect their desired outcome.”
Brief Tips for Selecting Long-Term Care:
· First, assess health care needs – immediate and future.  
· Explore services and limitations of the long-term care options in the community. 
· Develop an outline of the senior’s needs, preferences, and resources. 
· Determine how a health care provider’s past performance relates to the senior’s care needs
· Visit several long-term care communities – repeatedly – to form your own impression. 
Many selection tools and checklists are available on the internet.  Make sure you consider the potential bias of the sponsor of the checklist.   Click on the links below to obtain more information.
§ Comparing Home Health Agencies  (Centers for Medicare & Medicaid Services)
§ Comparing Nursing Homes (Centers for Medicare & Medicaid Services)
§ Checklist: What to Look for in a Nursing Home (AARP)
§ Consumer Guide To Choosing A Nursing Home  (National Citizens Coalition for Nursing Home Reform)
§ Choosing Assisted Living (Better Business Bureau)
§ Health Care Decision Making – who will decide when you can’t? (Nolo legal website) Alternate resource:  http://www.abanet.org/ftp/pub/aging/adb.doc
§ Aging Parents & Children Together fact sheets (Federal Trade Commission)
Article Submitted by:  By M.E. Day, LTC Ombudsman
First published by Cincinnati Bar Association