Assisted Living Checklist

Choosing the right facility

Most elderly seniors don't need continuous skilled nursing care. But, many do need help with various activities of daily living, including bathing and dressing — sometimes even reminders to eat. These people, including many seniors with early-stage Alzheimers disease, can benefit substantially from assisted living facilities, many of which are part of continuing care retirement communities.

Assisted living facilities vary greatly in their services and philosophy of care. Thus, it is important to find the right facility for your loved one. It will have a profound impact on their dignity, quality of life and sense of well-being.

Assisted living facilities vary widely in size, from a few residents to hundreds. They typically offer private rooms or small apartments, common areas for socializing and recreation, planned activities, 24-hour staffing and controlled access.

Most assisted living facilities offer personalized care and support services, including meals served in a common dining area or taken to a resident's room, shuttles for errands and appointments, housekeeping, help with medication management and emergency call monitoring. Assisted living facilities also offer some resident supervision.

Step One: Determine what you can afford

Many seniors who need help with their activities of daily living will never have to go to nursing homes — if they can afford assisted living. Unfortunately, Medicare pays nothing for assisted living, and Medicaid pays very little. Instead, virtually all expenses are paid out-of-pocket by residents and/or their families.

The good news is assisted living is not as expensive as it first seems. Instead, to an extent that varies from one person to another, it simply involves a shift of expenses from one living arrangement to another.

After a person's capabilities decline to the point where they need assistance, their move into a facility is usually permanent. When their former home is sold, most of the expenses associated with it can then be used to help pay facility-based expenses. And, the money from the sale of their home can be used, for example, to purchase a CD or annuity that pays monthly interest to boost income.

Also, since a facility's fees usually include all meals, no groceries are needed, thereby freeing up even more money. To help you evaluate your loved one's financial situation, we've included a worksheet, Assisted Living ExpensesFinding the Money.

The worksheet assumes no assets are spent down — that they'll remain intact with the interest/dividends they produce used to supplement your loved one's income. But, if your loved one is short on funds, some or all of their assets will have to be spent down. That is, the principal value will have to be converted into a stream of monthly income payments.

However, several factors need to be kept in mind ...

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