Many readers responded to my last article, "They Tried to Steal Mom's Money," (click here to read) where I described in detail how my Mom's long-term nursing care insurance carrier attempted to wrongfully deny coverage upon her admission to an assisted living facility.

One compelling follow up question I received was, "How did you go about choosing the care facility that was the best fit for your Mom?"

I could probably write an entire book on this, but I'll answer as briefly here as I can - - and end with an important piece of advice to parents that can help spare your children a great deal of time, expense, anxiety and anguish.

First, Assess the Level
of Needed Care

You may not be aware that there are different levels of senior care - - from in-home care to outside the home day care to assisted living facilities to skilled nursing homes, and everything in between. So the first step is to determine what level of care will be appropriate.

That's not so easy, but you can seek help. The starting point may be to have the senior in question examined by a gerontologist (I took Mom to a doctor at the UCLA Hospital gerontology clinic in Westwood). The doctor can assess the senior's condition (such as Alzheimer's or dementia) and the needed care level both now and in the foreseeable future.

The second step is to have the doctor refer you to a Geriatric Care Manager. This person is often a nurse or other experienced senior care professional. The Care Manager then can help look for the appropriate care giverand/or facility. (Note: sometimes a Geriatric Care Manager may also be able to do the initial care level assessment in connection with or in place of the gerontologist).

The Care Manager I was referred to (also at UCLA) helped me decide what was best for my Mom (who has early dementia), specifically whether in-home care coupled with outside day care a few hours a day, or an assisted living facility made more sense. This was probably the most painstaking and difficult part of the decision-making process. With the help of the Care Manager, I and my siblings went over the pros and cons of the alternatives and finally came to the conclusion that an assisted living facility would be best.

Next Choose the Right
Care Facility (or Care Provider)

The Care Manager then helped save me countless hours of time and effort by recommending several assisted living facility "placement agencies" (also known as "senior living advisors"). They do the initial scouting of available facilities in a particular geographic area, matching the level of care desired against what is offered by each. Based on the living advisor's past experience with various facilities, he or she can narrow the choices down and recommend a few. (Be aware that the living advisor usually is paid a referral fee by the facility you choose; this doesn't increase the cost but does mean you should get several recommendations of living advisors and maybe do a little online checking of facilities yourself.)

The Care Manager not only referred me to several living advisors but provided me the following links to help me when touring assisted living facilities:

The living advisor I chose (Bonnie Davis, [email protected]) helped me with every step. She spoke with me about the doctor's and Care Manager's assessments, my Mom's likes and dislikes, my preferences in terms of location, amenities (such as a private versus shared room), memory care programs, daily activities and cost (which I'll get into in a moment). She then sent me a list
to go online and check myself. Once I decided upon the facilities I was most interested in, she scheduled visits for me. After each visit, she debriefed me as to what I liked and didn't, which helped me further narrow down the number of additional facilities I needed to spend time to see. Lastly, shehelped me with finalizing the arrangements at the facility I chose.

But don't let me skip an important item here. Before I chose the appropriate facility, I had to. . .

Consider Budget Restrictions
(and Know What The Care Provider Really

At the same time I was evaluating facilities, I determined what was financially feasible by meeting with a financial advisor (Mom had one at Pence Wealth Management). Based on Mom's available resources and long term care insurance, I was able to come up with a range of what was possible. (By the way, when comparing the costs of facilities, I would caution you that you need to clearly understand not
only their "base" fee but all the other "additional charges" that may be involved, so you stay within budget!)

With all the good, professional help I received, the process of choosing the facility was a lot easier. But...

Then The Most Difficult Part Arrived:
Taking and Admitting Mom into the Facility!

Mom never had "the conversation" with her children as to her senior care preferences. For years, she had merely expressed that she never wanted to go to a nursing home (because she had seen her mother suffer and die in one). Mom simply declared she wanted to live at home for as long as possible. However, it eventually became clear that Mom couldn't be alone and none of her children could provide the almost 24 hour care she needed. Unfortunately, when it was time for the decision to move her to an assisted living facility,
Mom's dementia had increased to the point that the decision couldn't be left to her. So we had to make it for her.

Moving Mom wasn't easy, but after Mom's initial shock - - and numerous late-night phone calls complaining and pleading to leave (very gut - wrenching!) - - Mom did get settled in. Now she even raves about her new life, her new friends and all the interesting daily activities she enjoys!

But I can tell you that the week leading up to her admission and the first three afterwards amounted to about the worst month of my life. I was physically and emotionally exhausted. My wife and my friends told me they had never seen me look so worn-out.

So Here's My Advice to Parents

You've probably done an estate plan (or should do one, if you haven't!), in order to ease the transition of your financial, medical and personal matters to your loved ones when you become disabled and pass away. But, given the reported statistic that more than 70% of those over age 60 will requires some form of senior care during a "twilight period" of anywhere from 2 to 10 years (or more), you can and should do more. Develop a senior care plan with your children now. If you don't take the lead, your children probably won't feel comfortable talking about it - - until it becomes a very different situation for you and them, like what I and my siblings went through.

Actually visit some facilities while you still have the physical and mental ability. By choosing ahead of time where you would like to spend your later years and communicating it to your loved ones, you will make life so much easier on yourself - - and them!

Philip J. Kavesh
Nationally recognized attorney helping clients with customized estate planning guidance for over 40 years.