When it comes to elder care, there are many options out there—and it can be an incredibly daunting task when making critical decisions about the future. As a result, you may gravitate toward long-term care, or services that meet your loved ones’ personal needs over an extended period of time. These include home-based health care, day centers, assisted living facilities, and independent living communities.
But how should you broach the subject with your loved one? Being a support system for your aging parent or loved one often means having important conversations about the best choices for their health and well-being. Here, we address some common questions about long-term care—including when to consider it and which options are right for them—to help you navigate that key discussion with your loved one. We hope it will point you toward the best choice for your loved one’s situation.
How Do You Determine Whether Your Loved One Needs Long-Term Care?
It is important to note that no specific behavior indicates when it’s time to pursue care for aging parents or loved ones, but the behaviors listed below warrant further action.
If your loved one is displaying any of the following signs, they may need some form of long-term care support or services:
- Physical deterioration
- Mental deterioration
- Environmental deterioration
- Loss of two or more activities of daily living (ADLs)
Initiating the conversation early on—at the first sign of deterioration—can prevent undesirable outcomes. Early intervention can radically slow physical or cognitive decline, allowing you to avoid or delay short-term care alternatives, such as hospice care. By staying ahead of the curve, you can help your loved one lead a longer, healthier, and more satisfying life.
How Should You Start the Conversation About Long-Term Care?
Before initiating the discussion, all involved adults—including the loved one’s children, siblings, and in-laws—need to be on the same page about what they see and the best course of action. Once everyone agrees on what should happen next, follow these tips below:
Smooth out any conflicting opinions, and don’t spring the issue on your loved one(s) without warning. Instead, ease into the discussion by pointing out the things everyone agrees they’re seeing. Then, discuss ways they can help with finding home care or assisted living.
Emphasize the positive side—in particular, that this decision will improve their lifestyle and safety. Suggest touring some facilities, meeting with home care services, or consulting with a geriatric care manager.
Reassure your loved one that they will have a support system every step of the way, and encourage them to ask questions. It is essential that they feel secure and that you conduct an ongoing open dialogue about the process.
If they do react negatively, be patient with them. Try to listen to, empathize with, and support them.
What Long-Term Care Options Are Available?
While there are many elder care options to choose from, the best course of action will depend on your loved one’s needs, including the personal and medical assistance they require. Long-term care is available in the following forms:
- Assisted living facilities
- In-home care
- Nursing homes
- Independent living communities
Depending on their needs and desires, your loved one may prefer one setting to another—if they’re open to the idea at all. Certain choices may ease their transition process, encouraging them to embrace change over time. If your loved one isn’t interested in an assisted living facility, for example, a home-based option—where caretakers assist with cleaning, cooking, and more private personal care needs—may be a good alternative.
Similarly, day centers may serve as a meaningful stepping stone to independent living communities or nursing homes. Of course, when it’s time for assisted living, there’s little doubt that these changes are necessary. Still, there may be resistance, which is why approaching the topic with compassion and sensitivity is so important.
Pursuing long-term care can be a gradual transition that starts at home. But it’s a decision that can drastically improve your loved one’s quality of life—especially given the drawbacks of getting by on their own or receiving devoted care from family members.
It is also important to understand costs and how to pay for them via Medicare, Medicaid, income, assets, and insurance.
Is It Possible to Delay the Need for Long-Term Care?
There’s no guarantee that your loved one won’t need long-term care at some point. That’s why it’s never too late to start planning for costs and live as healthy as possible, which can delay or even prevent the need for care in the future. The sooner you start, the better!
Here are some great ways for aging adults to adopt a healthy lifestyle:
- Frequent exercise
- Puzzles and other brain games
- A healthy diet
- Alcohol in moderation
- Avoiding smoking
- Proper sleep
Nothing wipes out retirement faster than the onset of health problems—which is why staying healthy is one of the smartest financial investments a person can make.
My Loved One Isn’t Ready for Long-Term Care. What Happens Next?
You’ve approached your loved one about entering long-term care, but they feel it isn’t the right time. What should you do?
Try to understand. Your loved one will likely appreciate your concern but let you know they’re capable of performing ADLs. They might also maintain that any assistance from family members, such as driving or housekeeping, is minor and not medical. However, this discussion is an opportunity to discuss their wishes for the future and organize finances, estates, medical directives, and power of attorney (POA). During this conversation, everyone involved can determine their roles when the time comes.
Discussing long-term care with your loved one can be intimidating, so you should navigate the conversation with sensitivity and respect. Ultimately, you want what’s best for your loved one—both now and in the future. You can thoughtfully convey that message and ensure all parties are on the same page by following these steps.
Concerned about the costs of long-term care? Life settlements, which involve the sale of your loved one’s life insurance policy, can provide the financial security you’re looking for. These proceeds can be used for any purpose, including long-term care. In some situations, there may be tax advantages. By pursuing a life settlement, your loved one can receive about four times the cash surrender value of their policy—a significant addition to their retirement income.
If your loved one is ill, you may want to consider viatical settlements, which are life settlements for those with chronic or terminal conditions. Though each situation is different, viatical payouts tend to be higher, and—for certain patients—are entirely tax-free.
Seeking out the best long-term care option can be challenging: after all, each one meets a distinct set of needs. We hope this page can serve as a beginner’s guide to navigating long-term care—its benefits, costs, and timelines—and help you locate the best fit for you and your family.