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Ten tips


© St. Petersburg Times, published May 6, 2001

Elder care options for your loved one

The number of people who need help with basic daily-living skills is expected to skyrocket over the next two decades as the population ages. If your parent or loved one falls into this category and you're grappling over which form of care would be best, consider these tips from the Consumer Reports Complete Guide to Health Services for Seniors.

1. Assisted-living facilities. People are given their own residential units at such facilities, which combine features of apartment living and features of a nursing home. For a monthly fee, residents receive access to services such as meals, housekeeping, transportation and personal assistance. Such facilities might be a good option for sociable people who are starting to need help.

2. Home care. If your loved one loathes the idea of communal living, home care provided by a home attendant might be more appropriate. Attendants hired from a Medicare-certified agency charge about $20 an hour, while attendants hired from a licensed home health agency or a registry may charge less. Important factors to note: Your relative may not have much social interaction with this option, and the bill will add up fast.

3. Adult day care. This option works well in combination with home care. For several hours each day, people get out of the house and participate in activities. One drawback is that most people must pay the full cost for adult day care on their own, although some help might be available through a Program for All Inclusive Care for the Elderly. For information, call (703) 535-1565.

4. Continuing-care retirement communities. If you or your relative has a lot of money, CCRCs provide a range of care. Residents can buy or rent a living unit and live independently until they need assistance temporarily or permanently. At that point, they can go to the CCRC's assisted-living section or nursing home. Some CCRCs charge a hefty upfront fee as well as monthly fees.

5. Section 202 housing. People with small incomes should explore government-subsidized housing units offered under Section 202 housing. Such housing usually features shared dining rooms that serve one or two meals each day. But because many Section 202 buildings do not have coordinators or medical personnel, you may have to create your own array of services for your loved one.

6. Board-and-care homes. Basically, people with space in their homes obtain a license from the state and take care of four or five residents, providing meals, personal assistance and activities. This option costs much less than some assisted-living facilities, and sometimes Medicaid covers the expense.

7. Nursing homes. The Consumer Reports Complete Guide to Health Services for Seniors identifies problem nursing homes in each state. Be aware that many nursing home residents pay for their care by "spending down," or exhausting all of their income and assets before Medicaid kicks in.

8. Be discerning. Regardless of which option you select, visit the facility several times and determine the philosophy of care. Do the personnel seem helpful, considerate and genuinely concerned about your loved one? Is the facility functional for people who may have a hard time getting around and navigating distances?

9. Consider your finances. Before making any decisions, reflect on your financial situation, and your relative's, over the next four years or more. Make projections based on the fees charged by the facilities you've visited. You may want to seek out professional advice from a financial planner or an attorney.

10. Know where to turn. Call the Eldercare Locator at (800) 677-1116 so you can contact the nearest Area Agency on Aging and find out about services available locally. -- Compiled by Laura T. Coffey.

Sources: Consumer Reports Complete Guide to Health Services for Seniors by Trudy Lieberman and the editors of Consumer Reports (call (800) 500-9760 to order the book); and Administration on Aging (

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