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Long-Term Care Problem Solving

 
Dr. Karl Steinberg
Meet the Expert
www.karlsteinberg.com
  • What is a geriatric care manager?
  • How do I find a geriatric care manager?
  • How do I find long-term care for a chronically ill parent?
  • What is a 'geriatric screening' for long-term care?
  • What's the best way to approach other family members about long-term care for aging parents?
  • What if my parent is resistant to long-term care?
  • How do I help an aging parent if I live far away?
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Long-Term Care
 Long-Term Care 
  1. Dr. Karl Steinberg
  2. What is long-term care? 
  3. Why should I worry about long-term care? 
  4. Who needs long-term care? 
  5. What are long-term care services? 
  6. Who pays for long-term care? 
  7. What is skilled care? 
  8. What is unskilled care? 
  9. At what age do most people need long-term care? 
  10. What are the chances I'll need long-term care? 
 Choosing Long-Term Care 
  1. Dr. Karl Steinberg
  2. Who provides long-term care? 
  3. What long-term care options are available? 
  4. What is a long-term care facility? 
  5. Are long-term care facilities federally regulated? 
  6. What kind of certification is there for long-term care facilities? 
  7. Why is the type of long-term care facility so important? 
  8. Why are there so many names for long-term care facilities? 
  9. What is the most common type of long-term care situation in the US? 
 Planning For Long-Term Care 
  1. Dr. Karl Steinberg
  2. How can I plan for long-term care? 
  3. How do I prepare financially for long-term care? 
  4. How do I prepare legally for long-term care? 
  5. How do I choose the best long-term care situation for myself? 
  6. How do I choose the best long-term situation for my parents? 
  7. Why is discussing long-term care with my parent so hard? 
  8. What can I say when my parents want me to promise they'll never be 'placed' in a nursing home? 
  9. What if I can't provide the long-term care my parents need? 
  10. Why does the thought of my parent in a long-term care facility make me feel so guilty? 
 Long-Term Care Issues In The US 
  1. Dr. Karl Steinberg
  2. What is the 'Sandwich Generation' in regard to long-term care? 
  3. Who can help me make decisions about long-term care? 
  4. Why is long-term care such a hot issue right now? 
  5. What is the biggest problem with the long-term health care system in the US? 
  6. How many Americans can't afford long-term health care? 
  7. What happens if I can't afford long-term care? 
  8. What reforms could change the long-term health care system? 
  9. What is the single biggest misconception about long-term care? 
 Aging Parents And Long-Term Care 
  1. Dr. Karl Steinberg
  2. What are the signs my parent is ready for long-term care? 
  3. What is the first thing I should do if I believe my parent needs long-term care? 
  4. Who can help me implement a long-term care plan for my parent? 
  5. What should I consider before taking on the role of long-term caregiver for my parent? 
  6. How can I determine what type of long-term care facility my parent needs? 
  7. What is an independent living residence? 
  8. What is an assisted living facility? 
  9. What are board and care homes? 
  10. What is a nursing home? 
  11. Is a nursing home and skilled nursing facility the same thing? 
  12. What is a continuing care retirement community CCRC? 
Long-Term Care Problem Solving (Now Playing)
  1. Dr. Karl Steinberg
 Long-Term Care Legal Planning 
  1. Dr. Karl Steinberg
  2. How does 'power of attorney' affect long-term care? 
  3. What is an advance directive? 
  4. Why are advance directives important? 
  5. Where can I get an advance directive? 
  6. What is a declaration? 
  7. Why would I need a living trust for long-term care? 
 End Of Life Issues And Long-Term Care 
  1. Dr. Karl Steinberg
  2. What about end-of-life decisions and long-term care? 
  3. When should I start thinking about end-of-life decisions? 
  4. Who should know my wishes concerning end-of-life decisions? 
 Long-Term Care Insurance 
  1. Dr. Karl Steinberg
  2. What is long-term care insurance? 
  3. What does long-term care insurance cover? 
  4. At what age should I consider long-term care insurance? 
  5. What should I look for in a good long-term care insurance policy? 
 Independent Living 
  1. Dr. Karl Steinberg
  2. What is independent living? 
  3. What types of independent living facilities exist? 
  4. What are the requirements for independent living facilities? 
  5. Do independent living facilities provide medical care? 
  6. How expensive are independent living facilities? 
  7. Does Medicare or Medicaid pay for independent living facilities? 
  8. How can I find a good independent living facility? 
 Assisted Living 
  1. Dr. Karl Steinberg
  2. What is the difference between assisted living and independent living? 
  3. What services do assisted living facilities provide? 
  4. How does an assisted living facility differ from a nursing home? 
  5. How many US seniors reside in assisted living facilities? 
  6. Is there 24-hour supervision at an assisted living facility? 
  7. Do assisted living facilities offer medical care? 
 Costs Of Assisted Living 
  1. Dr. Karl Steinberg
  2. How much do assisted living facilities cost? 
  3. What services are not included in the monthly fee at an assisted living facility? 
  4. Are assisted living facilities eligible for Medicaid? 
  5. What should I look for when choosing a good assisted living facility? 
  6. What are the pros and cons of assisted living facilities? 
  7. Is there a regulating organization that ranks assisted living facilities? 
 Combination Facilities 
  1. Dr. Karl Steinberg
  2. What is a continuing care retirement community CCRC? 
  3. What range of services do combination facilities provide? 
  4. Does a CCRC meet its claim of 'aging in place'? 
  5. Why have CCRCs become a popular long-term care option? 
  6. Is a CCRC the same as a 'stepped care community'? 
  7. What are the advantages of a CCRC? 
  8. What are the disadvantages of a CCRC? 
 Costs Of Combination Facilities 
  1. Dr. Karl Steinberg
  2. How much does a CCRC cost? 
  3. Will the cost of a CCRC change based on the level of care I need? 
  4. Do you rent or buy units in a CCRC? 
  5. Is it wise to sign an all-inclusive contract at a CCRC? 
  6. What is a 'Life Care Contract' at a CCRC? 
  7. What is a fee-for-service contract at a CCRC? 
  8. Who decides when a patient needs to be moved from one level of care to the next in a CCRC? 
  9. Does Medicaid help pay for a continuing care retirement community? 
 Nursing Facilities 
  1. Dr. Karl Steinberg
  2. What services does a nursing facility provide? 
  3. How do I know if my parent needs to be placed in a nursing facility? 
  4. Do all nursing facilities offer 24-hour medical care? 
  5. Do I need to choose a nursing facility certified by the federal government? 
  6. What are the essential services a nursing facility must provide? 
  7. What are the most important services to evaluate when choosing a nursing facility? 
  8. Why is the staff to patient ratio so important in a nursing facility? 
  9. How important are recreational and social activities in a nursing facility? 
  10. What are the main concerns about quality of life in a nursing facility? 
  11. Is there an organization that 'ranks' nursing facilities? 
  12. What does an ombudsman do? 
 Costs Of Nursing Facilities 
  1. Dr. Karl Steinberg
  2. How much do nursing facilities cost? 
  3. What are the living arrangements in a nursing facility? 
  4. Are there any monthly fees in addition to rent at nursing facilities? 
  5. How much does Medicare pay for a nursing facility? 
  6. How much does Medicaid pay for a nursing facility? 
 Long-Term Care And Medicare 
  1. Dr. Karl Steinberg
  2. What is Medicare? 
  3. What is the difference between Medicare A and Medicare B fee-for-service plan? 
  4. What is Medicare C? 
  5. Who qualifies for Medicare? 
  6. What does Medicare cover? 
  7. When can I enroll for Medicare? 
  8. What is the difference between Medicare and Medicaid? 
  9. What are the worst widely-held misconceptions about Medicare? 
 Long-Term Care And Medicaid 
  1. Dr. Karl Steinberg
  2. What is Medicaid? 
  3. Why is it called Medi-Cal in California? 
  4. How do I qualify for Medicaid? 
  5. Who determines Medicaid eligibility? 
  6. Is it true Medicaid can recollect the cost of care from a person's estate upon death? 
  7. What does Medicaid cover? 
  8. What does Medicaid NOT cover? 
  9. Do all long-term care facilities accept Medicaid? 
  10. Does Medicaid only pay for certified nursing facilities? 
  11. How can I find out about my state's Medicaid program? 
 Long-Term Care And Medigap 
  1. Dr. Karl Steinberg
  2. What is Medigap? 
  3. Who is eligible for Medigap? 
  4. What does Medigap cover? 
  5. How much does Medigap cost? 
  6. How do I know if I need Medigap insurance? 
  7. Who sells Medigap? 
 Elder Care Benefits 
  1. Dr. Karl Steinberg
  2. What are elder care benefits? 
  3. Do all employers offer elder care benefits? 
  4. How can I find out more about elder care benefits? 
 The Dying Process 
  1. David Kessler
  2. What physical signs will indicate that my loved one is dying? 
  3. How will hospice make my loved one more comfortable before death? 
  4. Will hospice help me understand what my loved one can and cannot hear? 
  5. How do I explain death to my children? 
  6. How can I make my loved one more comfortable before death? 
  7. Will a hospice worker be present following death? 
  8. Will hospice help arrange for the disposition of the body? 
Karl Steinberg Dr. Karl Steinberg
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Transcript

Long-Term Care Problem Solving

What is a geriatric care manager?

A geriatric care manager is a person who can assist in assessing a patient and helping to determine what would be the best level of care, what kinds of services might be needed and what the best way to pay for it might be. Typically it might be somebody with some nursing experience, some social work experience and a variety of other people who have had training in gerontology or things in that general category.

How do I find a geriatric care manager?

If you are looking for a geriatric care manager, there are few options you can do, like calling the local senior services, the area agency on aging and so on, would be one good resource to find someone. Also, sometimes calling the local nursing homes or the Assisted Living facilities in your area, because they may know of somebody who works in that area that they can recommend. Again, take it with a grain of salt if it's somebody who is actually employed by one of these places, because they may have a little bit of an agenda to get your loved one into their facility. They may still be able to give you some very good information. Also, if there's a university in your area that has a gerontology program, that's certainly a very good resource to find somebody and it would probably also be less expensive through that setting.

How do I find long-term care for a chronically ill parent?

If you're looking for the ideal care setting for a loved one that is chronically ill or, let's say somebody that is suffering from dementia, including Alzheimer's, I would say that the main thing you want to keep in mind is you don't want to put the person in a care setting that is too high level for them. In other words, if you have somebody who is in the early stages of dementia, you don't want to put them in a place where most of the people are really advanced or end stage dementia patients. At the same time you don't want to put somebody in a setting where they're not going to get enough supervision. One thing is to go out and see the actual places that are available, observe the people that are residing there, talk to them and talk to the staff, and probably also talking to people in the communities, social service agencies, social workers, geriatric care managers and geriatricians or other physicians in the area who may be good resources to determine what the proper level of care is. If you have somebody who is still ambulatory and they have a tendency to wander, you probably want a locked unit or a unit where they can wear a bracelet or anklet like a wander guard that will alert somebody if they are trying to leave the premises.

What is a 'geriatric screening' for long-term care?

A geriatric screening would be a comprehensive assessment that could be done by a geriatrician, or in some instances, they have comprehensive geriatric clinics where they might see a variety of different professionals. They might see a psychologist, and a physical therapist and so on. And that would help to determine if a person needs to move to some sort of long-term care setting, or if not, how much assistance they might require in their own home, and things of that nature. So, those can be helpful.

What's the best way to approach other family members about long-term care for aging parents?

As far as talking among other family members, when you are thinking that it may be time to move your parents into some sort of supervised setting, I think just talking openly and probably doing it in an organized fashion is best. Ideas such as setting up a time for a teleconference or if you all live locally, a family meeting of some kind is the best way to do it. Even though you definitely want your parent, or parents to be part of the decision making process, I do think sometimes it is sort of like an intervention. So you want to maybe get together beforehand and just get all your ducks in a row, figure out what you need to say and maybe even what you plan to do if they don't want to go along with it. It is just depending on how unsafe you feel they are. I think it is just good to speak openly, honestly and expect a certain amount of dissent. People don't always agree and it is a very emotional and difficult decision when you are talking about putting your parents into an assisted living or, even worse, a nursing home.

What if my parent is resistant to long-term care?

I think you are going to get some resistance from you parents. They're not going to just willingly say "Oh sure! Just pack me up and send me to the nursing home." Things that you can do include, if you can remove their source of transportation if they're not safe, that is one thing you can do. I just think that at times you have to wait until something bad happens, but if you can nip that in the bud and prevent it, that is great. And exerting pressure from other people, other family members, loved ones, those things can be helpful in putting those kids of things into effect. Also, keep in mind that what you think is safe or unsafe may not actually be true, and again people are allowed to have bad judgement. You may pray that mom doe not fall and break a hip but she may have to do that and you have to recognize your powerlessness in some instances.

How do I help an aging parent if I live far away?

One of the hardest situations is when you live in one city and your aging, ailing parents live somewhere else. I know from personal experience, you can feel very helpless, you can feel guilty because you're not right on the scene when things happen and, and you feel bewildered because you just don't know what's going on with them on a day to day basis. I think obviously the best thing to do is have somebody there that you can really trust to serve as your eyes and ears. Talk to them often. Sometimes even if they aren't the kind to complain or they don't want to alarm you, you can tell certain things from talking to them. Visit your parents as often as you can and, you can do what I did, just go scoop your mom up and bring her to where you live, but you're likely to meet some resistance in those situations. But again, having a reliable family member near by is a great thing, and if you don't have that then you may want to contact the local area agency on aging or home health agency, their doctor, nowadays with the privacy laws, the HIPPA legislation, you have to sure that they clear it with the doctor to be able to discuss things with you, but keeping in contact with their physician can be something that also can be very reassuring and can also give you a little heads-up when something is brewing.

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  • What is a geriatric care manager?
  • How do I find a geriatric care manager?
  • How do I find long-term care for a chronically ill parent?
  • What is a 'geriatric screening' for long-term care?
  • What's the best way to approach other family members about long-term care for aging parents?
  • What if my parent is resistant to long-term care?
  • How do I help an aging parent if I live far away?

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