By Sallie Gowan

Buying a house? Call a real-estate agent. Getting married? Time for a wedding planner. With some of life’s milestones, we know exactly where to turn for advice. But when you’re caring for an elderly loved one, it’s harder to know who can help you navigate the changes ahead.

In an effort to assist caregivers with this complex challenge, here are six things you can to do prepare for long-term care:

1. Think through your priorities (as much as possible)

Give yourself at least two seconds to jot down any “must-haves” in a long-term care center. Location is a big consideration. Does your loved one need to be near a primary caregiver? Is there a central location that would better enable multiple family members to share responsibilities?

Think about specialized services too. These priorities may shift over time, but if you know dementia care is a necessity, keep that in mind from the start.

2. Get educated

Now it’s time to educate yourself on the available options. Your loved one’s primary care physician can make recommendations, and friends and family can also be good sources.

Oftentimes families find the most complete care in a skilled nursing care center. Once widely known as nursing homes, these centers offer individualized, 24-hour care provided by trained health care professionals in a residential setting.

To find a skilled nursing care center in Alabama, try the Alabama Nursing Home Association’s Facility Locator.

Tracy Pattillo

Tracy Pattillo

When you have a short-list of centers, make some phone calls and tour each one in person. Don’t forget to ask if there are openings for new residents (termed “available beds”).

“I encourage families to go and see the place and meet the staff,” said Tracy Pattillo, noting that making an appointment ensures that a knowledgeable staff member is available. As Crowne Health Care & Rehab of Montgomery’s clinical liaison, Pattillo routinely goes to area hospitals to meet with families when an elderly loved one is ill or injured.

3. Start planning for the cost

The cost of living in a skilled nursing care center starts around $6,000 a month. You’ll want expert help navigating the applications, requirements to qualify financially and various medical criteria.

Edie Belue

Edie Belue

“Everybody’s financial situation is different,” said licensed social worker Edie Belue of Senior Rehab & Recovery at Limestone Health Facility. “They need to have a trusted person they can talk with.”

The good news is that skilled nursing care centers have professionals on staff to guide you through the options including Medicare, Medicaid, long-term care insurance policies and private payment. Call and ask to speak to the admissions counselor or social worker. There’s a great deal of assistance available at no cost or obligation to you.

4. Document your loved one’s wishes – in writing

While this is certainly no easy conversation to start, it is an important one. Near the end of life, more than one in four older Americans face decisions about medical treatment that they are not capable of making, according to the National Institute on Aging.

“Sometimes you just have to say, ‘I love you and you’re probably going to outlive me – but I want to know your wishes. I don’t want to be second-guessing about what I think you would want,’” Pattillo said.

This kind of advance care planning can include an advance directive, with written instructions about a person’s wishes to guide medical decision-making in the event your loved one cannot communicate. Advance directives often take the form of a living will, which defines the medical treatment a patient would prefer. These documents can also designate someone as a medical power of attorney to make health care decisions on the patient’s behalf.

Requirements can vary from state to state, and support agencies for senior citizens can often connect you with free legal assistance. This directory of Area Agencies on Aging in Alabama may be helpful.

5. Get everybody on the same page

Ideally, an elderly person residing in a skilled nursing care center has what Belue calls a “united caregiving front.” That means everyone is on the same page, with a shared understanding of the person’s wishes, plans and preparations.

“I would absolutely encourage a family meeting where you sit down and talk about these things and make sure everybody understands,” Belue said.

Family members and others with close connections to your loved one need to be familiar with any advance directives, and copies of these documents should be shared with doctors and the skilled nursing care center.

“These things may change,” Belue added, noting that plans and documents will need to be reviewed periodically. And give serious thought to a “plan B” if your loved one’s preferred care option could cease to be viable for financial or other reasons.

6. Take the next step to provide the best possible care for your loved one

Given that 70 percent of Americans will need some form of long-term care; how do you know when it’s time for your loved one to move? “Sometimes it is a sudden realization, a crisis point,” Belue said. “And sometimes it is a gradual realization.”

If an acute illness or injury causes a sharp decline in an elderly person’s independence, moving that loved one into a skilled nursing care center can be a clear-cut decision. Other times, caregivers must discern when a familiar setting can no longer offer the safety and security of a true home.

Safety concerns usually take priority. Sometimes there are immediate dangers. Dad got lost in the neighborhood. The stove was left on leading to a fire. Other issues are no less serious – such as weight loss due to missed meals, inability to take medication properly or poor hygiene. Sometimes in-home caregivers can no longer keep up with daily needs.

“Home becomes a feeling, and we want to continue to provide that love and compassion and care for our residents.” Belue said. “They don’t live where we work – this is their home and we work for them.”

Adapted from “6 Steps You Can Take to Plan for Long Term Care Before It’s Too Late” published by https://careconversations.org.

Sallie Owen Gowan is a freelance writer in Montgomery, Ala.