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Senior Lifestyles

Exploring options for long-term care

Sometimes life really does change in an instant. The phone rings and you learn that your parent has had a stroke, or you are injured in a sudden accident.

Sometimes life changes slowly over time. You watch your parent gradually decline from an illness like Alzheimer’s or Parkinson’s disease.

Whether it happens quickly or slowly, deciding that long-term care is appropriate for yourself or a loved one is difficult. Are you prepared?

Most of us don’t plan ahead for long-term care. We wait until we are faced with a problem. Many people are surprised to learn that standard health insurance plans, including Medicare, do not cover long-term care. Medicare pays for medical care, not day-to-day personal care or room and board at a facility. There are many options for long-term care insurance, but finding and getting it can be confusing and expensive.

Long-term care is defined as medical and physical care for people with a chronic illness or disability. Usually it includes assistance with activities of daily living, such as bathing, dressing, grooming and eating. Although nursing homes are the best-known providers, there are many other types of long-term care, such as assisted-living facilities, day-care programs and even your own home. It is important to note that it is not just elderly people who need long-term care – it is for people of all ages.

Planning for long-term care should begin years before it is needed. A good way to begin planning is to contact your local Health Insurance Counseling and Advocacy Program (HICAP) office. HICAP is a wonderful resource that provides free Medicare counseling and long-term care planning in every county in California. To make an appointment with a HICAP counselor, call the Santa Clara County HICAP office at (408) 350-3260 or the state office at (800) 434-0222.

As part of the Stanford Health Library Community Lecture series, HICAP counselor Don Rush is scheduled to discuss long-term care planning 7 p.m. March 29 at the Oshman Family Jewish Community Center, 3921 Fabian Way, Room G106, Palo Alto. The talk is free and open to the public. Rush will discuss long-term care options, including insurance. Nothing is being sold or referred. To register for the talk, call 498-7826.

HICAP also publishes a booklet, “Taking Care of Tomorrow: A Consumer’s Guide to Long-Term Care” (California Department of Aging, 2007). This informative guide helps people consider their choices and make informed decisions when planning, providing and paying for long-term care. Throughout the book, names and telephone numbers of relevant agencies and other resources are included, along with a list of helpful questions to ask before purchasing long-term care insurance.

For a copy of “Taking Care of Tomorrow” in English or Spanish, stop by Stanford Health Library or visit www.aging.ca.gov/publications/hicap/hicap_TCOT_main.asp.

Stanford Health Library carries information, both print and online, covering all aspects of long-term care. A good book to start with is “Stages of Senior Care: Your Step-by-Step Guide to Making the Best Decisions” (McGraw Hill, 2010). This book examines the full range of long-term care options, including aging in place, family care, day care, independent living, assisted living, skilled nursing homes and palliative care and hospice.

Authors Paul and Lori Hogan own a business that provides nonmedical services allowing seniors to stay in their homes. They are clear about their personal bias in favor of in-home care whenever possible, but they do a commendable job of fairly presenting all long-term care options. They acknowledge that there is no “one-size-fits-all” answer.

“Stages of Senior Care” is well-researched and addresses difficult subjects, such as “parenting your parent” with compassion, even at a distance; how to know when it is time for additional care; sibling disagreements; and how to handle death and dying. This is an excellent choice for those of wanting to consider all aspects of planning for long-term care.

Although it is rarely a preferred choice, sometimes the best care option is a nursing home. We have all heard horror stories, but there truly are many positive aspects to nursing home care. “Living Well in a Nursing Home” (Hunter House, 2006) helps readers overcome fears and learn how to make good residential care choices.

Authors Lynn Dickinson and Xenia Vosen describe life in a nursing home and offer guidelines for selecting the right facility. The book comprises three parts: “Making the Long-Term Care Decision,” “You’ve Decided … Now What?” and “Making the Most of Life in a Nursing Home.” Checklists and exercises are scattered throughout the book to help readers clarify their thoughts and make informed choices.

There is practical advice ranging from helping someone make the transition to a nursing home to working with nursing home staff. The final section deals with end-of-life issues in a sensible and sensitive way.

In addition to the books mentioned above, Stanford Health Library has many more resources to help readers learn about planning for long-term care. For more information, visit healthlibrary.stanford.edu/resources/bodysystems/senior_decisions.html.

Stanford Health Library provides evidence-based answers to health-related questions. We will search the medical literature to answer your specific questions, at no charge.

The library is open in five locations: Stanford Shopping Center near Bloomingdale’s; the Stanford Cancer Center; Stanford Hospital (third-floor lobby); the campus of the Oshman Family Jewish Community Center at 3921 Fabian Way, Room G106, in Palo Alto; and the Ravenswood Family Health Center, 1807 Bay Road in East Palo Alto.

Nancy Dickenson is head librarian at Stanford Health Library. For more information, call 725-8400 or email This email address is being protected from spambots. You need JavaScript enabled to view it. .

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