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Iowa Department on Aging

Choosing a Long-Term Care Facility

Choosing a long-term care facility is an important decision. Before you make this decision, gather as much information as possible, then follow these steps:

1. Know which type of long-term care facility is appropriate for your loved one.

Assisted living programs provide housing to three or more tenants in a physical structure with a homelike environment. Additional services, such as health-related care, personal care or assistance with instrumental activities of daily living, may be included in the monthly fees or may be offered for an additional fee. The assisted living program philosophy encourages family involvement, tenant self-direction and tenant participation in decision-making.

Dementia-specific assisted living programs: (a) serve fewer than 55 tenants, with five or more tenants diagnosed with dementia between Stages 4 and 7 on the Global Deterioration Scale; (b) serve 55 or more tenants, with at least 10 percent diagnosed with dementia between Stages 4 and 7 on the Global Deterioration Scale; or (c) provide specialized care for persons with dementia in a dedicated setting.

Elder group homes are single-family residences that are operated by a person who is providing room, board and personal care to 3-5 older adults who are not related to the person providing the service within the third degree of consanguinity or affinity.

Licensed-Only nursing facilities are entities that are licensed only by the State of Iowa and are not federally certified.

Residential care facilities are institutions, places, buildings or agencies providing accommodation, board, personal assistance and other essential daily living activities for a period exceeding 24 consecutive hours. Individuals living in a residential care facility are unable to sufficiently or properly care for themselves because of illness, disease or physical or mental infirmity, but do not require the services of a registered or licensed practical nurse, except for emergencies. (Definition is found in Iowa Code chapter 135C.)

Nursing facilities are institutions or distinct parts of institutions housing three or more individuals for a period exceeding 24 consecutive hours, whose primary purpose is to provide health-related care and services, including rehabilitation, for individuals who, because of mental or physical condition, require nursing care and other services in addition to room and board. Nursing facilities do not engage primarily in providing treatment or care for mental illness or mental retardation. (Definition is found in Iowa Code chapter 135C.)

2. Check the facility's track record.

You can review the annual survey and complaint history for any facility. Each facility is required to keep a copy of their findings in a public area, but records are also available on the Iowa Department of Inspections and Appeals website. Nursing facility data is also provided by the federal government through Medicare's Nursing Home Compare site.

3. Visit the facility.

While there, take time to talk with multiple staff members and residents of the facility. Look around carefully and ask questions about anything that you do not understand. If at all possible, take your loved one to visit the potential long-term care facility before making a decision. Use the checklists below to prompt questions and take notes:

4. Make sure your loved one's wishes are known.

Help your loved one complete the "My Personal Directions for Quality Living" worksheet and provide it to the facility upon admission. This will help ensure the facility has background information about your loved one, is aware of his/her personal preferences and is as prepared as possible to care for your loved one in the manner that he/she desires.

5. Take care of yourself.

Moving a loved one into a long-term care facility can cause a caregiver to experience a number of emotions, including anxiety, anger, resentment, guilt, depression or grief. These feelings are normal, but should be acknowledged and addressed so you can stay involved in your loved one's long-term care.