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Posted on Thu, Feb 16, 2012 : 5 a.m.

Long-term care options today far exceed those in the past

By Ask Dr. K


My elderly father lives with my family. But I have my own health issues and don't think I'll be able to care for him much longer. What are my options for long-term care?


When I was in medical school, there were basically two options for long-term care: People moved in with their kids, or they were cared for in nursing homes. Nursing homes were an option only if the older folks had medical conditions that required constant nursing care.

Many people had no place in their homes for their parents. Also, there was no one at home during the day to be there for their parents when they needed help. And it was both unnecessary and humiliating for many parents to become dependent.

There are now more options for people like your father. There is a much better chance today that you will find something that suits your father's medical condition and his degree of independence.

For people who are only slightly impaired, group homes offer a good option. Also called board-and-care homes, they offer help with activities of daily living, but each resident has his own private space.

Senior apartments and subsidized senior housing enable residents to live independently while receiving help with tasks such as shopping and laundry. The buildings are designed with the elderly and wheelchair-bound in mind.

In an assisted-living facility, your father would live independently. But he could receive assistance with daily tasks as well as nursing supervision.

Continuing-care retirement communities offer skilled nursing care and allow you to increase services over time. They have different types of living arrangements for people with different levels of independence. There often are common spaces where the residents meet each other and various activities occur. Many have medical facilities somewhere in the complex of buildings. They often have a common kitchen and cafeteria where residents can get food. Your father might start with an independent apartment and a bit of extra assistance. Over time, he may need to take advantage of increasing levels of care.

Skilled nursing facilities, or nursing homes, provide the most far-reaching services. They offer long-term, around-the-clock care. And they can care for people with significant illnesses or mental or physical disabilities. Some have special units for people with dementia or Alzheimer's disease. Clearly, this is not appropriate for your father at this time.

To learn about local options, contact a local agency on aging or a social worker. Finally, visit several facilities before making any decisions.

We have more information on long-term care in our Special Health Report, "The Caregiver's Handbook: A Guide to Caring for the Ill, Elderly, Disabled ... and Yourself." You can find out more about it at my website.

You're wise to start planning now. Planning ahead gives you a chance to thoroughly research your options. And it allows time to move up the lengthy waiting lists you may find at many of the better facilities.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information:

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