As a population, Americans are living longer due to advancements in science, technology and health care. This phenomenon is sending millions of American families into tailspins as they face the challenges of planning for long-term health care.
According to the US Census Bureau, the population of people over age 85 is expected to increase by 33 percent by 2010 and by 2050 could amass to more than 19 million people. For aging Baby Boomers whose parents are in their 70’s, 80’s or even 90’s it’s not only time to retire, it’s time to address the responsibility of caring for one or more aging relatives.
"It was stressful finding a place for my parents," said Sharon Schmitt, daughter of Edward VonTobel, 95 and Evelyne VonTobel, 93, two of Las Vegas’ longest residents now living at Las Ventanas in Summerlin. "The whole family was involved. While we were searching for the best place for them, they were complaining they didn’t want to move. It was important to them that they stayed independent and felt comfortable."
Schmitt’s situation is not unlike millions of others. Searching for long-term care includes understanding the differences between Skilled Nursing (SN), Assisted Living (AL) and a new option called a Continuing Care Retirement Community (CCRC).
Tanya Wilson, divisional sales specialist for Atria Sutton on East Flamingo Road, said most long-term care facilities offer patient assessments to help families choose the right care.
"Our nurses do medical assessments of potential residents either in the hospital or in the home," said Wilson. "The assessment tool is about six pages long and patients are rated on a point system based on their ability to complete ADL’s [activities of daily living]. The results determine the level of care they need."
In Nevada, a skilled nursing facility (SNF) is a residential environment providing 24-hour, long-term skilled nursing care and health services as prescribed by a physician. Put simply, a nursing home is designed for people who need less care than a hospital, but require daily assistance. The Nevada State Department of Licensure and Certification licenses such facilities and has guidelines regulating nursing home operations, programs, and staffing.
Among the regulatory requirements, SNFs are staffed with medical professionals and offer medical care for those with severe but non-acute illnesses or injuries. Trained staff assists residents with personal and daily activities such as getting out of bed, bathing, eating, toileting and medication administration. SNFs offer daily meals, laundry, housekeeping, medical supervision and a variety of recreational activities.
In addition SNFs may also be staffed with other health professionals including licensed practical nurses, nurse aids, med techs, physical therapists, occupational therapists and speech therapists to help residents regain abilities through rehabilitation.
A nursing home may also be an option for people with Alzheimer’s or dementia who are unable to eat and or bathe without reminders. Several facilities in Las Vegas offer Memory Care and Respite services designed for this purpose.
Assisted Living (AL) facilities are residences licensed and regulated by the State of Nevada to provide a level of service for adults who may have physical or mental impairments and require at least moderate help with daily life.
According to the Assisted Living Federation of America, more than one million Americans live in approximately 20,000 AL communities in the United States. An AL facility is a combination of housing and personalized supportive services. In Las Vegas AL facilities generally provide meals served in common dining areas, housekeeping services, transportation, assistance with eating, bathing, dressing, toileting and walking.
"An AL resident cannot be bed-bound," said Wilson. "Residents must be able to ambulate with only one person assisting. We can bring you medications and hand them to you but you have to be able to take them yourself," said Wilson. "That’s basically the difference between AL and nursing."
Residents may participate in exercise programs as well as social and recreational activities. On-site security and staff are mainstays as are emergency call systems in resident units. AL is an option for people who are independent but may not be able or willing to prepare meals or drive to doctors’ appointments; who need assistance with laundry; or couples where one spouse is independent but may need assistance in feeding and or providing for the needs of the other spouse.
CONTINUING CARE RETIREMENT COMMUNITY
A new choice in retirement living is the Continuing Care Retirement Community (CCRC). Las Ventanas in Summerlin is the only CCRC in Nevada combining three levels of care into one community; independent living, AL and SN. Las Ventanas also offers "Life Care," which not only gives residents access to different levels of care based on individual needs over time, but may provide cost savings when a resident permanently transfers to a higher level of care.
With Life Care the resident pays an entrance fee and periodic adjustable payments, which gives the resident a package of residential and health services. Included are access to amenities such as a swimming pool, cyber café, fitness center, continuing education classes and health and wellness classes including Jazzercise and Pilates.
"A resident can enter the community at any stage," said Steve Whysel, director of sales & marketing for Las Ventanas. "But let’s assume you’re in reasonable health and independent when you move in and your health changes later; under Life Care you have the ability to move into the level of care that you need, stay living at Las Ventanas, and receive the financial benefits Life Care affords. You’ll still be able to take advantage of all the lifestyle amenities and visit with your friends and neighbors and not feel like you’re leaving home."
Whysel added that Life Care is especially accommodating for couples with different health needs. Such was the case with Schmitt’s parents. Schmitt said since her parents moved to Las Ventanas, they have lived independently and have had stays in SN and AL.
"When mother required nursing care for about a month, my father could walk over and see her all afternoon, have dinner together and then go to his own apartment at night," said Schmitt. "It made them happy and it saved me from having to travel across town, pick him up and bring him back home."
Generally a CCRC and Life Care is best suited for people who are in reasonable health and independent but want to plan or may even see the growing need for daily health care for themselves or a spouse in the future. Las Ventanas residents pay an entrance fee which is 90 percent refundable to the resident or his or her estate. Additionally, there are monthly payments that cover meals and other community services. Whysel added, however, that Las Ventanas is open to anyone needing AL and SN services and you not have to be a Life Care resident to receive those services.
COST OF CARE
A recent study released in May 2008 shows that nursing homes carry a heavier price tag in Las Vegas than in other parts of the country. Genworth Financial, a Virginia money-management company, found in its annual Cost of Care Survey that Las Vegans spend more money for nursing home care than elsewhere in the United States. A year at a private nursing home in Las Vegas costs $77,787 compared with the national average of $76,460. That reflects a 23 percent increase since 2004 and nearly $25,000 a year more than the city’s median household income of $53,000. Other survey findings include a private one-bedroom studio unit at an assisted living facility in Nevada ranges from $24,911 to $35,195 annually, compared to the $36,090 national average.
Medicare and Medicaid may cover the cost of some long-term care. Many families often purchase long-term care insurance in anticipation of the high costs. Most Las Vegas facilities accept a variety of payment options including private insurance, veteran’s benefits, and private funds as payment. It’s important to check with the facility to make sure you understand your obligations.
When choosing long-term care, it is important to do research and make educated decisions. Here are some helpful websites for more information:
Past performance of Medicare and Medicaid certified nursing homes: www.medicare.gov/NHCompare
Needs evaluation and types of senior housing: www.seniorhousingnet.com
Nevada State Health Division and regulatory information: www.health2k.state.nv.us
Nevada Division for Aging Services: www.nvaging.net