Finding and financing the right nursing home

Vanessa Richardson • E-mail

One of the hardest decisions anyone can make is to send a loved one to a nursing home. For many caregivers, it feels like they’re giving up and abandoning that person, and the guilt is tremendous. But in many cases, a nursing home is the best — and sometimes the only — option for a person with a serious condition who needs care 24 hours a day.

Making that decision is actually the easy part. The next steps — finding the best home and figuring out how to pay for it — are harder.

And don’t think these decisions are something to postpone until retirement age, said Alice Hedt, executive director of the National Citizens' Coalition for Nursing Home Reform, a consumer advocacy group in Washington. She urges people to begin planning years in advance.

“Nursing homes don’t just take care of elderly people,” she said. “They are often used for rehabilitation for people of all ages who are incapacitated by accidents, diseases and head injuries. So any adult needs to think about what they want for care in case they become incapacitated and (to) have a discussion with their family. It’s something to think about when you’re creating a living will and power of attorney.”

Prep yourself for the costs
Getting an early start can help you find the best possible home and the money to afford it. You can spend months, even years, researching how to pay for care, filling out applications and getting on the facilities' waiting lists.

Fact file Click for nursing home resources The Centers for Medicare & Medicaid Services maintains a Nursing Home Compare site. Eldercare Locator, a service provided by the U.S. Administration on Aging, offers a list of nursing homes in your area. The NCCNHR Web site has links to every state’s ombudsman program. Consumer Report's free Nursing Home Quality Monitor can help narrow your choices. For tips on using these resources, click here. MSNBC

Even though it’s a touchy subject, elder care needs to be brought up by children to their parents, said Charles Bell, programs director for Consumers Union, which publishes Consumer Reports. 

“Many times, children of aging parents aren't aware that the parents may need assistance in arranging for these long-term care services,” he said. “If you don't ask, chances are they may not tell you. Effective advance planning involves talking about money and assessing how much is available to pay for health care relative to other needs. You need to understand the details of your parents' retirement income and health insurance.”

Even if you’re on the younger side of retirement age, nursing home costs are something to pay attention to for your sake because they can add up. Nursing homes can charge an average of $5,000 per month, with annual costs ranging between $50,000 to $80,000.

“For people with moderate income, a year in a nursing facility could go through all their savings,” said Eric M. Carlson, author of "The Baby Boomers Guide to Nursing Home Care" and an attorney at the National Senior Citizens Law Center.  “You need to look at it as part of your overall planning for retirement, and make an estimation of what you’ll need.”

Long-term care insurance is a consideration, but from a financial standpoint it makes little sense to buy it before age 55.  “You don’t want to invest in insurance you may not use until 40 years from now,” says Carlson. “It’s a long time to be paying premiums when you have no idea what long-term care costs will look like in the future.”

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