When it comes to senior care, many people wonder if there are requirements that need to be met before someone is allowed to start receiving services.
This is a bit more of a complex question than it seems on the surface. The short answer is: it depends.
It depends on a number of things, but the two biggest factors are what the care providers requirements are and how senior care will be paid for.
Generally speaking, senior care providers offer services designed to meet the needs of elderly folk as they age. Many care services are completely full at this time because of the growing number of seniors in our communities. Because of this, it is not uncommon for care facilities–even those that don’t accept insurance like Medicaid–to be more selective of who is being served. As a general rule, the person receiving treatment should be struggling with their day to day life and need assistance to live a higher quality of life.
Knowing what needs are present before looking for senior care can help you to better locate the right care service based on their requirements.
Certain facilities look to more advanced needs prior to allowing someone to receive services. For example, many nursing homes require someone to have medical needs that require consistent care and monitoring. They can help with things like medication management, dietary monitoring, laundry, personal care needs like bathing and grooming, along with medical help. Many also offer rehabilitation and physical and occupational therapy. Assisted living facilities differ from nursing homes in that they do not offer medical services on-site.
It’s important to point out that both nursing homes and assisted living facilities vary from location to location. They are not all equal, nor do they all offer the same types and quality of services.
For insurance purposes, yes, there are requirements. Most insurance companies look at a standard known as “Activities of Daily Living” (ADLs) to determine whether or not someone qualifies to have their long term care costs covered by their respective policy. The generally accepted rule is that there are six main ADLs: grooming, bathing, transferring, toileting, eating, and dressing.
It’s important to note that not all insurance policies approach senior care in the same way. Even long term care insurance policies will vary, with different terms, amounts and types covered, riders, and more. If you’re unsure what your current coverage is, please speak with your insurance provider. They’ll be able to give you a better idea of what’s covered.
If you don’t have long term care insurance, speaking with an attorney or financial planner can help with guidance on how you should approach this. Talk with someone that you trust, and not someone just looking to make a sale.
This is a complex subject. It all needs to be addressed on a case by case basis. Having a team on your side can help make it more approachable.
We’re here to help. If you have questions about senior care in general, or how it might apply to your family’s unique situation, get in touch with us. One of our care professionals would be happy to talk more and get you steered in the right direction.
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