Senior Living Options in Michigan

One of the hardest questions for a family may be how to best care for the family members. We face these questions throughout our lives and the questions seem to get harder as the years pass. When we have aging parents who have medical or physical needs that surpass our own capabilities we are faced with the decision of how to best care for them in their later years. Each situation is of course unique, but it can be helpful to understand what the benefits and challenges are of each option.

For everyone in the family it is perhaps the most helpful to have conversations in advance regarding what your loved ones wishes are. Once you are actually in an emotionally charged situation it can be much more difficult to be able to give yourself the space and balance you need in order to make the best decision. It also can be very empowering for all parties to actually honor one another through asking and then listening to what is important to each person.

Finances and proper care and support of the individual, as well as available resources can all be important elements to consider when beginning the journey to consider your options. If you have a loved one who, for medical or safety reasons needs to begin to transition out of living independently to another housing option, these are some questions to begin asking.

1. What is the financial status of the affected parties?
   You need to evaluate and closely monitor the financial condition of your loved one. Does he or she have long-term care insurance? What debts and assets exist? Will you be assuming the financial burden for your loved one, and if so, what would each of the housing options you are considering require on a monthly basis? Remember that when you are evaluating finances required, you must also project anticipated finances required for future medical needs such as prescriptions and care as much as possible based on current doctor’s projections. It is important that you evaluate Medicare as well as any policies that have been obtained for long-term care insurance as Medicare does not often pay for the long-term cost of nursing homes.
2. What is the emotional, safety, and physical status of all interested parties?
   Does your loved one have physical or emotional limitations and if so, how do you and his/her doctor foresee those conditions progressing over the coming months and years? If you are considering having your loved one move in with you, evaluate the impact to your life and the life of your family. Do you have enough space in your home to house another person? Are there alterations to your home that you would need to make in order to house your loved one and protect his/her safety? Are there current daily activities that would need to be modified in order to care for your loved one? What do you anticipate the impact would be on our current family dynamic should your loved one come to live with you?

Living Independently

Living Independently is what we strive for throughout our lives. We learn as we are younger to become responsible, to look after our affairs, and part of our reward for learning those lessons is the joys (and challenges!) of living independently. This option for seniors is best suited for individuals who have minimal health concerns, have active and perceptive mental skills, and are able to handle the day to day maintenance of their homestead or are able to afford hiring out some of those maintenance activities.

Living With Care In The Home

At times, given the mental, emotional, or physical needs of the loved one, living with extended family can be a good option. Some families find they are able to best care for their loved one by having the individual move in with them. They can either live in the same home or a part of the home that is built just for that reason – often called a granny flat, or cottage home. Additionally, in-home care like nursing services can be contracted and brought into the home to provide for additional care that the primary family can’t provide for whatever reason. Many families find that this option provides a great in-between step, where the loved one gets the additional care they need in a home setting. If your loved one doesn’t need round the clock care or supervision, and has needs that are somewhat minimal but could benefit from being closer to loved ones to help take care of them, this can be a great option.

Nursing Homes

In Michigan, nursing homes are regulated as are the standard of care. There is a Patient Bill of Rights that covers the right to privacy, communications, meals and dietary allowances and billing, among others, including bias, harassment, and discrimination. Nursing homes provide for residential communities, meals, and nursing services as well as rehabilitation services.

Assisted Living

Assisted Living in Michigan is a broad and inconsistently used term. In general, the term assisted living in the state of Michigan is largely a marketing term. Assisted living can include a variety of different care services, from senior-centric communities offering free-standing apartments to facilities that provide numerous services. In Michigan assisted living could mean that your loved one lives alone, with you, or in a separate facilities that provides numerous services, but generally not the skilled nursing care that is found in nursing home facilities. The services are paid for and most often include meal plans, social interaction opportunities, some medical care or supervision and laundry options among others. In some cases, insurance will pay for assisted living facilities but in most cases, these facilities offer private payments only. Additionally, in some cases, long-term care insurance will help pay for the facilities and services, but again in most cases the costs are borne by the individual.

Within the state of Michigan, the Department of Human Services Bureau of Child and Adult Licensing is responsible to oversee the licensing of assisted living facilities. According to the Michigan Assisted Living Association, there are more than 5,000 licensed assisted living settings in Michigan, and over 45,000 people living in them. There are a wealth of great local resources that cater to those who have a need for assisted living care in Michigan, and we’re pleased to highlight some of those great resources through our advertising in this issue of CoSozo Living.

Adult Foster Care

According to the Department of Human Services, Adult Foster Care homes (AFC) are “residential settings that provide 24-hour personal care, protection, and supervision for individuals who are developmentally disabled, mentally ill, physically handicapped or aged who cannot live alone but do not need continuous nursing care.” Adult Foster Care facilities in the state of Michigan are regulated.

Homes for the Aged

Homes for the Aged in Michigan are, according to the Michigan Center for Assisted Living, “a supervised, personal care facility, other than a hotel, adult foster care facility, hospital, nursing home, or county medical care facility that provides room, board and supervised personal care to 21 or more unrelated, non-transient individuals who are 60 years of age or older.” Homes for the Aged in Michigan are regulated facilities.

Some of the critical points to consider before you are enlisting the aid and/or care of others for your loved ones include:

1. Background checks – Although we’d like to believe that no one would bring harm to our loved ones it is always a good idea to protect yourself and perform a thorough check of those to whom you will entrust their care. Particularly with seniors who may be fragile or vulnerable, it is of paramount importance to ensure your care providers are of good moral character and have a clean, unquestionable history and background. Should this be broader to be “review of personnel and facilities?
2. Licensing – If having a licensed care facility is important to you, make sure that you actually check that the facility you are considering is licensed. Due to the definition of assisted living in Michigan and the current law, there has been a number of controversies in recent years regarding unlicensed facilities. Under current law, individuals are allowed to run unlicensed facilities. Licensed facilities must meet state standards and be inspected, while unlicensed facilities do not and are very hard to even track or locate.
3. You can check out inspection reports at http://www.michigan.gov/dhs. Look at the Adult Foster Care/Homes for the Aged link to be taken to a search form that you can use to enter in criteria for the facility you are researching. The inspection reports can provide you with actual inspection information regarding any violations of training, care, safety, and other hazards that can be beneficial in evaluating whether the facility conforms to your standards of care desired.
4. There is a website designed specifically for Michigan seniors – http://www.seniorbrigade.com. That website has a very comprehensive checklist detailing things you should do if you are looking for a nursing home within the state of Michigan. Most of the guidelines can apply to nursing homes in virtually all states.
5. Facing the decision regarding the long-term care of your loved ones is an emotional as well as financial decision. The best gift you can give to your loved ones is to initiate the talks regarding their wishes long before the time before you need to start making those decisions. The decision made will impact all of your lives so give yourself the time you need to do adequate research of the facilities, monies, and care available.