The single most important factor for getting the best long-term care possible

There’s a common misconception that it costs a lot of money to move into a nursing home. While it’s true that paying for long-term care at a nursing home can be expensive—costs are up about 20% since 2011 and keep climbing—money is not a barrier to receiving care.

Every community has options for people in difficult financial situations. These include not-for-profit facilities that accept Medicaid and state- and county-run institutions that provide long-term care to those with limited financial resources.

However, most people are not trying to find the cheapest option. Their primary goal is to get the best possible care for their loved one.


Relying on Medicaid or moving into a charity-based or state-run long-term care facility are often arrangements of last resort.

No one wants to see their beloved parent or spouse in a facility that’s more like an institution, designed around serving the most people possible at the lowest cost. Sometimes they don’t have a choice.

How can you avoid having to rely on the options above? How can you ensure you have the freedom to make the choice that is right for your loved one and you?

Taking control

Taking control is the single most important factor determining the kind of care your loved one receives.

By taking control we mean proactively confronting the reality of long-term care needs as early as possible and acting accordingly to prepare for that eventuality.

It can make the difference between living one’s final years in a state-run facility versus living those same years in a nursing home with private rooms, gourmet meals, and the best possible quality of life.

Taking control will give you a tremendous advantage when it comes time to choose the right care and you’ll gain peace of mind knowing you’re prepared.

Why don’t people take control?

If taking control makes such a difference, then why don’t more people do it? Why do so many people find themselves in an avoidably tough situation when it comes to needing long-term care?

At the root of this problem is the simple fact that a person’s final years are challenging and represent realities that no one wants to deal with. Because of this, we often avoid tackling the important issues that make a difference in future quality of life.

For instance, it’s not easy to have discussions about giving up living at home, losing independence, or discussing personal finances between parents and children.

Complicating matters, these discussions often require multiple parties including parents, children, siblings, in-laws, medical professionals, and even legal and financial advisors. This makes a challenging conversation exponentially more difficult.

It’s understandable why people avoid dealing with this issue. Unfortunately, most run out of time and are forced to make a choice from undesirable options.

How can I take control?

How can you take control and ensure you’ve got the freedom to choose the best option for your loved one when the time comes?

Decide what you want the solution to look like

Start by deciding what factors are important and what you want the solution to look like.

How important is proximity to family? Is a private room desirable? What about dining options and culinary preferences? These are just a few of the factors to consider when trying to determine what the ideal long-term care solution should look like.

Determine costs

Once you have a good idea of what you want, make a list of the options in your community that fit your criteria. Examine the quality of care and the lifestyle at each. Eliminate options you don’t like and then find out what it would cost to stay at the remaining options. It’s safe to plan on two and one half to three years of residency.

Have difficult discussions

Once you know what you want in an ideal solution and what that will cost, it’s time to have difficult discussions.

In the case of preparing for your own long-term care needs, talk to your spouse about what you both want if nursing care becomes necessary. Include your adult children in this conversation, if possible. And, remember, it’s never too early to do this—the earlier the better.

In the case of a loved one, it can be more difficult to talk about future care. This discussion should happen over time and through multiple conversations.

It might be best to initially approach the topic from the perspective of your responsibility for them. For instance, telling your parent that, “I’m worried that you’re not going to get the care you need in the future,” is much better than telling your parent what they should or must do.

Leverage expertise

There are a number of people with formal and informal expertise that can help. Speak with medical professionals about options and how the continuum of care works.

Make sure you learn more about federal and state regulations regarding long-term care and how it’s paid for, as well as to get up to speed on Medicaid.

Don’t forget to talk to friends and neighbors who have already been through the process of placing a loved one in a nursing home. They can be an invaluable resource because they can share what worked well and what didn’t, helping you avoid common pitfalls.

We also recommend touring facilities that seem to meet your criteria. Do this well in advance of needing a place for your loved one. This allows you to review them objectively and without the pressure of needing to find a solution quickly. Use our handy nursing home checklist as a guide.

Of course, like any major decision in life, check with your legal and financial advisors, too.

Make a plan

Once you’ve done the above, it’s time to lay out a plan. Develop a clear plan that will get your loved one from their current financial state to one that will allow them to receive the best possible care.

There are many options available to accomplish your goals, including liquidating assets, utilizing investments, or claiming against a long-term care insurance policy.

The earlier you can develop and begin to implement a plan, the better your options will be when the time comes to chose a nursing home.


Some long-term care options aren’t necessarily expensive, but having the freedom to choose the nursing home that’s best for your loved one can take considerable financial resources.

The most important thing you can do to ensure they get the best care is to take control as early as possible. This means confronting reality, identifying the best solution, and making a plan.

No one likes to face these difficult discussions and decisions, but by being proactive you will be giving your loved one a priceless gift as they enjoy their later years.

It would be our pleasure to assist you as you work through this process. Please contact our office of social services to learn more.