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Study assisted-living options for aging parents

By Michelle Singletary
Sunday, May 30, 2010; G01

The residents at the assisted-living facility looked so frail, many sitting in wheelchairs or hunched over their walkers, making their way slowly along the hallways.

"Let's give our kids everything they want anytime they ask so they won't put us in a place like this," I whispered to my husband.

I was joking, of course. I had to lighten the mood. We are scouting places for my father-in-law. It was our first tour of an assisted-living facility, and this one was nice and homey, as were all the ones we visited.

A month ago, my 81-year-old father-in-law came to live with us while he recuperated from surgery. We now face a question that millions of adults are facing: What do you do with elderly parents or relatives who can no longer fully take care of themselves?

Thus began a journey that has caused me so much stress that I woke up one morning with a painful neck strain that lasted two days.

We are exploring various options, including having my father-in-law continue living in our home, returning him to his own home and hiring a home health-care aide to provide daily care, or having him moved into an assisted-living facility.

Since I first wrote about this new turn in my life, I've received dozens of e-mails from people with great advice and comforting words. There is so much to say about the issue of elder long-term care, more than I can address in any one column. For example, many people -- including a number of insurance agents -- wanted me to talk about long-term-care insurance. I'll do that in a future column, but it's too expensive to buy now for someone my father-in-law's age and in his medical condition.

Many pointed out that I should look into the Aid and Attendance program for veterans because my father-in-law served in the military. We had no idea he might be eligible for financial assistance from the Department of Veterans Affairs to help pay for long-term care. This special pension benefit is also available to a surviving spouse. We are studying this program, and I've found a lot of helpful information at Veteranaid.org.

But in the short term, we're looking for a temporary place for my father-in-law so we can take our regular family vacation. It's too late to cancel our plans.

On the advice of someone in the industry, we began checking out assisted-living centers that provide respite care or a temporary stay. It's a great idea because it allows my father-in-law to test whether he might like living full time in such a facility without making a long-term financial commitment.

Assisted living is a bridge between independent living and a nursing home. In assisted living, residents have their own space in mostly small studio or one- or two-bedroom apartments but are helped with "activities of daily living" or ADLs. (By the way, it really helps to become familiar with the terminology.)

In assisted-living facilities, the residents are provided meals and are helped with bathing, dressing, laundry, housekeeping and medications. Most facilities will tailor a plan for services for each resident.

Now comes the cost. About four out of five people pay for assisted living out of their own pockets, according to AARP.

You might need a chair, because the numbers are daunting. Last year, the national figure for assisted-living base rates averaged $3,131 a month, according to MetLife's Mature Market Institute, the company's research organization.

Costs vary widely depending on the location, the quality of the facility, the size of the apartment units and the level of service provided. The basic rate may include room and board only. In some facilities it can cover all services, or there might be additional charges for special services. Residents are evaluated to determine the care they need. The less needed, the lower the add-on fees. My father-in-law is a level one, meaning he needs the most basic care.

Most assisted-living residences charge on a month-to-month basis. If my father-in-law were to stay, several of the facilities require a nonrefundable entrance fee that is about the equivalent of one month's rent.

We've got a short list of places and prices for my father-in-law. Next we have to discuss with him what he can afford. It will be a tough talk.

I hope you stick with me as I chronicle each step we take in this process. We're all learning as we go.

Readers can write to Michelle Singletary at The Washington Post, 1150 15th St. NW, Washington, D.C. 20071.

Comments and questions are welcome, but because of the volume of mail, personal responses are not always possible. Please note that comments or questions may be used in a future column, with the writer's name, unless a specific request to do otherwise is indicated.

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