Long Term Care Planning Checklists

Every facility/community will need to assess a prospective resident`s functional capabilities. This checklist will assist you in determining the type of care and service required.

Current Resident/Patient Status	Yes	No	Type of Resident/Patient Accepted	Yes	No
Ambulation
Ambulatory			Accept ambulatory
Non Ambulatory			Accept non-ambulatory
Bedridden			Accept bedridden
Physical Health Status
Hearing impairment			Hearing impaired
Visual impairment			Visually impaired
Wears dentures			Resident with dentures
Special diet			Resident with special diet
Substance abuse issue			Resident with substance abuse issue
Use of alchohol			Resident consumes alcohol
Use of cigarettes			Resident smokes
Bowel impairment			Resident is bowel incontinent
Bladder impairment			Resident is bladder incontinent
Paralysis			Resident is paralyzed
Continuous bed care			Resident requires continues bed care
Skin breakdown			Resident has history of skin breakdown
Mental Condition
Confused/disoriented			Resident is confused/disoriented
Inappropriate behavior			Resident with inappropriate behavior
Aggressive behavior			Resident with aggressive behavior
Sun downing behavior			Resident with Sun downing syndrome
Able to follow instructions			Resident not able to follow instructions
Depressed			Resident with depression
Suicidal/self abuse			Resident that is suicidal
Able to communicate needs			Resident not able to communicate needs
Able to leave facility unassisted			Resident not able to leave unassisted
Capacity for self-care
Able to bathe self			Unable to bathe self
Able to dress/groom self			Unable to dress/groom self
Able to feed self			Unable to feed self
Able to care for own toileting needs			Unable to toilet on own
Able to manage own cash resources			Unable to handle own cash resources
Health Conditions
Contagious/infectious disease			Resident with a contagious/infectious disease
Allergies			Reisdent with allergies
Pressure sores			Resident with pressure sores
Gastrostomy care			Resident with gastrostomy
Naso-gastric tubes			Resident wth a naso-gastric tube
Tracheotomies			Resident with tracheotomy
Totally dependent on other for all ADL's
Oxygen - gas and liquid			Resident on oxygen
IPPB MAchine			Resident uses IPPB machine
Colosomy/ileostomy			Resident has colostomy or ileostomy
Urinary catheter			Resident has a urinary catheter
Managed incontinence			Resident has managed incontinence
Contractures			Resident has contractures
Diabetes			Resident is a diabetic
Terminal Illness
Requires pallative care			Resident needs pallative care
Requires hospice care			Resident needs hospice care

Income and resources must be identified to determine a budget. A checklist should be used to determine the monthly income that the resident will have to pay for care or alternative living.

Income Source	Husband	Wife
Social Security
Pension
Investment income from assets
Long term care insurance
Veterans benefits with Aid and Attendance
Medi-Cal/Medicaid
Other
Total Income
Total Income (Husband + Wife)
Less Cost of Care
Balance

Consultation with an estate-planning attorney versed in long-term care is highly advised to determine whether VA benefits and/or Medi-Cal benefits can be acquired. Click here or call 877-822-3335 to ask attorney, Stuart Furman a question or arrange a consultation.

Consultation with an estate-planning attorney versed in long term care is highly advised.

The basics before you search for a care home
Establish a budget (considering a spouse that might be living at home)
Determine the desired location
Determine an individual`s functional and mental capabilities

Estate planning documents are essential to manage an elder`s care plan. Estate planning documents are to eldercare as a full toolbox is to the construction industry. Unless you have the right tools, it is extremely difficult to accomplish anything!

Critical Documents and Questions Checklist

Document/Question	Yes	No
Living trust?
Will?
Financial Power of Attorney?
Health Care Advance Directive?
HIPAA release?
Catastrophic health care provisions?
Are the assets held in the proper name(s)?

If the answer is NO to ANY of the above, this is the time to prepare or amend such documents. Consultation with an estate-planning attorney versed in long term care is highly advised. Click here or call 877-822-3335 to ask attorney, Stuart Furman a question or arrange a consultation.

Living Trust.
A living trust is an entity that holds title to certain assets for easy management in the event of incapacity or death. A properly drafted and funded living trust avoids the need for Probate, Conservatorship or Guardian proceedings (over the financial affairs), can maximize tax savings for heirs, and can provide valuable tools to help the family qualify for certain governmental entitlements or benefits.

Will.
This is a last will and testament which gives a Probate court judge instructions as to whom you want to pass your assets to.

Financial Power of Attorney.
A financial power of attorney can be drafted giving current powers to an agent or can be a 'springing' power of attorney where the powers spring into effect upon incapacity. Powers of attorney can also be general powers of attorney or limited to certain actions.

Health Care Advance Directive.
This is a power of attorney to allow another person to make your medical decisions in the event that you are unable to make them for yourself. This document includes 'end-of-life' decisions including 'pulling-the-plug'.

HIPAA.
This is a general release of medical records for certain specified people.

Catastrophic health care provisions.
These are certain provisions drafted into the living trust and power of attorney that give the power to take action to protect assets and qualify an individual for governmental benefits.

Are assets held in the proper name? Certain assets, like real estate, must be transferred to the living trust in order to avoid probate. Other assets are not transferred to the trust but otherwise avoid probate, such as IRAs, life insurance and the like. It is important to review the 'vesting' of assets to make sure that all resources are in the proper name.

No one can be forced to move or do something that they do not want to do or against his or her will without a Court order (called a 'conservatorship over the person' or 'guardianship', in some jurisdictions).

A common fallacy is that a medical advance directive gives the 'agent' this legal power. The medical advance directive only grants the agent the right to make medical decisions for the individual not to physically force them to do something against their will.

Before considering a move, discuss the options with the elder that is competent to understand their situation and options. If they are not competent, you must determine the legal authority that you have (for 'combative' and for 'complacent' incompetent elders).

Home Health Care

What is Home Health Care?

Home health care is simply health care at home. It helps seniors live independently for as long as possible, given the limits of their medical condition.

More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one`s daily regimen of prescription and over-the-counter medications.

The distinction between home health care and home care services is not always clear. Home health care is medically oriented while home care is limited to chores and housecleaning services. Since there is a medical component to home health care, the care givers are often licensed nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state.

For more information on Home Health Care services:

1. National Institute on Aging (PDF)
2. National Institute of Aging
3. Medicare

What is Respite Care?

Respite Care is short-term, temporary relief for the primary caregiver of an elderly or dependent adult that would normally require assistance out of the home. Respite care can be provided through a variety of different programs and services:

• Adult Day Care: These programs provide care and companionship for frail and disabled persons who need assistance or supervision during the day.
• In Home Respite: This can be a variety of different services provided to the senior in their own home.
• Assisted Living/Residential Care: In care homes (large or small), these programs are very useful to a senior when: 1) He/she is being discharged from rehabilitation but requires more care and supervision before going home; 2) Temporary care and supervision is needed when the family care provider needs assistance. The fees are paid privately and typically are on a daily rate.

For more information on respite care:

1. National Institute on Aging (PDF)
2. National Institute on Aging
3. Medicare