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Shop for eldercare like you would for a car
Special to The Seattle Times
(Second of a series)
For too long, long-term care has escaped the scrutiny of savvy consumers — for many reasons.
Rules for how to choose good care aren't exactly engraved in stone anywhere. Time is short, and we're busy. Finding care means someone's ill and, well, we'd rather not think about it. And there's not much good information available to guide us. Most families wait until a crisis before beginning their search for care — Dad had a stroke or a spouse has Alzheimer's. Suddenly, with emotions running high and time running short, we pound the pavement and our computer keys, as we struggle to make sense of one of the most complicated industries in this country. It's like becoming a brain surgeon in a week — with few instructions.
In the 30 years I've worked in the aging field, I've witnessed a gamut of outcomes from this nonprocess. While some families are smart or lucky enough to find great care, many others choose services that are inadequate, wrong, indifferent, overpriced — or none at all. I've watched families dissolve under the stress.
One of the hallmarks of our robust economy is the huge variety of goods and services in the marketplace, but there's much less variety in eldercare. We take the rich diversity of older people — their different needs, disabilities, personalities, preferences, payment levels and lifestyles — and fit them like square pegs into round holes. Rather than create variety, providers offer mainly cookie-cutter services — in homecare, retirement communities, nursing homes and assisted living. For profit? Not-for-profit? Sometimes it matters, often not. With an iron fist developed to "protect" us, government maintains uniformity — and a lack of choice.
But the biggest barrier to better care is us: We haven't been voting enough with our pocketbooks to support high-quality, innovative care — because, I think, we don't know how.
Don't look now, but in just a decade or two, 78 million demanding, sassy, aging baby boomers will begin to need care. If we wait until then to take action, it'll be too late.
Information sheet: Liz Taylor's six steps to buying long-term care: seattletimes.com/living
If you prefer to receive this information sheet by mail, send $1 and a self-addressed, stamped envelope to Liz Taylor, PO Box 11601, Bainbridge Island, WA 98110
I estimate we have 10 years to accomplish a major miracle — turning one of the most calcified yet important industries in this country into something that responds to consumer needs. We have to start now — on behalf of our parents, spouses, aunts, brothers, grandparents and friends — to ensure better choices when it's our turn.
But the long-term care system is a very big ship, and it will be difficult to get it moving in a new direction. So let's begin!
A new way to think
about long-term care
To help with this task, I've developed six steps for becoming savvy consumers in the long-term care market — something you can check off and say you did in some reasonable sequence. It's based on how we buy cars.
We spend lots of time and energy buying cars. We research choices and comparison shop, read magazines, kick tires, talk to friends and search the Internet. Cars are too important, complicated and expensive not to do the job right. Well, so is buying care for our moms. But it's also highly emotional and can tear our hearts out if we don't do it right.
The steps we follow to buy a car provide a guide in how to buy care. Here they are, briefly. I'll be discussing each at greater length over the next several months.
The first step is to figure out our universe of choices. With cars, we need to know what sizes, models and brands are available. It's more difficult with eldercare, but the same principle applies. We need to know what services are available and what they do and don't do so we'll be in the right ballpark (or, ahem, car lot) when we go shopping. This is my next column's topic.
The second step is to understand costs and to determine what you can afford to pay. How you pay for care is critical in determining your choices.
The third step is to determine your needs — a simple task with cars, but a very difficult task with care. In the coming months, I'll provide a basic needs-assessment form to help you get the right answers.
The fourth step is to develop a list of specific choices from which to shop. Where can you find, say, assisted-living facilities or home-care agencies in your area?
The fifth step, for some shoppers, is to go to experts for advice. Car-advisory services can help you buy the right car; geriatric-care managers can help you choose the right care.
The sixth and most important step is to comparison shop; kick tires! It's not easy with cars, but it's a lot more difficult and complicated with eldercare. To make your shopping more successful, I'll provide the questions you need to ask for home and residential services.
Liz Taylor's column runs Mondays in the Northwest Life section. A specialist in aging and long-term care for 30 years, she consults with families and their elders. E-mail her at firstname.lastname@example.org or write to P.O. box 11601, Bainbridge Island, WA 98110. You can see all of her columns at www.seattletimes.com/growingolder/.
Copyright © 2006 The Seattle Times Company