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Make sure you read contracts when signing up for agency help

by Carol Bradley Bursack, Editor-in-Chief

When adult children or others are suddenly thrown into helping their elderly loved ones, they often see the need for outside help. Because the responsibility of personally providing care or finding good paid care is emotional, we often dive into the task with our brains disengaged. Then, down the road, we find we have moved our loved one into assisted living while we expected the skilled care a nursing home offers. We can be angry, but we need to be realistic. Did we read the contract to see what the home provides?

Nearly always, when you seek outside help for caregiving, you have a contract to sign. Whether it's an agency that offers in-home help, assisted living or skilled nursing services, a contract is there for the protection of both parties. Whether the company is for profit or non-profit doesn't matter. There are still contracts.

Do They Require You to Continue to Pay After Your Elder Dies?

A friend's mother lived in a nursing home for some time. After the mother died during the first week of one month, my friend was stunned to find she owed the home for the total month of care. This didn't compute for her, because her mother had only occupied a room for a week into the month.

The contract with the home, which she had signed, proved that the nursing home's policy was able to charge for the full month. However, at the time my friend signed the papers at the home, this very intelligent, professional person was far too emotional to bother with reading contracts. She was handing over her mother to the care of outsiders and that was all she could cope with. She just signed on the dotted line and never thought back.

My friend is now stuck with a large bill that the long-term care insurance will not cover, as care wasn't delivered to the policy holder during the remainder of the month. It's a huge blow to get news like that on the heels of a loved one's death, but it's not unusual.

Assisted Living Centers Vary In Services Offered: Read the Fine Print

I'm asked more questions about assisted living facilities than any other type of care. People often misunderstand what care is provided in assisted living. Assisted living centers are not as closely regulated as nursing homes, nor are they as uniform in the services they offer. Many have tiered rates, depending on the needs of the individuals.

I'd guess that the majority of people looking into assisted living for a loved one expect that the center provides medication services. In reality, most don't. If they do provide this service, there is generally an extra charge. Many assisted living centers contract with in-home care agencies, or even nursing homes or clinics, so that medication can be given to a resident. However, again, people who want this service may need to pay an extra fee. If they don't read the contract, they are often surprised and angry about this fee.

People sometimes ask why they should bother with the assisted living home if they have to pay for extra services such as medication administration. Why not just move an elder into to a nursing home? The answer I give is that just because someone may need help keeping their medications straight doesn't mean they aren't capable of keeping a significant amount of independence. Also, the person may not meet the guidelines to be admitted to a nursing home.

Many assisted living centers are basically retirement housing with the added security of an alarm system should the resident fall or need emergency help. They offer community meals, though many also have kitchen units so the person living there has to option of cooking. The atmosphere and apartment type living in many centers is less medical and more social than that of most nursing homes. This is a huge drawing factor for elders who may have lost many friends to death and therefore need to find a new social life. Many elders, once adjusted, love their assisted living facility.

Assisted living options, in my opinion, should only continue to grow. They offer a needed resource for elder care. By all means look into one if you have an elder teetering between in-home care and a nursing home. Just read the contract. Find out what services they offer under the basic contract and ask what other options are available for extra fees. Get it all spelled out so you know what you will be expected to pay.

Nursing Home, In-home Care or Assisted Living: Read the Contract

In-home health care is less complicated, but some offer nursing services and others don't. Know your loved ones needs before signing up. Check each contract, whether nursing home, in-home care or assisted living, to see what costs you are liable for if your loved one needs to move to a different level of care, or if he or she dies while under contract. If you are unable to set aside emotion long enough to read the contract, have someone you trust do so. It could save you frustration and nasty financial surprises down the road.