Solving the Long-Term Care Placement Mystery

Imagine if there was an episode of Columbo where he had to find a nursing home for his mother. The story goes that mother Columbo’s abilities had been declining for the past few years.  Small things like not cooking a big Sunday Italian family any more.   Mrs. Columbo has been widowed for a decade with Columbo and the family visiting and helping her.  Then it happened, an illness that landed her in the hospital.  The television social worker meets with the family about the need to make new living arrangements for his beloved mother.

Finding the right setting and support for Mother Columbo requires a highly skilled detective. In the words of Columbo there’s “one more thing….” to consider when selecting the right Long-Term Care (LTC) placement. 

In the true spirit of one of my favorite TV detectives, let’s tackle this issue using the F W’s of police investigations:

Who needs Long Term Care?

The term is used to cover individuals needing care as part of a hospitalization who are medically stable but still need to remain under the active treatment of registered nurses and therapists in an inpatient setting.  The term also applies to people needing help constant supervision and assistance with activities of daily living due to disabling or terminal health conditions that are considered medically stable. 


What is the right level of Long Term Care? 

Long Term Care during a hospitalization happens in three settings: skilled nursing facilities in sub-acute settings, acute rehabilitation and long term acute care.  All three occur at the hospital or when transferred to another facility certified and staffed with nurses and therapists taking orders directly under physician supervision. This level of Long Term Care is paid under the Medicare program.

Long Term Care when a change in level of care is required is funded by private insurance, private pay or Medicaid benefits.  Consumers select from; home health service while aging at home, assisted living facilities or nursing home placement.


Where do you find the best Long-Term Care providers? 

The Medicare Nursing Home Compare site ( is the national database and oversite of the nation’s nursing homes.  Each State has their own Department of Elder Affairs or Health Affairs that monitors Assisted Living Facilities or using ElderCare Locator (


When do you visit Long Term Care facilities?

Arrange a formal tour of all the facilities under consideration.   The admissions representatives are helpful so write down all of the questions and concerns you may have prior to the visit.  Visit and compare many facilities to find the best fit.

Once the list is narrowed, visit again.  Unannounced. Go during meal time.  Go when the staff should be most active with the residents to get a realistic picture of daily life in the


Why is this Long-Term Care decision so difficult?

There are so many uncertainties and emotions involved in making a long-term care decision.  Does the senior adult agree with the decision?  Is there insurance or private funds available to pay for the level of care required?  What other changes does this long-term care decision require to adjust to this new reality.


Columbo solved his mysteries by collecting information and looking for clues.  Real life does not wrap up so neatly as a television mystery but we can use the same skills for making the best long-term care choices. 


REUNIONCare is your virtual social worker for collecting information by engaging families and care providers with the senior adult to make informed decisions.  Consistent communications and checkups educates providing families and caregivers with the clues required for selecting the bestlong term care option.  REUNIONCare changes the way we care for each other.

JR KeeneComment