Caring for someone in long-term care
Moving someone into an assisted living community or nursing home is one of the hardest decisions a caregiver can make, but your presence and voice remain essential. Your role as a caregiver doesn't end—it evolves—transitioning from managing daily hands-on care to becoming their primary advocate. Partnering effectively with facility staff is the best way to ensure your loved one receives safe, respectful, and quality care. Discover trusted tools and community networks below to help you navigate long-term care facilities with confidence.
Decision process
Looking into long-term care can feel overwhelming at first. Start with a clear process to make the transition easier and help ensure the best care for the person you support.
1. Assess the level of care needed.
Begin by evaluating the person’s needs:
- Help with daily activities (bathing, dressing, eating)
- Medication management
- Memory care needs
- Medical supervision
Talking with a doctor, hospital discharge planner, or social worker can help determine whether the person needs assisted living, skilled nursing, memory care (in an assisted living or skilled nursing home), or home care.
2. Learn about long-term care options.
Research the different types of care available, such as:
- In-home care
- Assisted living communities
- Skilled nursing homes
- Memory care neighborhoods
Understanding the differences helps match the level of care with the person's needs. See the residential facilities section below for more information.
3. Understand how to pay for care.
Long-term care can be expensive, review financial options such as:
- Private pay
- Long-term care insurance
- Medicare (limited short-term skilled care)
- Medicaid (covers many long-term care services if eligible)
- Veterans benefits through the U.S. Department of Veterans Affairs
4. Prepare legal documents for the future.
Before finalizing a transition to a facility, ensure essential legal protections are in place so someone trusted can make decisions on the person's behalf. Key documents include:
- Medical Power of Attorney: Designates a trusted person to make healthcare decisions if someone becomes unable.
- Financial Power of Attorney: Authorizes someone to manage bank accounts, pay bills, handle property, and navigate Medicaid applications.
- Advance Healthcare Directive (Living Will): Outlines specific preferences for medical treatments and end-of-life care.
- HIPAA Authorization: Grants medical staff permission to discuss health details with designated people. Consulting with an elder law attorney can also help navigate complex estate planning or Medicaid eligibility rules.
5. Research and compare facilities.
Trusted resources to compare facilities, include:
- Centers for Medicare & Medicaid Services Nursing Home Compare website
- Your local Area Agency on Aging
- Seniors Blue Book
These tools provide ratings, inspection reports, staffing levels, and quality measures.
6. Visit and tour facilities.
When possible, tour multiple facilities and:
- Observe cleanliness and staff interaction
- Ask about staffing ratios and activities
- Ask about facility policies related to the person's needs
- Review menus and activity calendars
- Talk with residents and families
7. Review resident rights.
Understand resident rights, including privacy, dignity, participation in care decisions, and protection from abuse. See the resident rights section below for more information.
8. Ask about care plans.
Each resident should have an individualized care plan based on their needs. Ask:
- How often care plans are updated
- How families are involved
- Who to contact with concerns
9. Check licensing and complaints.
Review state inspection reports and complaint history through your state’s long-term care regulatory agency. In Utah, that's the Division of Licensing and Background Checks. To look up a facility, click this link and then click on "find a facility."
10. Plan for ongoing advocacy and connection.
Moving into a facility is a major transition, and your role as a caregiver will shift to being an advocate. To ensure your loved one continues to receive the best care, you should:
- Establish a regular visiting schedule to monitor their well-being and stay visible to the staff.
- Attend care plan meetings.
- Get to know the facility’s Long-Term Care Ombudsman (a free, state-mandated advocate who helps resolve resident complaints and protects their rights). See the Long-Term Care Ombudsman section below for more information.
- Connect with the facility's family council, if one exists, to share resources and support with other families.
Simple starting point:
- Talk with a doctor or social worker
- Research care options
- Review finances and insurance
- Compare and visit facilities
Residential facilities
Understanding the difference between assisted livings and nursing homes helps you and the person you support choose the right level of care for their needs. The main differences involve the level of medical care, independence, and qualifications needed to live there.
Assisted living
Assisted living is designed for people who are mostly independent but need some help with daily activities.
Services provided
- Help with bathing, dressing, and grooming
- Medication reminders or assistance
- Meals and housekeeping
- Transportation and social activities
- Limited health monitoring
Level of care
Residents usually do not need constant medical care. They are generally able to move around and participate in daily life with some assistance.
Qualifications for assisted living
A person may qualify if they:
- Need help with activities of daily living (ADLs) such as dressing or bathing
- Are mostly independent and mobile
- Do not require 24-hour skilled nursing care
- Do not have complex medical conditions requiring constant monitoring
Nursing home (skilled nursing facility)
A nursing home provides a higher level of care for people with serious medical needs.
Services provided
- 24-hour nursing care
- Medication management and treatments
- Physical, occupational, and speech therapy
- Assistance with all daily living activities
- Medical supervision by licensed nurses and physicians
These facilities are regulated by the Centers for Medicare & Medicaid Services and may be covered in certain situations by programs like Medicare (short-term rehabilitation) or Medicaid for long-term care.
Qualifications for nursing home care
A person may qualify if they:
- Need 24-hour medical or nursing supervision
- Require rehabilitation services after surgery or illness
- Have complex medical conditions
- Cannot safely live independently or in assisted living
Resident rights
One of your primary roles as a caregiver to someone who lives in long-term care is advocating for them. Understanding what rights they have in a facility can help you make sure they’re being treated fairly and take appropriate action if their rights are violated.
Long-term care resident rights are legal protections that ensure people living in nursing homes or long-term care facilities are treated with dignity, respect, and autonomy. In the United States, these rights are largely established under the Nursing Home Reform Act, which is part of the Omnibus Budget Reconciliation Act of 1987.
Below are the key rights residents generally have in long-term care facilities:
1. Right to dignity and respect.
Residents must be treated with dignity and respect at all times. Staff must honor personal preferences, cultural values, and individuality.
2. Right to privacy.
Residents have the right to privacy in:
- Personal care
- Medical treatment
- Phone calls
- Visits with family, friends, clergy, or advocates
3. Right to participate in care decisions.
Residents can:
- Be informed about their medical condition
- Participate in planning their care
- Refuse treatment or medication
- Choose their own doctor when possible
4. Right to be free from abuse or neglect.
Residents must be protected from:
- Physical abuse
- Emotional or verbal abuse
- Sexual abuse
- Financial exploitation
- Neglect
5. Right to manage personal finances.
Residents can manage their own money or choose someone they trust to do so. Facilities must provide financial records if they manage funds.
6. Right to visitors.
Residents can receive visitors of their choosing, including:
- Family members
- Friends
- Legal representatives
- Advocates
7. Right to voice complaints.
Residents can file grievances or complaints about care or facility conditions without fear of retaliation.
8. Right to participate in activities.
Residents should have access to social, recreational, religious, and community activities that support quality of life.
9. Right to be informed.
Residents must be informed about:
- Facility services and charges
- Rules and regulations
- Their rights as residents
10. Rights regarding transfer or discharge.
Residents cannot be transferred or discharged unless:
- Their needs cannot be met
- Their health improves
- They pose a safety risk
- Payment issues occur
Residents must receive advance written notice before discharge. See discharge section below for more information.
Why these rights matter:
These rights ensure that anyone living in long-term care maintains autonomy, safety, dignity, and quality of life, even when they require assistance with daily living.
Use these federal standards as a guide so you know what to expect in your family member or friend's care.
Discharge
Long-term care discharge refers to the process of a resident leaving a nursing home or long-term care facility, either permanently or for a short time. Discharges are strictly regulated by federal laws to protect residents from being moved unsafely or unfairly. (Note: This specific process does not apply to assisted living communities, which have their own rules.)
As a caregiver, knowing these rules helps you protect the person you support from being forced to leave suddenly or without a proper care plan in place. If a facility tries to move them, understanding their discharge rights gives you the power to speak up, appeal the decision, and make sure they always have a safe place to go.
Long-Term Care Ombudsman
A Long-Term Care Ombudsman is an advocate who helps protect the rights and well-being of people living in long-term care facilities, like nursing homes and assisted living communities.
As a caregiver, you don't have to solve every problem on your own. If you have concerns about how your loved one is being treated but aren’t sure what to do, the ombudsman can help you navigate the next steps. They act as a free, private partner who can work with you and the facility's staff to fix problems, answer your questions, and make sure your family member or friend gets the care and respect they deserve.
The main role of a Long-Term Care Ombudsman is to:
1. Advocate for residents.
Ombudsmen represent the interests of residents and help ensure they are treated with dignity, respect, and fairness.
2. Investigate complaints.
They help investigate concerns from residents or families about issues such as:
- Poor care
- Abuse or neglect
- Staff behavior
- Food quality
- Room conditions
They work to resolve these issues with the facility.
3. Protect resident rights.
Ombudsmen help ensure residents and facility staff understand these rights, including:
- Privacy
- Participation in care decisions
- Freedom from abuse and neglect
- Ability to voice concerns without retaliation
4. Provide education.
They educate residents, families, and staff about:
- Resident rights
- Long-term care regulations
- Available resources
5. Visit long-term care facilities.
Ombudsmen regularly visit facilities to:
- Speak with residents
- Observe conditions
- Identify potential problems
- Promote quality care
6. Help with transfers or discharges.
They assist residents who believe they are being unfairly discharged or transferred and help them understand their rights and appeal options.
Find your local Long-Term Care Ombudsman at this link.
Who can contact an ombudsman?
Anyone can request help, including:
- Residents
- Family members
- Friends
- Facility staff
- Community members