Many families find themselves seeking information and help when a loved one experiences a crisis that has been brought on by acute illness, accident or disease. Often, appropriate help is found and the individual recovers after a treatment and recuperation period. At other times, however, a full recovery is not possible.

The crisis event represents the last straw, the painful reality that a loved one’s physical or mental health has declined to the point that he/she can no longer take care of himself/herself and be safe.

This reality is difficult to accept for both the individual and family members. Loss of ability to care for oneself represents a huge change in lifestyle and support needs, and can place a family under intense strain. As families consider care options, they need to follow a series of steps to ensure that they make the best decisions possible.


1. Medical Exam
    It is imperative that your loved one has a complete physical exam to help determine the
    causes of any problems being experienced. Symptoms like confusion, depression and
    memory loss may be the 
result of infection, thyroid imbalance, trauma, stroke or 
    medications, and may not herald the onset of dementia or Alzheimer’s disease.
    Without a proper medical evaluation, your loved one may not be correctly diagnosed or 

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2. Community Resources
    Wake County currently offers a variety of services for aged and disabled adults; however,
    there is a general lack of knowledge about these services because of fragmentation in
    the system of service delivery. To make informed decisions, families must know
    what options are available. A good information source in Wake County is Resources 
    for Seniors, Inc. Resources for Seniors is a nonprofit agency in operation since 1973 
    providing home and community-based services to aged and disabled adults. Additional
    information can be obtained by calling Resources for Seniors at 919-872-7933.

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3. Long-Term Care Facilities 
    A. If residential placement is the option chosen for a loved one, care must be taken to
    choose a facility that is a good match for the individual being placed and that provides 
    high quality care. The better informed a family is about a particular facility, the greater 
    the likelihood that a successful placement will occur. After a physician determines the 
    level of care that an individual needs, the family should investigate which local facilities 
    provide this level of care, which facilities the family/individual can afford, and which 
    facilities provide high quality care. To answer these questions, families can access the
    following resources:

    B. Each licensed facility is required to have its state license posted. The license is
         renewed annually and indicates the category of licensure, expiration date and
         maximum number of residents to be served. Follow up and ask questions about any
         facility whose license is not posted.

    C. As the process of choosing a facility unfolds, there are several issues
         that families must consider.

  • It does not matter how much a family likes a particular facility if the loved one does not. The loved one is the person who will be residing there, so he/she must “buy in” to the placement process. Adults who have not been judged incompetent in a court of law have the legal right to determine where they will live, regardless of what family members think is best, and have every right to discharge themselves from a facility if they wish.
  • Facilities should be chosen based on the care they provide—not on how nice they look or where they are located. Aesthetics and convenience are of little consequence if a loved one’s care needs are not met.
  • Placement in a long-term care facility does not necessarily equate with aging in place. Categories of licensure define the kind of care provided by different types of facilities and provide guidelines to ensure individuals are appropriately served. As the care needs of an individual change, he/she may need to relocate to another type of facility to have needs met.
  • Any facility's policies should be documented in writing and given to prospective families/residents. If a policy is not in writing, it does not exist. Facility policies may not conflict with state licensure rules, so check with the Division of Health Service Regulation regarding state or federal rules if there are any questions.
  • Discharge from a facility can be a stressful time if the resident/family does not want to relocate. Discharge rules governing nursing homes and adult care homes are very strict and grant the resident/guardian the right of appeal if the facility initiates the discharge. Taking time to become educated about discharge rules is time well spent.
  • Facilities do not provide one-on-one care. Adults needing this level of supervision need to seek services elsewhere.

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4. Consumer Influence

    The most powerful influence over the continuum of long-term care is the one least used
     the power of the consumer. Consumers can best exert this influence in the following 

  • Become educated about the continuum of services offered in the community.
  • Take time to ask questions and seek help from a variety of sources. Put the needs of your loved one before your own.
  • Do not tolerate poor quality care and services. Speak up about any concerns that you have.
  • Do not patronize agencies or facilities that fail to deliver services purchased and expected.
  • Advocate on behalf of your community’s senior and disabled adults


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