With the availability of in-home services for older adults in Allegheny County, individuals in need of nursing home services have the option of receiving them in their homes for as long as they are able and choose to do so. This option means that the decision to place a loved one in a nursing or personal care home can be delayed for months, years and maybe even indefinitely.

Yet for some of us, the time comes when we need to seriously consider transitioning a loved one into a place that can provide a higher level of care. While this decision is never easy, it can be made with more confidence, trust and ease by using the following steps and questions as a guideline for navigating the process.

When and where should I begin to look for a facility?

The answer is depends on your circumstances and needs. Perhaps you have become uncomfortable living alone due to the loss of your spouse, getting sick, safety issues such as worrying about falling, or difficulty taking care of your home the way you’ve always been accustomed to do. Or you notice that your loved one isn’t able to cook for themselves or manage routine tasks, including personal hygiene. But how do you know if in-home would be adequate or if something more is needed? “The first step is to get a needs assessment to determine the correct level of care,” says Toni Allen, supervisor for the Allegheny County Department of Human Services Area Agency on Aging (DHS AAA) Ombudsman Program. The DHS AAA can perform an assessment, or you can ask your physician do to one for you. “The assessment should tell you what the least restrictive level of care would be for you or your loved one’s needs.”

Once it’s determined that a nursing or personal care home is the appropriate option, the most important thing you can do is visit the facility. “Geographics are important,” Toni adds. “It’s good for the family to make sure that they can easily visit their loved one.”

How does the selection process differ between a nursing and personal care home?

Before we discuss what to look for when you make that visit, let’s define the difference between a nursing facility and personal care home. Nursing homes are licensed medical facilities that are inspected and licensed by the Pennsylvania Department of Health.

They must meet both state and federal regulations, and they offer third-party (Medicare and Medicaid) reimbursement for those who qualify, based on income. Nursing homes are for residents who require a higher level of care.

Personal care homes are residential facilities that offer personal care services, assistance and supervision, and are inspected and licensed by the Pennsylvania Department of Public Welfare. The terms “assisted living residence” and “retirement home” can be used interchangeably, and their residents are typically more independent, mobile and interested in participating in activities, both inside and outside the facility. A personal care home must have a license to operate in Pennsylvania, and must follow regulations aimed at protecting the health, safety and well- being of the residents. Federal regulations for personal care homes don’t (yet) exist, and they do not offer third party reimbursement.