Caring for aging loved ones is an evolving process. Some need just a little help for an otherwise independent life; others, round-the-clock nursing care. With so many options and needs, it can be a confusing world to navigate.

This is National Assisted Living Week, a good time for a shout-out in appreciation for the care staff at such facilities, whose compassion and strength have been called upon even more than usual by those most vulnerable to a pandemic.

Challenging times indeed for these unsung heroes, quietly working every day to meet the needs of the aged or infirm in isolation. Especially so for seniors and others in such protective isolation — many for nigh on six months.

I miss my mom. But I’m lucky enough to know she truly is safe and comfortable, treated with respect, and in good hands.

After strokes impacted her health, navigating an unfamiliar and complex world of senior care options, medical needs, paperwork, costs, Medicare and Medicaid rules and terms was dizzying to the point of distress (not to mention wills, advance care directives, and health care choices). But with help, I found the right fit for us at a Post Falls facility and learned a few things along the way.

1. Paying for it. It’s confusing, even to a lawyer. Federal Medicare (health care coverage) offers some coverage for nursing home care, but doesn’t pay for assisted living. In most states including Idaho, state Medicaid (assistance to seniors with monthly income under $2,370 and limited assets) might pay up to two-thirds of costs of assisted living via a “waiver,” if a “nursing home level of care” is needed, but Medicaid doesn’t pay for room and board. Social Security (except $90 for personal expenses) and personal resources would. For many of the nicer facilities, a two-year “family contribution” payment may also be needed.

Facilities and services vary a lot; total price tag can run from $3,000 to more than $5,000 monthly in Idaho. After Social Security is used and with Medicaid eligibility, the resident and family may pay none, some or much of that. Primers such as Medicaidplanningassistance.org and Payingforseniorcare.com help explain.

2. Skilled nursing facilities (SNF): For those who need 24/7 nursing care, with doctors and physical therapists on-call or on-site. Residents may be short-term (e.g. after surgery) or permanent. Private pay, Medicare (may be full coverage when doc-recommended), or Medicaid.

3. Assisted living (AL): Single room, shared room, or apartment-style with services such as prepared meals, housekeeping, medications, laundry, and regular check-ins. Generally must be able to shower, dress, and groom independently. Private pay and/or Medicaid.

4. Memory care: Special care facilities for seniors with dementia; physical safeguards for those who wander. May be a stand-alone facility or a wing within an AL or SNF setting. Private pay, Medicaid.

5. Home health: In-home skilled nursing (typically LPNs and LVNs, rather than higher-qualified registered nurses), physical and occupational therapy as prescribed by a physician. Aides also provide personal care (bathroom/bathing). Private pay, sometimes Medicaid. Hourly around $20.

6. Residential/group homes: Smaller senior communities. May be called residential care homes, adult family homes, personal care homes, adult foster homes, group homes, or board-and-care homes. Typically provide basic care for seniors in a small home-like setting.

7. Adult day care: Not residential; can be routine or occasional. Meals and basic services in a group setting for non-independent adults when their caregivers work or need time off. Participants may be physically, mentally, or functionally impaired, or may simply need companionship or temporary supervision. Some specialize in Alzheimer’s care.

And if you’re caring for a loved one at home full-time, need help for an elder who’s living alone, or are 60 and older and having a problem, the Area Agency on Aging offers practical and confidential help and referrals (AAANI.org — 208-667-3179).

When checking out a facility or service, be sure to check references and any complaints (if you don’t know how, try AAANI or dial 211). After a guided tour, visit unannounced at least once and listen carefully to your loved one's feedback. They’re the ones whose lives are being transformed and who’ll have to live with it. Even in the best of circumstances, it’s a very difficult, often painful time.

Body and soul, in our earliest and latest days we most need protection.

Sholeh Patrick is a columnist for the Hagadone News Network. Contact her at Sholeh@cdapress.com.

Editor's note: Because of space limitations, Grey Kitty's rather pathetic portrait did not appear in Thursday's print edition with this column. Here's the beast — who is loved dearly.