Making the decision

Watch for changes at home and in the person: trouble cooking safely, missed medications, poor hygiene or clothes that don’t fit the weather, a cluttered or unsafe house, unopened mail or unpaid bills, falls, or getting lost. Changes in mood, memory or judgment matter too. One sign by itself may not mean much, but a pattern usually means the current setup isn’t working.

Occasional forgetfulness is a normal part of aging, but serious memory loss, personality changes or poor decisions can be signs of a medical condition. Start with a visit to the person’s doctor, because some causes of confusion can be treated. If dementia is diagnosed, the Alzheimer’s Association 24/7 Helpline at 800-272-3900 can help you plan next steps.

Yes. Depression and memory problems are often easier to hide during a short visit than over several days. If you can, stay longer, and with your parent’s permission, check in with neighbors, friends, local relatives or their doctor. Look in the fridge, the mailbox and the medicine cabinet for clues.

Take it seriously and get help right away. Call or text 988, the Suicide and Crisis Lifeline, which is free, confidential and available 24 hours a day. For a veteran, dial 988 and press 1 for the Veterans Crisis Line. If someone is in immediate danger, call 911.

Start early, before a crisis, and ask your parent how you can be most helpful rather than announcing a plan. Explain why you’re asking about health or money, since many older adults don’t want to worry their children. Focus on what matters most to them, such as staying near friends or keeping a pet, and look for options that protect those things.

An adult who can make their own decisions has the right to make choices you don’t agree with. Try smaller steps first, like a few hours of in-home help, a medical alert device or an adult day program, and frame them as ways to stay independent longer. Sometimes advice lands better from a doctor, clergy member or trusted friend. If you believe the person can no longer understand the risks or is being harmed, contact Utah Adult Protective Services or talk with an elder law attorney about options.

Hold a family meeting, in person or by video, and split tasks by what each person can do: hands-on help, bills and insurance, research, appointments, or giving the main caregiver regular breaks. Keep a shared calendar and a shared list of doctors, medications and contacts. Revisit the plan as needs change, because what works this year may not work next year.

A lot can be done from a distance: managing bills and insurance, researching options, ordering supplies, arranging in-home help, and keeping records organized. With permission, you can join telehealth visits or care team calls. Plan visits ahead with the local caregiver so you use the time well, and offer to give that caregiver a break, even if that means paying for respite care.

It depends on how much help is needed and when, whether the home is safe or can be made safe, how much family can realistically do, and cost. Home care works well when needs are predictable and family can fill the gaps. A facility may be safer when someone needs help day and night, wanders, or falls often, or when family caregivers are worn out. A doctor, hospital social worker or your local Area Agency on Aging can help you weigh the options.

In-home care ranges from a few hours a week of personal care to skilled nursing visits ordered by a doctor. Adult day programs offer meals, activities and supervision during the day. Assisted living provides housing, meals and help with daily activities. Nursing homes provide 24-hour nursing care and supervision. Hospice provides comfort care near the end of life wherever the person lives.

Memory care is a program or unit, often inside an assisted living facility or nursing home, set up for people with Alzheimer’s or other dementia. When you visit, ask how staff are trained in dementia care, whether the unit is secure with safe outdoor space, how the facility prevents wandering, and what it does before turning to medications for behavior changes.

Respite is a short break for a family caregiver. It can be a friend or relative stepping in, an aide for a few hours a week, an adult day program, or a short stay in a facility. Utah’s Caregiver Support Program, offered through your local Area Agency on Aging, can help with respite and has no low-income requirement.

Yes, quite a bit. Medicare pays for short-term skilled care, home health and hospice when its rules are met, but not long-term custodial care in any setting. Utah Medicaid can pay for nursing home care and, through waivers, some care at home or in community settings. See our Paying for care questions for details.

Visit more than once and at different times, including a mealtime. Notice how quickly staff respond, whether residents look clean and engaged, whether there are strong odors, and whether people are calling out without help. Talk with residents and families if you can. Bring the same written checklist to each place so you can compare fairly.

Ask about staffing levels during the day and at night, how care plans are made and how family is included, what therapy is available, how emergencies are handled, and how concerns are resolved. Ask exactly what the base rate covers, what costs extra, how often rates rise, and whether the facility accepts Medicare or Medicaid. Ask about daily life too: meals, activities, visiting, bringing furniture and choosing a schedule.

Care Compare at medicare.gov/care-compare gives nursing homes an overall rating of 1 to 5 stars based on health inspections, staffing and quality measures. Look at the details, not just the stars: inspection findings from recent years, nurse hours per resident and staff turnover. Watch for an abuse icon or a “special focus facility” alert, which marks homes with a history of serious problems. Medicare says the ratings are not a substitute for visiting.

Utah’s Office of Licensing, part of the Department of Health and Human Services, offers a facility search with licensing compliance history and posts lists of provider sanctions from the past three years at dlbc.utah.gov. Health facility records there go back to October 2023; older records can be requested through a public records (GRAMA) request. Care Compare covers Medicare- and Medicaid-certified providers, so the state lookup is the place to check assisted living.

The Utah Long-Term Care Ombudsman Program advocates for residents of nursing homes and assisted living, and also helps people who are choosing a facility. Ombudsmen keep information confidential and serve people regardless of income. Call 801-538-3910 or find your county ombudsman at daas.utah.gov.

It is a document where a person names a health care agent to make medical decisions if they can’t, writes down their wishes about treatment, or both. Utah updated its law on January 1, 2026, and the state provides an optional Advance Health Care Directive form that covers naming an agent, life-sustaining treatment wishes, organ donation and more. Using the state form is optional; the important thing is that the document meets Utah’s signing rules.

Under Utah’s current law, naming an agent requires the person’s signature and one adult witness; a notary is not required. The witness cannot be the agent or the agent’s spouse or partner, and for someone living in or getting care from a nursing home or assisted living, the witness cannot be an owner, operator, employee or contractor of that facility. Give copies to the agent, family and doctors, and bring one to any hospital or facility.

In general, yes. Utah’s law says a directive made before January 1, 2026 is valid if it met the law that applied where and when it was made, or if it meets the current law. If your family has an older directive, it can still be a good time to review it, since wishes and agents can change.

Utah law sets an order of people who can act as a “default surrogate” when someone can’t decide for themselves and has no agent or guardian. The list starts with an adult the person named outside a formal document, then generally a spouse, then adult children or parents, followed by others such as a partner, siblings and grandchildren. When family members in the same group disagree, the provider generally follows the majority of that group. A directive avoids this uncertainty.

A POLST (Provider Order for Life-Sustaining Treatment) is a signed medical order that records a person’s wishes about life-sustaining treatment so that EMS crews and other providers can follow them. A physician, advanced practice nurse or physician assistant completes it with the patient or their surrogate on a state-approved form, and both sign it. Hospitals, facilities and EMS crews in Utah must treat a copy the same as the original. Ask the person’s doctor whether a POLST makes sense.

A power of attorney lets a person name an agent to handle money and property. In Utah, a power of attorney stays in effect if the person loses capacity unless it says otherwise, and it must be signed in front of a notary. It does not cover health care decisions, which need a separate advance health care directive. Utah’s courts offer a statutory form, but they recommend talking with an estate planning lawyer.

Guardianship is a court process where a judge gives someone legal authority to make decisions for an adult who cannot make or communicate decisions about basic needs. The judge must find incapacity by clear and convincing evidence, and the adult has the right to a lawyer. Utah courts prefer a limited guardianship, giving only the powers that are needed, and treat guardianship as a last resort. The Utah courts’ self-help pages explain the forms and steps.

Less restrictive options include arranging help and services so the person can keep making their own choices, a supported decision-making agreement, a power of attorney, an advance health care directive, a trust, or a representative payee appointed by Social Security or the VA to manage benefit payments. Many of these require the person to still have enough capacity to sign. An elder law attorney can help you choose; the Disability Law Center also helps with alternatives to guardianship.

Not always. Under HIPAA, providers may share information that is directly relevant to a family member’s involvement in care, as long as the patient doesn’t object, or if the patient is unable to agree and sharing is in their best interest. A health care agent or guardian is treated as the patient’s “personal representative” and has broader rights, including access to records. A signed HIPAA authorization naming family members can still make things easier, especially for billing and insurance calls.

In a planned move, you have time to tour, compare costs, check records and get papers in order. After a hospital stay, decisions often happen in days, so ask for the hospital social worker or discharge planner early, ask what services and equipment will be needed, and get written discharge instructions and a medication list. Having a directive, power of attorney and a list of preferred providers ready ahead of time makes an emergency much easier.

A person can stay in a hospital bed as an outpatient “under observation” instead of being admitted. Observation and emergency room time do not count toward the three-day inpatient stay Original Medicare requires before it covers skilled nursing facility care. Ask the hospital directly whether the person is an inpatient or under observation, and if Medicare changed the status, ask about appeal rights.

People with Medicare can ask for a fast appeal. Hospitals must give the “Important Message from Medicare about Your Rights” notice, and skilled nursing, home health and hospice providers must give a “Notice of Medicare Non-Coverage” before services end. Follow the instructions on the notice by the deadline listed, and an independent reviewer will decide. Medicare Advantage members appeal through their plan, with different rules.

Common signs include feeling exhausted, overwhelmed or hopeless, losing patience easily, trouble sleeping, frequent headaches or other aches, skipping your own meals, exercise or doctor visits, pulling away from friends, and leaning on alcohol or medications. Feelings like guilt, sadness and frustration are normal. Don’t wait until you’re completely worn out to ask for help.

Your local Area Agency on Aging runs Utah’s Caregiver Support Program, which offers counseling, education, support groups and respite with no low-income requirement. Family caregivers of veterans can call the VA Caregiver Support Line at 1-855-260-3274. Dementia caregivers can call the Alzheimer’s Association Helpline at 800-272-3900, day or night. Tell your own doctor you are a caregiver, too.

Watch for unexplained bruises, burns or cuts; preventable bedsores; poor hygiene or an unsafe, dirty home; missing glasses, dentures or hearing aids; withdrawal, agitation or fear around a certain person; and sudden money problems, unpaid bills or changes to wills and accounts that don’t make sense. A pattern is more telling than one incident. Trust your instincts and report concerns.

Call 911 if someone is in immediate danger. Otherwise, report to Utah Adult Protective Services at 1-800-371-7897, Monday through Friday from 8 a.m. to 5 p.m., or file a report online at any hour through daas.utah.gov. Utah law requires anyone who has reason to believe a vulnerable adult is being abused, neglected or exploited to notify Adult Protective Services or law enforcement right away. You don’t need proof to report.

You can raise concerns about a licensed facility with the Utah Department of Health and Human Services Office of Licensing at (801) 538-4242 or through the online concern form at dlbc.utah.gov. For problems affecting nursing home or assisted living residents, the Long-Term Care Ombudsman at 801-538-3910 can also step in. If you suspect abuse, report it to Adult Protective Services as well.