What advice do you have regarding nursing homes for elderly family members?
My parents are in their 60's and health issues are starting to pop up more now.
What advice do you have for those of us who are considering nursing homes for our elderly parents in the future?
Answers ( 1 )
The first thing you, as the Child, may wish to do is discuss with your Parents their wishes; the same way you, when so much younger than they as a child, were nice enough to tell them what you wanted for Christmas, it would be just as nice for your parents if you had an inkling of how they may want their end of life time to go.
That means an uncomfortable discussion- or three. If you have siblings, even more. Also, an Elder Lawyer would be smart- it will save you guys making any rookie mistakes like thinking Mom and Dad can sell you their house and property for a dollar, and then go live off Medicaid in a Skilled Nursing Facility, thus making sure everyone gets their fair share of the inheritance..
Not to mention the whole Code Status and, even more difficult, Advanced Directives decisions; trust me, fighting with your siblings over whether or not it's time to let Mom go after her fourth stroke and inability to swallow this time is not the way you want to remember your Mom's end of life.
The second thing you may want to consider is sixty, medically, really is the new fifty. True, in the sixties, it takes longer to get over illnesses and disease flairs, and there is increased arthritic limitations and increased risk of any of the problems of aging, but- and this is something you need to consider- unless one or both of your parents have a diagnosis which indicates a shortened lifespan is in their future- such as COPD or CKD or CHF (Chronic Obstructive Pulmonary [lung] Disease, Chronic Kidney Disease, Congestive Heart Failure) then average lifespans are into the mid-seventies- so don't put your cart before their horse. It isn't your life- it's their lives; you need to accept that, as adults with all their Constitutional Rights, they get to make their own choices until that right is taken away by a Court.
Which doesn't mean that you can't all sit down and discuss things exactly like adults.
But, that you need to consider what you now in your thirties, are going to think about you then in your sixties when your young adult kids (who are still making stupid-to-you decisions) come to you and want to discuss the nursing home they see in your near future. Be considerate, and very, very respectful of the fact they STILL know more about life, the universe and everything than you do.
So, the time has come, the time is now, how do you decide Assisted Living (ALF) or Skilled Nursing (SNF) or Memory Care? You ask their doctor which level of care s/he believes might be appropriate. And then you keep in mind the following phrase for when you are looking at ALFs and Memory Care facilities: "Do you allow your Residents to age in place?"
That means do your parents get to stay in that facility no matter what happens to them health-wise, no matter how much nursing care they need? If not, well, there's a tough choice in front of you: Most ALF/Memory Care facilities are private pay- they do not take Medicaid, or, if they do, they only have a room or two which is rated for Medicaid- trust me when I tell you a private pay facility will run you between $8k and $12k a month- possibly per person, might be a deal for a couple. Far, far less expensive to get home health care and allow your folks to stay in their home with some assistance- especially if one of them is in better physical shape than the other. Skilled Facilities (SNFs) are most usually Medicare/Medicaid Certified, meaning there is very little out of pocket costs- at least, until the estate gets settled. What- you thought the Government wasn't going to get its piece of the pie? That's why you want that Elder Care lawyer.
So how do you choose a facility, at all? Once you know from the doctor what level of care s/he thinks is appropriate, you gotta do the work. You have to make calls, ask pertinent questions about staffing levels, amenities, medical directors, cost- and these places aren't going to want to tell you that over the phone. They want you in person so they can sell you- especially if they are private pay. To make sure you aren't dazzled by the decor and miss the warning signs of a bad facility, follow these guidelines:
That's a good start, anyway. If you have any specific questions, don't be afraid to ask- I'm trying to make sure everyone knows how it should work, so when I- and you- get there, it'll be working right.