Making a life-changing decision on a loved one’s long-term care and considering a nursing home or assisted living facility is never easy and there are many hurdles that must be overcome. For many, this may not be necessary as they will receive the care they require in the comfort of their own home, which is certainly the first option for a large percentage of seniors receiving care.
According to an AARP study 89% of those 65 and older would love to age in place for as long as possible, and there are several important benefits of aging at home, like improved health, routine, independence and the familiar setting. If medically and financially possible, there is no place like home. In-home care can be affordable, when limited in services and in number of hours per day.
For low income seniors, there are several programs, like the In-Home Supportive Services (IHSS) program, the Cash and Counsel program, or if you or your family member is a US veteran, the VA administration for veterans may cover a variety of in home care services in your state. Services that are typically covered by these programs include, health care, personal care, homemaker care, adult day care, transportation, medical equipment and some minor home remodeling.
For those that prefer a group setting, or home care is not appropriate and/or affordable, and the family feels that a nursing home or assisted living facility would be the be the best fit, obviously there are many emotional issues that need to be dealt with. Often there are conflicting emotions raging, including, guilt, anger, sadness and helplessness, when they are no longer able to provide the care that their loved ones now require.
Another area that needs to be navigated when considering a nursing home, is how to pay the bill, which for many American families is financially out of reach even after saving up for a considerable number of years. The same situation arises with home care services; unless the person has savings, equity in their home, or Long Term care Insurance, cost can be an issue. The federal and state governments provide Medicaid/Medical help if the individual meets all financial and medical eligibility guidelines. There is often a grueling task, companies like Senior Planning Services could help you with the Medicaid application process, or you can address your local Medicaid office, often, with the risk of failure quite high.
Last but no least, there are considerations as far as choosing the right nursing home or assisted living facility for mom or dad, to the right in-home care agency that will take into account all personal, cultural, religious and location-based preferences. This accumulation of stress is enough to inundate any sane person, but for the nearly 65 million heroic individuals providing care in the US for a loved one, this is often the best care option for the senior.Having worked for many years as a nursing home placement coordinator for a NJ-based Medicaid planning company, I’d like to share the personal saga of one of our clients which touched me deeply.
Several months ago I was contacted by a woman living in northern New Jersey. Her mom, who resided in central NJ in Ocean County, was suffering from severe dementia and the daughter wanted her admitted to a nursing home in her own area, up in northern NJ, in Bergen County. In addition to her dementia, the elderly woman also had severe behavioral issues.
The family was in the Medicaid application process and their application was in the pending status. Because of her unique needs, our options were quite limited. We needed a nursing home with a secure unit where the residents could not wander out of the unit, since a wander guard would not have been sufficient for this woman. Dementia patients tend to become so confused and lost in their surroundings, that they will try to leave the premises even when wheelchair bound.
The woman, as we mentioned earlier, also had violent tendencies and would sometimes act disrespectfully, hit other residents and caregivers, and needed a nursing facility that was equipped for these needs. These issues made finding the right facility a nightmare.
When we did find one or two, we were turned down, since our Medicaid status was still pending and not all nursing homes were willing to work with Medicaid-pending applicants.
In the meantime, we found placement for the woman in a nursing home in the Ocean County area which was able to provide all of her needs. I had a good working relationship with this facility and, after some cajoling, they accepted her, confident that the Medicaid application would be approved. It didn’t satisfy the requests of the daughter, though, who wanted mom close by.
When the Medicaid application was subsequently approved, we were successful in transferring the woman to a facility closer to her daughter in Bergen County. We were all very excited that it had worked out well for everybody, at last. The daughter thanked me profusely for the effort I had expended in making it happen.
It was heartbreaking when, days later, the woman passed away at the facility…
Conclusion: You know, as professionals, we try to maintain a certain degree of detachment in order to be better able to assist our clients, but at the end of the day… it’s painful. We do develop relationships with the wonderful people whose long-term care is entrusted to us and when they go so quickly, it’s like losing a friend or relative, in a sense.
In collaboration with Benjamin Lamm, a senior advocate.