Even when it has become clear that nursing home placement is in the best interests of a loved one, the decision of where they would be best served is not an easy one. Whether a nursing home placement comes after a long decline or a sudden medical emergency, family members are often conflicted and unsure of how to best help their loved one. If skilled care becomes a necessity for your loved one, a number of issues should be considered, including the following:
Location: The facility’s location should be convenient for those who will visit the resident to ensure continued regular contact with family and friends.
Care: The facility should be able to provide the appropriate level of care for the individual’s needs. In addition to medical care, the facility should meet the social, religious, and other nonmedical needs of the resident.
Costs: The individual’s income and assets should be evaluated to determine the potential sources of payments. Nursing home costs can be substantial and if MassHealth (Medicaid) is expected to help certain asset restrictions must be followed.
Hospital patients who are Medicaid eligible are often pressured to accept the first bed located by hospital discharge planners because locating a Medicaid eligible bed is often more difficult than a private pay bed. However, individuals have the right to refuse a placement if it is unreasonable. This could be the case, for example, if the location is too far for family members to visit. If a placement is in fact unreasonable, Medicaid should continue to pay for hospital care until a more reasonable placement can be found.
Special Considerations for Alzheimer’s Care Placements
If you are trying to choose an appropriate nursing home placement for a loved one suffering from dementia, special considerations are in order. The following checklist details some of the important considerations that should be discussed:Is a specialized dementia/Alzheimer care program available?Is an individualize needs assessment done for each resident?Do other residents have similar needs/capabilities as your loved one?Is a care plan created by an interdisciplinary team, and are you consulted?Will a change in abilities result in a transfer or discharge?Is the environment calm and pleasurable?Does the size of the program offer benefits?Do residents appear content, and well engaged?Are restraints used and if so, is use appropriate and closely monitored?Are all aspects of care supervised and evaluated?
Call an elder law attorney if you have any questions about planning for your loved one’s care.