As an elder law attorney, I frequently meet with individuals who have an elderly family member who needs long-term care, such as care in a nursing home. Oftentimes, the elderly individual has been slipping either physically or mentally, or both, for some time, but a sudden event, such as a slip and fall, forces her limitations to the fore. The elder is in the hospital or a rehabilitation center, and her family members are wondering how to care for her.
My mother currently requires long-term care. Like many elderly individuals, she has been failing for the past two years, and now, the care she needs is more than my father can provide at home. My mother never wanted to live in a nursing home. “Just shoot me,” she would say. Hundreds of my clients have expressed the same sentiment to me.
But as I tell clients, “You never know. The care you need may be more than your family can handle, and many times people just don’t pass quietly in their sleep.” Life isn’t like a light switch. It doesn’t just turn on and off.
When we are young, every day we grow stronger and become more and more self sufficient, but the process takes years. Similarly, when we are old, we become less and less self sufficient, and the process takes many years. It’s sad, but it’s true.
Going through the experience of arranging for the long-term care of a family member allows me to experience firsthand what my clients talk to me about. It’s bad enough to see a loved one require long-term care, but on top of that, the process of arranging for the loved one’s care can be quite frightening.
For instance, like most people, my mom went to the hospital and was then discharged to a rehabilitation center. The goal of her rehab was to get her up and walking again, so she could be somewhat self sufficient when she went home. Given her age and her health, the rehab doesn’t seem to be achieving its goal, so she probably will have to stay at the nursing home.
After being at the nursing home for rehab for two weeks, the facility called and told our family that my mother was going to be discharged from the facility in several days and that my family should make arrangements for her care at home. Now, being an elder law attorney, this statement didn’t concern me at all.
Unlike most of my clients, I know that a “rehabilitation center” is a nursing home. Part of the facility is dedicated to rehab and part is dedicated to long-term care, but in most facilities, all of the beds in the facility are designated as Medicaid long-term care beds. I also know that a facility cannot discharge a patient unless the discharge is safe, meaning that there is proper care arranged for the patient at home that is appropriate for that patient’s needs.
What these facts mean for facilities, in short, is that nursing facilities are stuck with a patient once the patient enters the facility. The facility cannot get rid of the patient. I was told that I would have to “fill out an application,” as if the facility would have to agree to accept my mother and if they didn’t, then we’d have to take her home. Of course, I know that the facility already has accepted my mother.
I could easily see though how the manner in which the facility’s staff speaks and phrases their statements that a family member who lacks knowledge about how things work would be scared to death. Not only are they dealing with the grief associated with a family member who requires care, but they also are led to believe that their family member will be out on the street. I’m not worried about my mom living on the streets, and you shouldn’t be worried about your mother living there either.