Is it time to consider a nursing home?
By Sandra Roche

Whatever you’ve thought of nursing homes in the past, as your parents get older, and recovery from certain ailments takes longer, you’re likely to find the topic coming up. Nursing home care is now a fact of life for many of us; nursing home care is part of the post-hospital plans for recovery in stroke, fracture and surgical incidents.
 
It’s projected that about 12 million Americans will need skilled care by 2020, so the chances are good that at some point, you’ll need to decide about nursing home placement for you or a loved one. In this and future articles, we try to provide the information to help make the best choice.

It is important to understand what modern nursing home care means, as well as how that care will differ from the acute hospital environment; and how you will probably get to the point where the placement decision need to be made.

In the acute care hospital, the focus is on treating and curing the illness that caused the hospitalization. As the recovery proceeds, there comes a point when the patient’s medical condition no longer requires such a high concentration of resources.  The patient is now better served by focusing medical attention on her /his ability to “get back to normal.”

At this time, the patient’s medical needs and his or her current abilities are assessed and a “post acute care” plan is developed. The hospital social worker will ask questions about the home environment and match those answers with the patient’s abilities in order to determine the safety of a discharge to home. 

If the discharge to home will be safe but the patient will need additional services or equipment, orders are written for home health care services, such as nursing, physical therapy, speech therapy or equipment, like a walker, cane or commode. In most cases, the social worker/discharge planner will take care of all ordering all the items needed and you will be contacted by the provider to set up delivery time.

If on the other hand, if the patient still requires skilled nursing care on a daily basis, the discharge orders will be written for a nursing home care.

In the nursing home, the health care resources are focused on achieving quality of life that the patient enjoyed prior to the hospitalization.

When your loved one is ready for nursing home care, you will usually be notified by your social worker/discharge planner. When asked, this person can also provide a list of facilities that have beds available for your loved one.

“Bed available” does not necessarily insure admission to the nursing home. The facility is under obligation to accept only patients whose  needs can be met in that particular facility at the time of admission. If your loved one has a particular requirement that the facility can not accommodate or if the level of care needs of the patients already admitted is particularly high, your request for admission may be denied. Nursing homes have patients admitting and others discharging every day, so you can’t always predict what may happen on a given day.

Post-hospital care can be a complicated process, even for those of us in the industry.

When you are faced with questions, even those you do not know how to ask, write to us at: 

Reference Web Sites:

http://www.medicare.gov/ - will give you a great over view of the Medicare System

http://www.medicare.gov/LongTermCare/Static/Home.asp - will answer most of your nursing home questions and you can click on to the glossary if you are having trouble with some of the terms you are hearing.

TIPS FOR DEALING WITH NURSING HOME ADMINISTRATORS
Stay organized

Keep a folder and/or a medium-sized alligator clip in your purse. It will hold all of the papers and business cards together.  You’ll accumulate a lot of paper in this process.

Talk to the right people

In the acute care setting, the social worker/discharge planner has the best overall view of the patient and the community resource you may need. Keep her/his card on top.

When it comes to financial or coverage issues…medical staff are not the best resources. For financial questions, you should ask xxxxxx 

Be kind

You might be in the middle of a frustrating situation, managing all the paperwork for a sickly and uncooperative parent. But don't take it out on the nursing home staffers. Take yourself out for a plate of hot wings on the way home instead.