by Jane A Malkoff MSN RN NP
- When is it time to consider nursing facility care?
- How do you make a selection?
- Now what do you do after the move takes place?
#1 When is it time to consider a nursing facility?
Don’t let anyone coerce you into thinking there is a correct answer to this question. There isn’t. People who know me have heard me tell the following story more than once over the years and it remains evergreen when offering guidance on the topic of when to assist a loved one to enter a skilled nursing facility or an assisted living facility.
On a Tuesday I answered my phone. The caller was in need of urgent assistance to find her mom the right nursing facility. Her mom had fallen on the basement stairs and suffered a broken bone in her leg. She said, “My mom is in the hospital. She has fallen in the past and has become frail over the past few years. She refused to stop going to the basement no matter what I said. Her washer and dryer are down there and I told her she did not need to do laundry because I would take care of it for her. She is not going home again! It is not safe. I need your opinion on the best location for her”. On Wednesday I answered my phone. The caller was in need of urgent assist to find home care options for her mom. Her mom had fallen on the basement stairs and suffered a broken bone in her leg. She said, “She has fallen in the past and has become frail over the past few years. She refused to stop going to the basement no matter what I said. Her washer and dryer are down there and I told her she did not need to do laundry because I would take care of it for her. It is risky no matter where she lives! I do not want her in a nursing facility. I need help putting a plan in place with home assistance”. Who is right?
There are many health care providers, websites, facility marketing representatives, discharge planners, etc. that share their own opinions about what is right in any scenario. The fact is, most of us will decide based on which opinion resonates most. It is certainly a good idea to take into consideration key factors to consider when making such an important decision. For instance, the following list contains a nicely condensed version of when to consider nursing facility care.
- When the primary family caregiver cannot manage the intensity of the care even with home care assistance. This could be from stress, fatigue, physical strength issues, health decline or other reasons.
- When the cost of care in the home is not affordable and Medicaid as an option would not provide enough care hours to compensate for the expense required to meet care needs.
- When it takes more than one person at a time to provide care such as with agitated behaviors and certain immobility issues.
- When care needs are intense and specialized such as with wounds, tube feedings, high-flow oxygen, complex medications regimes to manage, and no family to oversee the day-to-day.
Most importantly, don’t let anyone convince you of making any move you are not comfortable with. It is perfectly fine to take the time you need to decide regardless of pressure you may feel to hurry up and decide. Discuss with your loved ones (your mom, your dad, your spouse…) what the realistic options would be when (not if) one or more of the four scenarios listed above presents itself. It is best to have open discussions on these topics well before there is a crisis –such as falling down the basement steps and breaking a bone after a few years of stubbornness.
Next time – #2 How do you make a selection?