Discussing Senior Care Options with Family

As the news media reports on the presidentail campaigns, we now all know Barack Obama is taking a couple days off the campaign trail to visit his sick Grandmother, Madelyn Dunham, in Hawaii.  She was discharged from the hospital to her home and her condition is described as serious.  Details of her illness have not been released but it is clear she preferred to go home to recover.

Medicare will pay for a temporary stay in a nursing home for rehabilitation after a hospital stay.  Medicare does not pay for long-term care in the home nor in the nursing home.  Only Medicaid, which very low-income seniors can qualify for, will pay for permanent long-term care in a nursing home (there are a few states, such as Vermont, developing in-home programs for Medicaid care).  Typically states require a senior to have no more than $2,000 in assets to qualify for Medicaid benefits.

Have you had the discussion with your parents regarding where they would like to receive care if the situation would present itself?  Do they prefer to go to a nursing home for recovery?  If so, which nursing home in your community do they prefer?  Hospitals will send a patient to any nursing home in their area, based on the discharge planner's instructions.  One time I was going to a hospital to meet with a patient regarding her care needs.  She had no immediate family and when I arrived, I discovered she had already been discharged and sent to a nursing home.  Her Guradian thought she was going to be discharged to a different (and better) nursing home.  The nursing home she was sent to was primarily a nursing home for Medicaid patients and unfortunately all the stereotypes that go with that were present (it did smell like urine, patients were medicated and parked in a room, sitting in their wheelchairs for the day).  This client was uncooperative at the nursing home, as soon as she was moved back to her home she was eating and talking again and her health improved.

Every situation is different.  Many times a nursing home can be the best option.  But it is important to discuss the wishes for care with the senior and become educated on the options in your area.   Medicaid is what it is - a regular government check the nursing facility will receive until the senior passes on.  A Medicaid pateint is not going to threaten to leave if conditions are not up to par - they are receiving a free place to stay from the government and do not have that option.  As nursing homes are businesses seeking to make a profit, it is important to ask the right questions. Find out what percentage of beds are Medicaid and find out the staff-to-patient ratio.

As the cost is typically nearly the same, more and more seniors are opting to go home and receive a private duty caregiver rather than go to a nursing home - - they are guaranteed one-to-one care from a caregiver where most nursiing homes have one nursing aide for as many as 12 to 15 patients.





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