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FrontRangeLiving.com -> Family/Health -> Investigating a Nursing Home
Choosing a Nursing Home can be Overwhelming
By Niki Hayden
At 79, Doris Hass is trying to care for her ailing husband
and watch over her own health, too.
Ever since Willard was diagnosed five years ago with the
neurological disorder, Parkinson's, she has kept up his spirits, monitored
medication, dressed him in the mornings and cooked his favorite meals--all the
while keeping an eye on him.
Willard often takes off
through the front door bound for church, although he has long forgotten which
way to go.
Then Doris fell, broke a hip, and found herself to be an
example of a grim statistic.
A 1999 study at the University of Pittsburgh found an
increased risk of illness and death among those who care for their spouses. All
were between the ages of 66 and 95.
“Sometimes you don’t always know when you need to stop
and get help,” Doris says. “and then something happens.”
Suddenly Doris and Willard required round-the-clock care. A
competent and caring home health service took over her tasks, allowing Doris to
recuperate from the fall. But when monthly bills topped $8,000, Doris knew she
needed advice and called her daughter. While she has been able to continue
in-home care, a nursing home looms in the future.
“I’ve been fortunate to have had the same wonderful
people around because Willard’s hallucinations are so difficult, but I’ve
had to accept that it’s a downhill situation,” she says.
ROLES OFTEN REVERSE
Choosing a nursing home for an aging parent is a wrenching
experience. Usually a crisis in the health of a parent means that family roles
reverse. The child must choose where the parent should live. To complicate the
decision, of the 17,000 nursing homes in this country, many are
ailing.
Vencor, Sun Healthcare Groups and Mariner Post-Acute
Network, some of the largest chains in the nursing home business declared
Chapter 11 bankruptcy in 1999 and January, 2000. These companies own
hundreds of nursing homes in nearly every state, involving thousands of
residents. Altogether, about 1.5 million Americans live in nursing homes.
Nearly a third of the nursing home revenue in their $87
billion-a-year industry comes from the Federal Government, mostly through
Medicare and Medicaid. When Congress passed the Balance the Budget Act of 1997
and trimmed Medicaid expenses, critics say that nursing homes had taken on
considerable debt and were deeply mired in extended building projects. Many of
the biggest firms saw their stock prices plummet and lost needed capital.
Their woes are compounded by a strong economy and fewer
workers. Nursing home salaries are among the lowest for skilled workers. Those
charged with most of the patients’ care are paid on average $7.45 an hour.
WATCHDOG EFFORTS ON THE RISE
At the same time, consumer watchdog groups are clamoring
for Congress to impose more accountability, some suggesting that cameras be
installed in every nursing home room.
The practice of elderly law, evidenced by the membership in
the National Academy of Elder Law Attorneys, increased tenfold in recent years
to 3,500 members. And support groups for children of the aging have sprouted
everywhere.
One result of consumer watchdog efforts is that it's now
easier to investigate how nursing homes stack up. The official Medicare site
includes a page dedicated to nursing home comparisons: www.medicare.gov/NHCompare/Home.asp
Click on the web site and you’ll be asked to supply a zip
code. The page will display all the nursing homes in the zip code with the
results of their most recent inspection. Consider that about 40 percent of
nursing homes with the most severe deficiencies are repeat offenders. This site
makes it possible to weed out those facilities.
Nursing home care averages about $300 a day, which is not
enough, industry representatives say, especially for very sick people. The
average elderly individual who enters a home runs through his entire assets
within six to nine months. At that point he’ll become a Medicaid patient,
dependent on funding from the government. That’s why it’s important to
understand the eligibility for Medicaid as well as Medicare. A nursing home that
says “Medicaid-certified” indicates that your parent will not be removed
when private funds run out. Before this happens, says Eileen Doherty, the
executive director of the Colorado Gerontological Society, find legal help to
protect financial assets for the remaining spouse.
BECOME AN ADVOCATE FOR YOUR PARENT
Despite the dismal health of some nursing homes, there are
caring and well-run facilities. Some may be long established with an
excellent record. Or, they may be recently built with a top-notch staff. Either
way, when you investigate a nursing home, you’re catching it at a moment in
time. You may have to move your parent if the quality of care declines.
Doherty rarely recommends searching out a nursing home
ahead of time. “They can turn around on a dime. Perhaps the administrator
leaves, and the staff follows. So it’s not safe to make these recommendations
in advance,” she says.
After checking state inspection results, visit the homes of
your choice. Ask for the patient-to-staff ratio and request to be introduced to
a family organization--or consider starting one. These are valuable support
groups and often will help to check on your parent if you need to take an
extended vacation.
For those nursing home residents who have no family or
friends to look after them, one non-profit organization has taken on the
challenge.
The Denver Regional Council of Government offers the
Ombudsman Program, a free advocacy service for both nursing home and
assisted-living residents. Volunteers visit residents among the 250
assisted-living facilities and 100 nursing homes along the Front Range.
Advocates for the elderly complain that as many as
two-thirds of nursing home residents see fewer than a single family member once
a year. While this may be because many of the residents have memory loss, it’s
important that their health and well-being be monitored as often as possible.
Even if your parents are confused, or no longer recognize family members, you
remain their best advocate.
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