Helpful advice for family members
* Have patient sign a Power of Attorney form appointing another person to make financial and medical decisions for them if they should ever become unable to make decisions on their own. The earlier you obtain this the easier it is to get the patient to sign. Do this prior to discussions related to the patients health or living needs.
* Try to convince the patient of the factual needs they have that are not being met at home, i.e., safety issues, meals, care of self and their home.
* Investigate and pursue assisted living placement if the patient has monetary savings or income sufficient to pay for assisted living and they qualify medically (continence of bowel and bladder or able to manage incontinence own their own, independent in ambulation – wheelchair or walking, can exit building within 13 minutes, and other specific requirements as set by each independent center). If the patient has greater medical or safety needs than can be met in an assisted living center or lacks resources to pay, investigate nursing home admission.
* If the patient’s medical needs are greater than stated above and/or are confused to the point they are a danger if left alone (cannot find their way out of their home if it was on fire), then nursing home placement should be investigated. Talk with a local nursing home’s Social Worker or Admissions Coordinator about the needs of the patient for determination of eligibility for admission. If the patient does not medically qualify for nursing home admission then the patient must remain at home or live with a relative or friend. Some patients have provided free living quarters to another individual in return for seeing after their needs or they have moved into small boarding homes. There is no government subsidies or government paid insurance for assisted living centers as there are for nursing homes.
* It is hard to get a person admitted to a nursing home due to the scarcity of beds. The following are suggestions which will greatly enhance your chances for obtaining a bed.
a) Investigate what nursing homes you would consider for admission (Use nursing home check list). Place the patients name on the waiting lists at all those centers.
b) If the patient does not or will not have enough funds to pay for their care indefinitely, make sure the centers you have selected all accept Medicaid payment. (Not to be confused with Medicare).
c) If the patient will require Medicaid payment starting with the first month of admission, go ahead and apply for Medicaid funding at the Department of Human Resources. ALSO, obtain a Preadmission Evaluation form (PAE) from a local nursing home and have the attending doctor or home health agency complete it and mail it to the appropriate state address to obtain medical approval. Medicaid requires financial and medical approval to pay for nursing home care. Make sure you notify all the centers that has the patient’s name on their waiting list of Medicaid approval once the financial and medical approvals have been obtained. Also watch that the PAE is renewed per state requirements as needed so it remains effective.
d) If the patient’s condition is such that they have immediate health needs talk to their doctor and see if hospital admission could be obtained for evaluation and testing as needed. **It is easier to obtain admission from a hospital, especially if the patient has Medicare or another insurance which the nursing home could bill for a short period of time of skilled care. Again, make sure the nursing home the hospital wants to send the patient to accepts Medicaid (unless patient won’t need it) and it is a center you have checked out and approved. It is also easier on the patient and family when a patient is admitted from the hospital to the nursing home. The patient more readily accepts the need for placement due to doctors and hospital involvement.
e) Have the Power of Attorney ready to use. If the patient cannot
make clear thought out decisions in their best interest, the Power
of Attorney may have to help make decisions for them concerning
admission to a nursing home.
Above all, have patience and don’t give up if what you are trying to do is in the patient’s best interest!