Here are some questions to ask when considering a nursing home:

Regular Health Assessment

Has the senior been assessed recently? If a nursing home is being considered as the next step after hospitalization, this probably has already been done. However, if a senior is considering a move from home or another facility, a more formal assessment by a medical team can help clarify the senior’s needs and see if other housing options may be a possibility.

Safety

Can the senior’s needs be met safely in other housing situations? The risk of falls may be too great, or the senior’s medical needs may no longer be able to be met at home or in another facility. If the senior needs 24-hour supervision, or is in danger of wandering off or forgetting about a hot stove, for example, a skilled nursing facility may be the best option. If the senior’s needs are solely custodial, though, an assisted living facility may be a better fit.

Caregiver

Can the primary caregiver meet the senior’s needs? Caregivers are often juggling the needs of work, their own family responsibilities, and their own health. It’s not possible for one person to be awake and responsive 24 hours a day. Sometimes other family members can help fill in the gap. Day programs, home care services, and respite care, where a senior temporarily stays in a nursing home, may also provide the support a caregiver needs.

Costs

However, there may come a point where medical needs become too great and home care services are unable to bridge the gap or become too expensive.
Would the need for a nursing home be temporary or permanent? Sometimes, a temporary situation may be covered through home care, or family members might be able to rotate care on a short-term basis. However, if the level of care is expected to be permanent, this may be too expensive or coverage might not be enough.

Medicare

Seniors and their families facing a near-term need for a nursing home should first determine whether Medicare will cover at least a portion of the stay. The Medicare program provides coverage for rehabilitation—but not long-term care. If an individual has spent at least three days in a hospital for medically necessary care, Medicare will pick up the tab for up to 100 days of convalescent care immediately following discharge, as long as the patient goes to a home that’s a Medicare-certified skilled nursing facility. Medicare can also help if a long-term nursing home situation looks inevitable but isn’t immediately necessary. For as long as the individual is able to stay at home, Medicare can be tapped for up to 35 hours per week of home health services. Medicare covers home health services like intermittent skilled nursing care, physical therapy, speech-language pathology, and occupational therapy for up to 60 days at a time, called an “episode of care.”

To secure these funds, individuals must be living at home, not in a nursing home or other long-term care facility, must have their physician approve a plan of care, and must use a Medicare certified agency. If you require help only with personal care, such as meal preparation, bathing, using the bathroom, and dressing, you do not qualify for the Medicare home health benefit. A government-published guide offers details on which home health services Medicare covers.

U.S. News’s Best Nursing Homes indicates which nursing homes in each state accept Medicare.

Medicaid

If an individual lacks enough savings to cover the cost of a nursing home—or if the cost of a protracted stay exhausts their assets—they can become eligible for assistance from Medicaid. To qualify for Medicaid, applicants must have minimal assets—no more than $2,000 in cash and cash equivalents such as bonds and IRAs. For married couples, the spouse staying at home may have assets worth an additional $115,920, the annually adjusted Social Security cap for 2013. While some seniors might be tempted to make large financial gifts to their children or grandchildren in order to hasten qualification for Medicaid, doing so within the five years prior to applying for the program could disqualify them from receiving its benefits.

Connie’s comments: Assess your parents or seniors’ health regularly. Are they over medicated, have difficulty breathing, constipated, sleeping during the night, agitated, losing weight, losing appetite and any chronic health issues such as pain, coughing and UTI.

Call 408-854-1883 or motherhealth@gmail.com for bay area nursing homes referral, senior advocacy, caregivers, in home care and just to ask questions on how to care for your aging parents.