Preparing a loved one for a nursing home

The challenge of placing a loved one in a nursing home or residential care facility is a topic none of us look forward to facing.  Often, those moments are made all the more difficult when we recognize that our loved one requires a higher level of round-the-clock care that we are not able or qualified to provide on our own. Many family members find themselves conflicted with emotions like guilt, regret, and ultimately a sense of relief as they go through the process.

As a first step, you should sit and discuss the topic with legal counsel.  Often, the preparation of estate planning documents is critical to a successful transition for any loved one.  Second, it may help to understand that placing a loved one in a nursing home is a fairly common challenge. According to statistics published by singlecare.com, in 2016, roughly 8.3 million people received long-term care services in a regulated facility (quoting the National Center of Health Statistics, 2019).  There are more than 800,000 people in assisted living throughout the United States (quoting AHCA/NCAL. 2015).  And in 2016, there were approximately 65,600 regulated long-term care facilities in the United States.

In some cases, your decision to place a loved one in a care facility is because of a sudden injury or the unexpected onset of a debilitating medical illness such as a stroke. For others, chronic health conditions that impact functioning abilities occur slowly and over time making it more difficult to recognize the point when long-term caregiving in a residential facility is necessary. In either scenario, loved ones should pay close attention to various physical, mental, and behavioral signs displayed by the prospective applicant. Additionally, speak with medical providers to discuss your loved one’s diagnosis and the prognosis for recovery.  In summary, those in need should receive assisted living or residential nursing care when they pose a danger to themselves or others, or when they cannot function independently, or when their current caregivers can no longer provide the level of day-to-day support that is required.

Sadly, some families wait too long and delay the decision until their loved one is at high risk.  By that point, it is often too late to explore all the options that would otherwise be available.  Actions that are now caused to be taken immediately may then amplify the stress on everyone involved.  That is why it is never too early to sit and discuss the topic with older adults.

So, when is the proper time to place your loved one in a nursing home or residential care facility?  While there is no perfect method, you should seriously consider assisted living or nursing home care if you recognize any combination of the following signs:

• The loved one has fallen multiple times, resulting in bruises, broken bones, or other injuries; or
• The loved one frequently visits the emergency room or hospital; or
• The loved one’s ability to perform day-to-day activities is declining; or
• The loved one has gotten lost or confused after wandering away from home; or
• The loved one suffers from severe bladder and/or bowel incontinence; or
• The loved one becomes more socially withdrawn or less interested in fun activities; or
• Their primary physician notes it is time for nursing home care; or
• You lack enough financial support or help from other family members to continue caregiving; or
• Your own health begins to deteriorate because of the care you provide to your loved one.

It pays to be proactive. The more research and planning you do now, the more positive the outcome will be. By planning well ahead of time, you will be better prepared if an emergency occurs that requires you to make quick decisions. When it comes to placing a loved one in a nursing home, decision-making should not feel rushed. The best outcomes are usually the result of reasoned collaboration between the loved one and all of their family members.  In next month’s article, we will discuss how to develop your plan once the decision has been made to place a loved one in a nursing home.

Todd Miller is a monthly contributor and regularly writes and speaks on various legal topics including bankruptcy, estate planning, probate, and elder law.  He formed the Law Office of Todd Miller, LLC, 1305 Southwest Blvd., Ste. A, Jefferson City, Missouri in 2006.  He has been awarded the Substantial Contributor Attorney Award by the Missouri Bar and ranked as one of the “Top Attorneys in Missouri” by The Legal Network.  Mr. Miller earned his juris doctorate degree from the University of Missouri School of Law in 1999 and graduated with honors from Lincoln University in 1991.  You may find him at www.toddmillerlaw.com (573) 634-2838 or on Facebook, Instagram, and Twitter.