What If My Parents Need Nursing Home Care?

One of the most common calls to our office is "How am I going to pay for my parent's nursing home care?" In our meeting, the real underlying issue is "What do I do when my parents need nursing home care?"

I understand. Years ago, I was faced with a similar question for myself. My 86-year-old grandmother was being cared for by my mom, who was 67 at the time. We had a plan. My mom was going to take care of my grandmother until she passed away. Frankly, the thought of me taking care of my mom had never even crossed my mind, but certainly I had never thought about taking care of my grandmother!  After all, mom was only 67. But then one morning, mom didn't wake up, and all of a sudden my responsibilities leapfrogged to my grandmother. Did she need to go into long-term care? What all do I need to consider?

When we are working with a family faced with that decision, one of the early questions is whether long-term care is necessary or appropriate. Are there alternatives that we can consider? What alternatives are available in the community where the parent is located? Do we need to relocate the parent?

The beginning discussion (and the most important) is: what does the parent want? Having a discussion about failing health and long-term care can be the most difficult discussion that you will ever have with your parent.

• Some alternatives for home care include:

• Do nothing

• Someone to do a drive-by check

• Senior companion

• A family support system

• In-home care

• Tapping into home care benefits such as VA Pension

• Home and community-based services

• Home health agencies

If services cannot be provided in the home, then what are our next steps? What about independent living that can include fall alerts and daily checkups? What about a group home? Is assisted living appropriate? If the aging or chronic illness is dealing with some type of dementia, sometimes a Home Plus may be a great alternative.

The next step may be long-term care. But what type of long-term care facility is appropriate for your parent? What are the facilities ratings and reputation? Is it clean? Does it offer activities that will stimulate your parent or do people just sit in the hall? Is it appropriate given your parent’s personality? Is it close enough for you to visit? Would you stay there? 

A key to all of these alternatives is to be sure that your parents are getting good and appropriate care. That means checking out the provider. That may mean doing some homework. It certainly means that you have to spot check how things are going. This is true whether you are providing in-home care or nursing home care. You always want to follow up to be sure your parents are getting good care. I believe in the squeaky wheel theory. But understand you will not be able to eliminate all risks. 

Back to my grandmother. We tried all of these methods. What works during one period does not necessarily work in the future. My grandmother progressed from living independently with a relative checking on her, to home health that evolved into assisted living. That went on for ten years.  Finally the last fifty days of my grandmother’s life were spent in the nursing home. 

I feel like that the most important thing that my office does for our clients is help them traverse the system so that their loved one is in the least restrictive environment as long as possible, as safely as possible, and always getting the best care possible. I know that when I was caring for my grandmother, I could not have done it without the assistance of a care coordinator from my office. I was overwhelmed with the responsibility of caring for my grandmother. Instead, the care coordinator made the journey much easier and more comfortable, and I was much more confident that I was able to help my grandmother through the end of her life in a setting that she appreciated.