To Move or Not to Move…
To be clear, this article is not addressing a short-term stay in a nursing home for rehabilitation, but of becoming a permanent nursing home resident. The latter is a decision that changes many things irrevocably, so if you’re grappling with this possibility right now, the following five considerations may help your decision-making.
Reason #1 Your aging parent can walk well
According to the Centers for Disease Control and Prevention, the risk of your mom or dad falling in a nursing home is twice that of falling in the community. Are you surprised by that? Let’s be honest—this is not exactly a selling point for nursing homes. Think you can guess how the fall risk is reduced inside these facilities? If you’ve ever been to a nursing home and seen residents in wheelchairs rather than on their feet, then you know the answer. So what happens when your 89-year-old mother enters a nursing home able to walk, but is encouraged to roll? Over time her leg strength diminishes and along with it her mobility and sense of autonomy.
Reason #2 Good health is on your aging parent’s side
Nursing homes were created for people who require some sort of treatment, management, observation and/or evaluation by skilledstaff. Skilled staff (as defined by Medicare) includes nurses, physical therapists, occupational therapists, audiologists and speech pathologists. Examples of care that only a skilled staff member can provide would include wound care, physical therapy and/or intravenous injections.
Needs that fall outside of those described above (think bathing and grocery shopping) would be considered unskilled. If your aging parent has unskilled needs alone, moving him or her into a nursing home is likely to be overkill.
Reason #3 Your parent is safest at home and prefers to live there
One of the toughest things for an adult daughter or son to do is to recognize what’s working “well enough” and then leave it alone. So your aging parent lives happily at home but your top concern is safety? Join the club! Then quit the talk about a nursing home. Now’s the time to prevent a fall by:
• Making sure all rooms in your parent’s house are well lit and free of clutter, etc.
• Broaching the topic of some adaptive equipment for the bathroom and maybe even a personal emergency response system.
Reason #4 You can hire enough help at home to meet your aging parent’s needs
Now we’ve arrived at the tricky place. If you can’t (or your parent can’t) afford to hire help at home, then ask yourself this: Can one of you afford the cost of a nursing home?
That’s right, Medicare does not pay for nursing homes after the first 20 days, and even then, your aging parent must have a skilled need. So if you were thinking that a nursing home would be the most cost-effective long term care option for your parent, think again.
Nursing homes cost $10,000–$13,000 per month depending upon where your aging parent lives. Yes, you read that right— $10,000–$13,000 per MONTH if he/she doesn’t have Medicaid. Even at a cost of $20 per hour, home care would still cost less.
Reason #5 Your aging parent is connected to a physician whom they trust
It’s hard to overstate the value of your aging parent being known to a physician in the community who will take his/her calls and even more importantly, take interest in helping your parent to manage his/her health over time. It’s an important relationship and a move to a nursing home could sever it.
Finally, your parent wants to live at home as long as possible. Make sure that if you make the decision for a nursing home it was the choice of last resort.