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Transitioning from home to a nursing home or facility can be traumatic. Your loved one is entering the last phase of his or her life and the move means relinquishing a certain degree of privacy, individual decision-making, and freedom. Coming to this decision is often an uneasy one, since your parent may well resist the move and refuse to cooperate. This decision can be equally traumatic for you since you will be taking on new responsibilities if you want your loved one to be comfortable in her new surroundings.
Before your loved one moves into a nursing home, here are 10 top things to know:
1. What to do if your loved one is reluctant to move
You may have to convince your parent that the move is necessary for his or safety and well-being. Point out specific instances where her safety has been at risk such as falling or getting lost when going for a walk, not knowing where she is or why, leaving appliances on, not recognizing family or friends, and others, or not having friends. If necessary, get advice or help from a geriatric care manager, social worker or psychologist.
2. Check out the facility and know what is required
There are federal and state regulations on what a nursing home is required to provide. These include proper and clean bedding, a window to the outside, a clean room, storage space, and appropriate furniture for their specific needs. Be sure the living space is large enough, especially if your parent has a roommate or is in a wheelchair. If you are unclear about what the facility must provide, talk to an elder law lawyer.
3. What services are included in the home and what are not
For instance, ask if the following are provided or if these services and items are extra:
- Television and cable service
- Wifi service
- Laundry and dry clothing service
- Bedding and towels
- Phone service
- Certain outside recreational activities or outings
4. Have a family plan
If you have siblings, meet with them to discuss the aspects and implications of moving your parent to a nursing home that may include:
- Payment for services–what does medicare cover or other insurance plans and what is to be paid by you and your siblings
- Will the person qualify for long-term Medicaid benefits and will the nursing home help with the application process or is there a need to hire an outside Elder Law Attorney
- Establishing a visitation schedule
- Payment for additional expenses such as clothing, gifts, furniture, hair care and nails, or special events
- What the care plan will include
5. Prepare for the move
Prepare yourself and your loved one for moving day. Your parent may be leaving a home he or she has lived in for decades so when the time comes, be ready for tears and resistance from all sides. It helps to have other family members there to support him/her and remind him/her that he/she will be making new friends, will still be able to do what he/she wants but will have staff there ready to ensure his/her safety. Assure him/her that you and your siblings will be visiting regularly and staying in touch. Ask him/her to give the move a chance to work and that he/she will see how much easier life will be in the new home.
6. Make a list of what to bring
It is likely that your parent will not be able to bring everything he/she wants to the home due to space. Go over photographs, collections, art pieces, dishes, books, and other personal items that your parent will want to bring. Anything else can go into storage and be available whenever your parent wants them or he/she can decide that certain items should go to specific family members. You may need to bring towels, kitchen items, sheets and blankets, television set, or other necessary items for your parent’s needs and comfort. Do not bring items that have significant value since there will be various staff that will be coming into the apartment.
7. Prepare the new apartment
If the new apartment or unit is similar in many respects to your parent’s home, then the transition can be that much easier. Be sure his/her favorite music, magazines, chair, flowers, paintings, pictures, or other items are there before the move in day if possible. If you can, have the rooms painted in favorite colors and try to match the decor to the former home that would also be ideal and make the transition a little more comfortable.
8. Meet the staff and work with them
Meeting the staff and knowing who will be interacting with your parent is essential to ensuring they know of your parent’s special needs, health care plan, and behavior. Review the daily routine with them so your parent will know what to expect. Your parent should know the meal times, shift times for certain staff members whom your parent may become fond of or depend on, and is aware of activities that the home sponsors.
Each resident will have a periodic care conference or meeting. Attend these to get an update on how your parent is coping as well as his/her health. If a particular staff person is a favorite or spends the most time with your parent, get updates from him or her. Treat the staff with respect and be reasonable with them regarding certain requests. An occasional box of candy or a “cheese cake” goes a long way to show your appreciation for all their time spent with your parent.
9. Prepare for depressed moments
A move like this can produce severe depression in some people. The first few weeks or months is often critical for your parent and he/she can express his/her dissatisfaction with the new arrangements. Talk with your parent about what he/she has done to meet new people or become involved in various activities. You and your siblings may need to stay in daily contact with him/her until your parent becomes acclimated and more accepting of the new environment. If necessary, have a social worker or other professional meet and work with your parent to help ease your parent’s concerns and depression. Let him/her know that you have not abandoned him/her. Take your parent out for meals or at your home or their favorite restaurant once a week or more.
10. Be a VIGILANT and STRONG advocate
Unfortunately, abuses are not uncommon in nursing home facilities. Staff shortages, long schedules, lack of training, and organization can lead to errors or omissions regarding medications and special care needs for residents. Abuses among staff include verbal abuse as well as physical. Failing to clean rooms, to not bathe residents who are unable to care for themselves, not administering medications or administering the wrong medications, using restraints, isolating individuals, or slapping residents occur more frequently than any of us would like to think about.
If your parent appears fearful of certain staff persons, refuses to eat, becomes abnormally depressed, has injuries that appear suspicious, then you need to act quickly. You can review the staff records and have your parent examined by a physician. Consider having an elder law lawyer review the facilities contract before signing it, also to the facility records, and medical records for evidence of possible abuse. Check with the local ombudsman for any violations that are known.
Consult Elder Law Lawyer Patricia Bloom-McDonald
Patricia Bloom-McDonald has been representing the interests of the elderly for decades. She has been an advocate for seniors and their families who have questions about or need assistance with MassHealth or estate planning Contact her today for any concerns or issues you have regarding elder law matters.