Placing a loved one into a nursing home is a daunting task. For most people, it’s a once in a lifetime experience, and for many, they might not even have one friend or family member who’s had to choose a nursing home who they can talk to. A big part of the decision will be based on the level of care needed. Does your loved one just need a little help getting through the day and making sure nothing bad happens, or do they need constant medical care? But after that, how do you narrow down the choices available? And what do you do when things go wrong?
Choosing a nursing home
Start by coming up with a list of several nursing homes that fit your budget, even if some options might mean you’ll have to drive a little farther to visit. A big part of the decision is going to be based on your gut feel when you tour each facility, and you can learn a lot about what to look for just by noticing differences between homes. When you tour a potential nursing home, do the following:
- Check that it is fully licensed as required by your state.
- Go on the official tour to see how staff present the facility.
- Talk to current residents. They might withhold negative information if they feel pressured by staff members, so read between the lines and try to get a feel for if they’re really happy.
- Talk to people visiting current residents, preferably outside in the parking lot or at a nearby coffee shop. They know what you’re going through and will be able to be more candid than someone living there.
- Pay attention to whether there seems to be enough staff members and if they seem stressed out or overworked.
- Ask questions about the staff members. What is the hiring process like? Why do they like working there?
- For options that make short list, stop by unannounced at a different time of day to see if it’s similar to the day you did the official tour.
An attorney who regularly practices elder law can give you insider knowledge you might not otherwise have access to. They know which nursing homes have a lot of complaints against them about living conditions, staff behavior, and medical care. They can also help you review the financial aspects of the decision by ensuring you won’t be surprised with future fees down the road, that any insurance coverage you’re expecting to apply will, and that you’re protected in the event that the facility goes out of business.
While the above is a broad overview of how to choose the right nursing home, the process takes a lot of time. If your loved one is declining in health, but you delay , you may be rushed into a bad decision. Even if you’re taken by surprise by a sudden debilitating illness, look for temporary options, such as a live-in caregiver for a month or two, so you can take the time to make the right decision for what will hopefully be years to come.
Nursing home neglect
Unfortunately, some nursing home staff members are overworked, abusive, or too lazy to do their jobs properly. This could lead to a loved one being maltreated or neglected in even the best of nursing homes. Some warning signs to look for include:
- Unexplained weight loss
- Bruises or cuts without a good explanation
- Damaged clothing
- Dirty rooms
- Social isolation
- Seeing rude or belligerent behavior from staff members even in front of visitors
If you suspect a loved one is being abused or neglected, start by talking with them and don’t end the discussion until you’re sure they’re not just telling you what they want to hear and aren’t withholding information because they’re afraid of the staff. Use discretion and talk to your loved one before speaking to management – you want to be sure you aren’t placing anyone at risk of retaliation. Then speak to a nursing home attorney about solutions including:
- Having the staff member fired
- Terminating your agreement with the nursing home
- Bringing the matter to the attention of state regulatory authorities
- Possible criminal charges
- Any other steps that will make sure your loved one is safe and happy in the future
My spouse has just entered a nursing home and I didn’t plan ahead
Do not panic. There is still time to plan. It is imperative we take advantage and maximize the protections available to you as the spouse remaining at home also known as the community spouse. We will help you analyze and implement the current strategies available, including but not limited to:
- Conversion of non-exempt assets into exempt assets
- Transferring assets
- Annuitization of assets
- Purchasing a life estate for either spouse
- Utilizing a Medicaid-sheltered annuity
- Care provider contracts
Using a combination of these strategies is often necessary to develop a plan to achieve the maximum retention of the your assets. In many cases, it is also necessary to modify the wills, life insurance contracts, and title to real estate in order to allow the sick spouse to be cared for if the healthy spouse predeceases the sick spouse.
Liens on homes
Although the individual’s home may be an exempt asset, Massachusetts under many circumstances will place a lien on the home to collect for the Medicaid benefits received by the individual. We can instruct clients on how best to protect your home from this lien.