I was recently speaking with my millennial son about a close friend whose elderly mother was having a health emergency. Her mom, Rita, lives in an apartment and has a caregiver during the day but has refused help at night. Rita could not be alone, and my friend had to cancel her plans and stay up all night with her mom and then go to her demanding job the next day. “Put her in a nursing home,” said my son. “That’s too much for your friend to handle.” In addition to convincing me not to make my son my healthcare proxy, his comment got me thinking about when it is the right choice to place a loved one in a long-term care facility. The following are some factors to consider:
- Every person is an individual and has his/her/their own preferences about what later years look like. A social person may prefer a communal living situation. Rita, however, had strongly expressed her wish to remain at home. In her case, adding an overnight caregiver would be a compromise to honor Rita’s wishes while improving her safety and allowing her daughter to function in her own life.
- The title “nursing home” conjures up negative images, especially for the older generation. Most nursing homes today are a more palatable choice, and there are other options, such as Assisted Living, that provide a more independent feel while offering care, socialization, and activities. There are also continuing care retirement communities (CCRCs), which allow a senior to move from independent living to higher levels of care on the same campus. It can be very helpful to visit facilities before a crisis so there is a realistic understanding of the choices.
- As with many things in life, finances play a major role in determining the best option. Home care is primarily a private pay service and can become quite expensive if a live-in caregiver or separate day and night shifts of caregivers are required. While some people want to remain at home no matter what, Medicaid coverage for home care is limited. In addition, most facilities in our area require a two- or three-year private pay period before accepting Medicaid, so it is important to consider a move to a facility that accepts Medicaid well before your assets are depleted.