How To Get Your Loved One In a Nursing Home

A nurse with an elderly woman.

The transition of your elderly loved one into a nursing home can be a delicate thing. It is hard to know exactly when is the right time to make this change. You may experience feelings of guilt and fear due to the uncertainty of such a decision. However, sometimes making this difficult decision is the best thing you can do for your loved one. To make this process a little less rocky for you, we will thoroughly discuss what you can do to navigate this difficult time. We will explain in detail what you can expect as you help your loved one transition into a nursing facility. But first, let’s make sure that this is the right decision for you and your loved one. After all, what qualifies a person for a nursing home? The following list includes some signs you can look for to determine if long term care might be the right thing for your loved one:

  • Needs 24-hour care or supervision
  • Frequently experiences trips and falls
  • Significant changes in wellness or behavior
  • Isolates him or herself
  • Has little to no nutritional food in their fridge or pantry
  • Eats foods that do not work well with his or her medications
  • Has no interest in caring for their home–it is messy or you notice that things are not getting fixed, such as the electrical or HVAC systems
  • His or her pets are malnourished
  • He or she exhibits signs of memory loss; including the inability to recognize family or friends, inability to converse, or repeating previously-held conversations
  • Requires help when buying groceries
  • Poorly manages his or her own medications
  • Needs help with dressing, bathing, showering, toileting, continence, eating, and getting around
  • Needs frequent specialist care
  • Requires rehabilitation

Perhaps your loved one displays some of the symptoms on the list. Enrolling him or her into a nursing home facility could dramatically improve these problems, and therefore his or her life quality. We will now discuss the process of how to get your loved one into a nursing home with as much ease as possible. To give you an idea of what you can expect, the following is a simplified list of the steps to getting someone in a nursing home. We will then explain each step in detail.

  1. Identify the best facility.
  2. Gather the necessary paperwork.
  3. Complete the application.
  4. Complete the Medicaid application.
  5. Complete the admission agreement.
  6. Moving day.

Finding the right facility for your loved one is key.

1. Identify Which Facility Best Suits the Needs of Your Loved One

Once you know what your loved one needs and why they need to be put into a nursing home will help determine what kind of care facility is necessary. There are many levels of care options, and which facility you should choose all depends on the person’s ability to take care of themselves. For instance, your loved one may still be quite functional and active, but still need some help with things like cleaning or yard work. In this case, an independent senior living community would probably best suit his or her needs. If your loved one has some medical issues and cannot properly take care of his or her daily needs, you will probably want to look at skilled nursing facilities. Skilled nursing care is meant to help someone recuperate from a temporary illness or injury, and will usually return to their own home after they have convalesced. If you are noticing Alzheimer symptoms, you may want to start considering a continuing care retirement community (CCRC). If your loved one needs help with their daily personal care, and not so much their medical needs, consider a nursing home which will provide long-term care services. 

Have a talk with your loved one about how they feel. Then talk to other family members in the decision-making process to make sure everyone is on the same page. It may be helpful to meet with your loved one’s doctor to assess their particular needs. Once you have decided what kind of care your loved one is in need of, review pamphlets of different options to consider. Do not just keep just one facility in mind. You may find yourself surprised as you research what some facilities offer. Then take the time to tour multiple facilities at the top of your list and figure out how each would benefit your loved one. Choose the facility that will best suit his or her medical, social, and daily needs. Here are some of the greatest advantages of nursing home care:

  • Socialization: Living in a nursing home allows seniors the ability to be around others their own age. Socializing is so important for our health and well-being, especially the older we get. Interacting in a social environment with other nursing home residents reduces the stress, anxiety, and depression that comes along with a life of loneliness and isolation. This also encourages more fitness, greater self-esteem, and even a longer life span. 
  • Consistent care: As your loved one ages, they may require more and more attention to their needs. This may not be possible for you to constantly keep watch of him or her and anticipate the needs of your loved one. Enrolling in a nursing home will allow consistent care through regular check-ins. The medical staff will have a better idea of what your loved one needs and can better anticipate any surprises in their health that may arise. 
  • Medication management: Your loved one may easily be mixing up their medications or keep forgetting to take them. This often leads to them taking it at the wrong time or wrong amount, which is detrimental to their health. And you may not have the time to remind them, or you may even mix them up yourself. Trained professionals in the nursing facility will easily ensure your loved one takes the recommended medication at the correct time, leaving the burden off of you.
  • Meal preparation: This allows your loved one with less stress about how and what they will eat next. In nursing homes, the meals are prepared and administered at consistent times. They are also prepared with your loved one’s specific diet in mind, ensuring the best quality sustenance for their individual needs. 

2. Gather the Necessary Paperwork

Now that you have decided which senior housing facility is the best fit for your loved one, it is time to gather the necessary paperwork the facility will need. Here is a list of the paperwork for nursing home admission requirements:

  • Patient Review Instrument (PRI): The PRI is a tool used to assess the physical, medical, and cognitive state of the patient to see if a nursing home is the right place for them. It also documents any services they may need. The test is administered by a registered nurse and can possibly be covered by insurance. If your insurance provider does not cover it, you may have to pay out-of-pocket. 
  • Medical Screen: A medical screen will check for any diseases or health conditions the patient may have. This has to be completed to assess what kind of care your loved one will need. 
  • Medical History: Your loved one will need to visit his or her primary care physician (PCP) to gather any medical history, prescription use, diagnoses, and any other documents that the nursing home would need. 
  • Financial History: Most facilities need to see proof of your loved one’s asset limits and resources. They will probably review the financial history of the last 5 years as well as make sure you have started a Medicaid application. 

Your loved one’s PCP should look over all the information above and help ascertain which kind of facility is best. He or she may have a different opinion than what you had in mind and could recommend either a higher or lower level of care. An example of higher level of care could be a dementia unit, while a lower level would be an assisted living facility. 

The nursing home may also recommend end-of-life planning documents, including a MOLST form (Medical Order for Life-Sustaining Treatment), a DNR Order (Do Not Resuscitate), power of attorney documents, a health care proxy, and a living will. It is wise to consult your elder law attorney if you haven’t already.

While you are gathering all the necessary paperwork, you will also need to be thinking about preparing your loved one’s home or property for the eventual move. If your loved one cannot afford the nursing home, sometimes a lien is placed on the home to be used to pay for costs in the facility. You may also think about transferring or selling the home to prevent it from being used to pay for costs. However, this could affect Medicaid eligibility. With the rest of your loved one’s assets, consider holding a yard sale to get rid of any unnecessary furniture or household items. Space in a nursing home is limited, so help your loved one prioritize what is most important to him or her.

3. Complete the Application

Next, you and your loved one should complete an application to turn into the nursing home’s admission staff. They will also need the documentation mentioned above to assess if the facility is a good fit for your loved one, whether it be medically or financially. Having a copy of the financial records will help them determine if your loved one can adequately afford nursing home costs. The application will also ask more questions about what kind of medical care your loved one may need. Try to get the nursing home application process started as soon as possible, due to the fact that some facilities may have a waitings list. This applies especially to those nursing homes that work with Medicaid.

It’s always a good idea to visit the nursing home first to see if it’s a good fit for your loved one.

4. Complete Medicaid Application if Applicable

The cost of nursing home care can be staggering. If you do not have long-term care insurance, you will need to consider other forms of payment assistance. Unfortunately, Medicare is not meant for long-term care facilities. Typically Medicare is only useful for those entering a skilled nursing facility for short-term recuperation. The Medicaid program, however, is the largest single payer for nursing home care. Keep in mind that Medicaid is a means-tested program, which indicates that the applicant must verify eligibility based on his or her means. Another factor to consider is that receiving Medicaid assistance can limit your social security income to as low as $30 a month. This is a big factor for those that rely on SSI.

As you complete the nursing home’s application process, it will become clear to you whether or not your loved one could be eligible for the federal government’s Medicaid funding. If he or she is eligible, it is important to start the Medicaid application process sooner rather than later, because the process can be lengthy. The nursing home may have a Medicaid coordinator that can help guide you through the process. If not, you can check at your local county Medicaid office for some assistance. 

Your loved one’s Medicaid application process will include an in-depth analysis of the past 5 years’’ finances. They will ask questions about any large sums your loved one has received, and require explanations of them. In order to complete the application process, the following documents will be needed:

  • Birth certificate (of both the resident and their spouse)
  • Marriage certificate
  • Military paperwork (if applicable)
  • Property documents (could include closing papers, deed, etc.)
  • Bank statements (from all accounts, and extending back 5 years)
  • Life insurance policies

Nursing homes have different procedures for admitting residents while their Medicaid eligibility is being determined. Some facilities will intake new residents while the application is in progress, while others will not admit them until Medicaid has already been approved. That is why we stress that you start this application process early to ensure your loved one enters the facility when the time is right. 

5. Meet with Nursing Home Staff Members: Complete Admission Agreement

If your loved one’s nursing home application is accepted, this means that they sufficiently believe that his or her medical needs can be met by the facility and that the financial aspect is in order. To complete the admission agreement, you and your loved one will meet with the admissions representative, a social worker, or another worker. The admission agreement will cover the following topics:

  • The Facility: The legal certifications of the facility will be discussed. It will be made clear what level of care they are able to administer.
  • The Resident: It will be discussed what is expected of the resident, including what his or her rights and responsibilities include. The rules will be made clear, such as the establishment of a non-smoking policy.
  • Finances: The agreement will make clear all the costs of the facility. You will know exactly how much room and board, care, food, and other expenses will cost. As an example, one room including food and care can be about $200 a day.
  • Personal Needs Account: This is for the residents that are receiving Medicaid assistance. A portion of the money they receive is allowed for personal use, and is put into an account meant for the patient and managed by the facility. 

After the paperwork has been thoroughly discussed and understood, the admission agreement will need to be signed by your loved one, or their representative. Be sure to ask for a copy for your personal records.

6. Moving Day

Moving into a nursing care facility is a big change for older adults. Your loved one will need your support in this sensitive time. They will be going from a familiar environment, surrounded by their own things and furnishings, to a single room nursing home placement. It may be helpful to tour and measure the size of the room beforehand to know what to expect on moving day. Take pictures to remember the room and the amenities so you can help pack all the things that will fit. 

Your loved one will have some new things to get used to, including possibly sharing a room, a bathroom, and be surrounded by louder residents. He or she may not be used to this type of environment and it is best to ease them into it, if possible. Try to fill the new room with things that will make your loved one feel at home and comfortable. However, keep in mind not to bring items that are valuable as dementia patients may misplace things, plus the possibility of theft.

Support Network

Taking care of aging parents can also take its toll on you. Family caregivers, usually adult children, can experience a lot of stress when making these types of difficult decisions. We hope that with this clearly laid-out process for your next steps will help alleviate some of that burden. Finding the right senior care facility for your loved one will help make their and your life easier. We here at CareAsOne wish you and your loved one ease in this transition process, surrounded by a caring support network of helpful nursing home staff.

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