Should I put my Parent into the Nursing Home

Should I put my elderly parent into the Nursing Home? This is a question many people face as their loved ones age and require more care than they can provide at home. While nursing homes offer professional care, safety, and socialization, they can also be expensive and result in a loss of independence. Before deciding to put your Loved One into a nursing home, it’s important to consider all factors involved.

Benefits of Nursing Homes:

  1. Professional care: Nursing homes are staffed by healthcare professionals who are trained to provide specialized care for the elderly. They can provide round-the-clock care, including medical attention, assistance with daily activities, and social activities to keep your loved one engaged.
  2. Safety and security: Nursing homes provide a safe and secure environment for your loved one. They are equipped with various safety features, such as handrails, non-slip flooring, and emergency response systems to ensure your loved one’s safety.
  3. Socialization: Nursing homes provide a community environment where your loved one can socialize with others, participate in activities, and make new friends. This can help prevent feelings of isolation and loneliness, which can be common in elderly individuals.

Drawbacks of Nursing Homes:

  1. Cost: Nursing homes can be expensive, and not all insurance plans cover the cost of long-term care. This can be a major financial burden for many families.
  2. Loss of independence: Moving into a nursing home can feel like a loss of independence for your loved one. They may feel like they are losing control of their lives and become resentful or depressed.
  3. Quality of care: Unfortunately, not all nursing homes provide the same level of care. It’s important to do your research and choose a nursing home with a good reputation and a high standard of care.

A few health related questions to ask the facility.

You may ask the facility under about the current status of the “health of the facility”.  How many residents have Covid or the flu?  What is their protocol in the event of a Covid outbreak? Do they have the staff and equipment necessary to meet the needs of your declining parent? 

Nursing Home Staffing Levels

Also ask about the nursing home’s staffing levels.  Many facilities are struggling to hire enough staff to be able to properly handle the needs of their residents. Of course the state may have mandatory minimum staffing requirements – but is the minimum enough.

If your loved one is in a nursing home now, you may be able to test this.  If you are visiting and your loved one has a need, how long does it take help to arrive after you hit the call button?  Understand that staffing levels may vary based on day of the week and time of day.  You may expect to see less staff during the weekends or at night.  But if a need arises during those times, how long does the resident have to wait before help arrives?

What are the requirements?

Federal law (Sec. 1919. [42 U.S.C. 1396r)(b)(1)(A) requires that “A nursing facility must care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident.”  (...this may be a little vague, don’t you think?)

There is a Centers of Medicare Services (CMS) blog article that states in part that: 

Federal law currently requires Medicare and Medicaid-certified nursing homes to provide 24-hour licensed nursing services, which are “sufficient to meet nursing needs of [their] residents” and must use the services of a registered professional nurse at least 8 consecutive hours a day, seven days a week.

If all of this sounds a little vague and less than adequate, I would agree.  The same article linked above cites efforts to roll out a comprehensive set of reforms, but the article also pointed out the reality of staffing challenges, which is a major obstacle to solving the root problem of being able to provide sufficient assistance for their residents.

Give credit where it’s due

To their credit, many of the nursing homes that I have visited have “help wanted” signs, posters and even banners in front of their facilities advertising (and practically begging) for help. Finding sufficient quantities of CNA’s to adequately meet the needs of their residents is an ongoing struggle for many facilities.

Even if the laws change to significantly increase staffing requirements, if nursing homes can’t find more workers, the law change won’t help.  One factor is the ability of nursing homes to recruit more CNA’s.  Those in the nursing home industry may say that Medicaid funding is not sufficient to allow them to hire new workers.  Others say that nursing homes have plenty of money for new hires – but that they refuse to pay enough to attract sufficient help.

Is going into the Nursing Home truly the best option? 

The easiest decision sometimes is just to skip directly to the Nursing Home option.  You know where it’s at, you know what they do (sort of), and you know that your Mom needs help quickly. But easy doesn’t always mean best.

You should ask yourself whether a nursing home is truly the best option for your parent. Have you explored all other care options? Is a nursing home decision really in your parent’s best interest? If your parent requires 24/7 professional nursing care, then a nursing home may be the best option. However, it is important to consult with their physician to ensure that this is the right decision.

Even though the physical move to a nursing home may be easy, this can be a a guilt-ridden, gut-wrenching decision – especially with the seemingly never-ending dark cloud of Covid or some other rapidly spreading virus looming over the facility.  Even if you know she needs to be there, is moving her there now a good decision?   

Curbing Guilt & Regret

If you rush this decision, you may face guilt and regret. Likewise, there may also be backlash from your family, friends, and even from the Loved One in the nursing home. You may also begin to wonder whether you are just taking the easy way out.

In order to limit these thoughts and feelings ask yourself a couple of questions. 1) Have you really exhausted all of the other care options? 2) Is a nursing home decision really in Mom’s best interest? 

Sometimes the answer is Yes. If she really needs 24 X 7 professional nursing care, then a nursing home may be the best option. Consult with her physician on this issue.  

However, before pulling the proverbial trigger, consider the alternatives if possible:

  1. In-home care: In-home care provides your loved one with professional care in the comfort of their own home. This can help them maintain their independence while still receiving the care they need.
  2. Adult day care: Adult day care provides socialization and professional care for your loved one during the day, while still allowing them to return to their own home at night.
  3. Assisted living facilities: Assisted living facilities provide a combination of independent living and professional care. They allow your loved one to maintain their independence while still having access to professional care when needed.

Other Key Factors

In addition to the rudimentary pros and cons, there are three other key factors that should be taken into account when deciding whether a nursing home is the right choice. These include the quality of life quotient, your time availability, and how to pay for nursing home care.

1) The Quality of Life Quotient

These were supposed to be “the golden years”, but it may not be turning out that way.  If you divide the care needed by the resources available, what is the end result?  This is what we refer to as the quality of life quotient. When looking at the end result, it’s important to determine whether there is any way to achieve an end result that would provide better care in a less restrictive and more efficient manner?

2) Your Time

Your time (or lack of it) may be one of the critical decision making factors.  The bottom line is that you may not have the time flexibility to provide the care that Mom needs yourself. You may have done what you could in the past to help – spending an hour in the morning on your way to work or a couple of hours in the evening on the way home.  But now Mom needs more help.  You love Mom, but simply don’t have the time to personally provide the needed assistance. 

3) How to Pay for Nursing Home Care

Your Mom may have stayed at home alone for as long as possible.  You and your siblings have helped as much as possible but now she needs extra care.  Obviously this care will cost money, so a determination has to be made as to how this care will be paid.  Does Mom or the family have money to pay privately for care? If not, stay tuned.

One common government program that pays for Nursing Home expenses over the long term is Medicaid. If you have checked into this a little, you probably have heard various stories as to whether Mom could qualify for Medicaid assistance and if so, when it would actually start paying her Nursing Home bill.  One pro-tip here is to not take “advice” from friends, the internet or your barber – go see an Elder Law Attorney. There is a lot at stake here! 

The scary part is that until Medicaid actually starts paying, the monthly out of pocket cost for Nursing Home care in our area of the county is in excess of $7,000 per month.  In some areas of the country, it is well in excess of this number. The key is to be able to help your Mom get the care she needs without totally running out of money and options. 

In conclusion, as a caregiver, it’s important to consider all available options when making a decision about nursing home care. The quality of life of your loved one should be the top priority, along with your ability to provide the necessary care and the financial resources available to pay for care. By exploring all available options and seeking the advice of professionals, you can make an informed decision that meets the needs of your loved one and ensures their well-being.

Next Steps:  

Are there ways that you could make staying at home work for a while longer?  Have you investigated alternate facility options, such as independent living with outside caregiver assistance? OR Assisted Living Facilities?  How will Mom be able to pay for any of these options?  We will discuss some of these options in future posts.  In the meantime, please let us know which options you have considered by typing in the box below.

We’ve been there & we understand.

In our time as caregivers, we have amassed a wealth of knowledge that we desire to pass on. We understand the emotions involved while making necessary decisions. Likewise, we have met many professional caregivers, as well as other family members who were thrust as Family Caregiver. All caregivers have shared the same advice – Join a community! There is nothing more cleansing for our situation than knowing that we are not alone!

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About the Author

Doug & his wife Cindy have not only helped hundreds of families with their estate planning and elder law needs over the years, but have personal experience as caregivers and advocates for their Loved Ones as well.

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