My mom is 86 years old. When the time comes, I will place her in a nursing home, though she has said she doesn't want to.
I DO NOT want the responsibility of being the caretaker. I am the only sibling here. How do I prepare for this next phase?
She has excellent insurance, so I'm wondering should I start interviewing N.H. now?
If it is correct, then with respect this is not your decision. It is for your mother to plan her own later life and end-of-life care. You can make it clear that you will not participate, and you can stick to that, but you cannot choose to place her in a nursing home without her agreement; so as she has excellent insurance I should start researching what other options are available to her.
They really like where they are, have made new friends and attend the activities. We would have engaged them more in the search however, they were being moved from AZ to Florida. If I were you, I would do the initial search narrow it down and then take her to see the best options.
she cannot just enter a NH at will &
the LTC policy will have needs restrictions &
some NH do not take LTC policies.
Now if she’s got tons of $$$, she can get into an only private pay type of exclusive facility whatever her needs are & it will be breathtakingly expensive. But otherwise, she will need a referral from her MD & a needs assessment done by the facility. This is all about ensuring her care needs are what facility can do. Sometimes NH will actually decline admission as the elder needs locked ward MC or does not actually need skilled level of nursing care or has medication management that the facility is not set up to do.
Regarding facility not taking LTC insurance, my moms NH did not. It was MediCARE, Medicaid or private pay only. In chatting with billing, I was told was that LTC policies were flat too much of a bother. That there tended to be myriad of items / paperwork needed to get paid & foot dragging about something or other. NH could easily fill their beds without LTC insurance residents. I have no idea if this is common, but I was surprised. I’d try to clearly find out what’s what for facilities in her area. Also ask if the NH puts an extra fee on for administrative costs associated with LTC insurance policies.
Please carefully review policy as to the terms. Like if has inflation rider. Also what gap is for start of policy. Most have set period of time for start day of of eligibility - perhaps 60, 90 or 120 days from her entry for LTC with documented need for skilled nursing care that is private pay. She needs to have cash to pay for the gap as MediCARE or secondary health insurance is not going to pay her room & board. Also look as to daily amount paid once LTC policy is activated & if it’s enough AND if there are restrictions as to who must provide care.
If she is still in payable premium mode, look to see if an increase is looming. Lots of folks encounter. If this is a last millennium policy, several insurers do not write new policies and service on LTC specifics is spotty. Really read the fine print now so minimal surprises later.
That said, find out if her insurance policy pays for Assisted Living and if so, find a facility with a continuum of care. She can start out now, or soon, in Assisted Living, then move to Skilled Nursing as her needs increase, depending upon how long her policy pays for. My mother has been in AL since 2014 and she has a good time with all the activities and other elders to hobnob with. AL has extended her life....she is 93 in Jan and would have passed away long ago if not for the nurses catching 2 cases of pneumonia immediately. There's lots of good to be said for AL, that's for sure.
Go check out some places and speak with the staff and the residents about their satisfaction level with the facility. I've found that to be most beneficial when looking for a good place for my folks.
Gold luck!
At the very least if you don't go with questions, take a notebook with you. Record the name of the facility, date you visited/called, names of people you talked to, and their phone numbers for follow up questions.
You say that mom has 'excellent insurance' but it might be that not all facilities accept it. Assume nothing and ask them.
The amount of info you need is daunting... and the financials can be overwhelming when you are being asked to complete multi-page forms. From doing these I put together a one-page 'cheat sheet' on my FIL that includes everything being asked, from when and where he was born, active dates of service duty, marriage, employment history, banking account balances, life insurance face and cash value, burial plot, etc. It's all there so we can readily see it.
Good luck!
I would add that visiting the facility at different times of day and night to see if what the "interview" process reveals and real life are the same. Many facilities have a beautiful brochure and will give you a tour of the best rooms available. But what you get may not be what you see.
BUT, from past experience, real life differs greatly. At night, the number of staff drop dramatically, Also nurses may be LPNs, not RNs. (Any LPNs, please don't take offence, the amount of training makes a real difference.)
Also, many high school students are convinced that medical care is where the jobs are and go to school to become an aide, with plans of completing school for their nursing degree, but life gets in the way. Marriage, babies , school debt and never go any farther then an aide. Many don't like their jobs but are stuck because they thought they would continue their education and it didn't work out.
With this said, there are many caring aides, LPNs and others but to find a facility that has all of this on each is a stretch.
Good luck to you - it's a daunting exercise but if you're prepared and ask the questions that are important for you and your Mom, you will feel better about your decision.
Also, does her "excellent insurance" pay for in home care? She says, she doesn't want to go to a NH? I don't blame her. I would not either.
I say, as a caregiver myself, people want to remain, in their own homes. That's what I do. In home care, with an agency. That can be pricey, though
"When the times comes" as you say, her dementia may significantly increase, thus her care increase.
Do your research. I can't stress this enough. You may get a "perfect pitch" from some of these, "institutions" but dropping in, unannounced, is the best way to get a feel of, what the care is.
Talking to children, of their parent. How is the care?
Good luck, my friend
Red flag was a huge glorious & impressive lobby but small tight spaces for residents because that means they are all show
Factor in how far a drive it is for you - my mom was moved closer so that towards the end I was able to go 4 minutes to see her many times a day whereas before she was 40 minutes so I could only get to see her several times a week - quite frankly the closer it is the better - she doesn't need to know how close so when you take her there go a longer route
Nobody puts on their bucket list 'I was to go to a NH' so she'll always say she doesn't want to go - good for you for knowing your limitations from the outset - my mom would go to 10 activities plus religious ones a week & she bloomed with something to do rather than just watching TV all day
My mom was in 2 NH - one had tile floors but noise level was higher the other was carpeted in halls & bedrooms which was quieter/calmer - however every few months they would move everything to shampoo the carpets so she couldn't use her room for part of that day but they let me know in advance so I could visit with her during most of the 2 to 3 hours they were working on her room so really no problem - hope this helps
If she is caring for herself an Independent Living Facility or Assisted Living might be right. If she has memory problems or if there is a chance she would wander off then Memory Care might be better for her. And these would cost less than a Nursing Home.
You need to determine at what stage you will place her, what is it that would trigger that decision for you? It might be very possible that if she has no medical problems, and has no dementia she may not need any facility. (My grandma took care of herself well into her 90's it was cancer that killed her)
Talk to an Eldercare Attorney and get things in order now.
If there is a possibility that she would need Medicaid down the road now is the time to find out what can be done to make the transition easy. Many facilities will take a longtime resident that had been "Private Pay" if they go on Medicaid. So look for places that will allow the transition. There are many very nice places that will not accept Medicaid and if you select one of them she would have to be move if she had to go on Medicaid.
Ok...I just read your profile and (should have done that first) I see that she is now in Independent Living. Does the facility where she is have Assisted Living? Does it have Memory Care? If so she can transition from one to the other without a drastic move.
Discuss with the Director as to what would happen IF she did need more skilled care. Do they have the ability to do that? Many places have Rehab on site and if they do take rehab they may very well be able to handle the skilled nursing if she should need it.
And she may never need skilled nursing care and your search may not be necessary.
In-home care cannot touch or administer any medications your Mother is most likely having to take on a daily basis and different times of the day. The caregiver is not licensed to do this as 99.9% are CNAs working toward their RN degree.
Caseworkers who specialize in your situation are fantastic.
My fear just as so many of us have regarding the sad fact of the elderly being physically abused, YOU NEED TO HAVE THE COMFORT 1ST, THEN YOUR MOTHER'S.
I feel so blessed the caseworker who helped me (my husband was deeply involved too), took us to visit an assisted living group home. THE MOMENT I WALKED THROUGH THE DOORS, I KNEW I WOULD NO LONGER BE AFRAID FOR MOM AS WELL AS MY STEPFATHER.
I live out of state as well as my brother. I have 2 siblings who still live in the state but do not visit Mom; one sister has never visited as far as I am aware. The mgr and I are in constant contact, she sends pictures to me, the contracted doctor's PA contacts me regarding every exam.
This home just had their surprise State inspection and once again the State gave them a perfect score. Be sure you ask to see their scoring certificate from the State.
I visit Mom/Stepfather every month and I have NEVER seen any situation of abuse. This home doesn't even have that nursing home "SMELL". They even allow the residents to have their pets reside there too.
Again you need to feel comfortable first, ask questions even with residents who may be there due to physical disability. I can sleep knowing I've placed my Mom in wonderful hands. Mom's youngest brother visits 1-2 times a week so I have extra eyes.
I did this with my father. When the time came, I placed in him the one that he said he liked best. The transition was fairly smooth.
Second, if your mother qualifies for Nursing Home someone will still have to be "Power of Attorney" or "Medical Power of Attorney". That being said someone will need to be sure that all of Mothers' needs are met and she is cared for correctly. That meant for me all her needs were met and appropriate. My Mom could not do this for herself any longer when we (yes I have siblings) that she needed a lot of care and got her into Assisted Living. Mother was 92 when this became necessary. Her reaction to every medical and living needs was "NO". and this was a big problem. Being a "caregiver" has many levels of work.
Being the only child can be difficult and time consuming when caring for an aged parent. Good luck and be sure you double check everything. And starting your search for the best available option for your mother now is a good idea. Yes interview, visit, etc. is a good approach.