Not satisfied with your loved one’s care? Get involved
April 21, 2018
By: Mark Harvey
Email: harvemb@dshs.wa.gov
Today, I want to talk about skilled nursing facilities, aka nursing homes.
And what I want to say is geared primarily toward families, spouses and loved ones who have a person in a nursing home, or can imagine a scenario like that in the future.
I’ll begin with this: I am not an anti-nursing home guy; sure, that’s something that almost all of us would prefer to avoid. Well OK, Harvey, tell the truth: The fact is that, after 30+ years in this “business,” it’s pretty plain that most of us are less afraid of morgues than we are of nursing homes! But that still doesn’t make me anti-nursing homes, and here’s why:
Sometimes, for some people, there is just no other way. Maybe it’s because of Alzheimer’s/dementia and the care required is killing the caregiver or maybe it’s any number of unfortunate physical/medical developments, but the bottom-line is that somebody we care about needs 24/7 care, and we just can’t do it. When that happens, nursing homes are, often, a Godsend.
And I know plenty of good, gentle, caring people who work in nursing homes – HARD work! – Who go above-and-beyond every day, to do the best job they can of providing care, with dignity and respect.
Thank you.
I also know that, sometimes, it’s tough for families to navigate and/or understand what’s going on and why – Particularly if there’s a discharge in the offing – And, Yes: People do get discharged from nursing homes; maybe because they got better, maybe because the family structure at home changed and they can provide the care themselves or maybe their person just wants to go home to die.
But folks do leave nursing homes.
And I’ve had plenty of families tell me that they believed that the discharge process was unnecessarily drawn-out because the resident was on “private pay” (meaning, NOT Medicaid) so, considerably higher. Is that possible? I suppose, but I’m not sure it’s helpful for me to ramble on about possible motives or corporate evil or whatever else. What might be more helpful is make some concrete suggestions about what to actually do! – So, let’s do it.
First, at the time of admission, PAY ATTENTION! Don’t let the paperwork (OR the emotion!) overwhelm you. Nursing homes must state, in writing, what services it will provide and what the fees for those services are – You want to know that! Also, make sure you understand what the timeline for a discharge is; in other words, how much notice do you have to give? The facility must state how much notice it needs/requires for a discharge.
While the facility may offer to manage the “resident’s” personal funds as part of services provided, that cannot be required; now, there might be good reasons to do that or NOT do that, but be clear that it’s a choice, not a mandate.
And, during your person’s stay in a facility, be very careful about the facility changing your person’s pharmacy! Why? Well, all of a sudden there could start being bills for the same prescription medications that insurance used to pay for, because it was changed to a pharmacy that’s contracted with the facility/corporation. If that happens, don’t be in a big hurry to pay the bill, because that’s not allowed without informed consent.
So, now, let’s say that a discharge is in your person’s future, but it seems to be taking a really l o n g time – Can you do something about that? Yes! But you’ll have to get involved, and expend time and energy. You’re OK with that? Good for you! Consider these:
- If you’re told that “…we can’t get this-or-that set up right now…” or “…so-and-so hasn’t responded to the referral (e.g. Home Health or Hospice), check with that agency yourself, to be sure that the referral has been made, and to know what you can expect (and when!). You can also have your own physician (as opposed to the facility’s doctor) make the referral, so you can more effectively track what’s going on;
- There’s a “delay” in getting the hospital bed (or whatever) delivered? Check with the company yourself; often, same-day delivery is standard;
- You’re told that arranging for transportation to home (or wherever) is problematic? Well, maybe it is, but you can get involved in that. And if you’ve been transporting your loved one to medical appointments or visits or holidays or whatever/wherever, why isn’t that form of transportation acceptable now? It is.
Get the drift? Get involved.
Many of us tend to shrink in the face of anyone or anything “medical,” because we believe that we are required to remain passive and sedate until otherwise instructed – No, we’re not! – We can do a lot of the work, and usually in much less time, ourselves, remembering what we said about required notice of discharge, at time of admission.
Now, here’s the most helpful thing I’ll share: If you, or someone you care about, is encountering a “difficulty” with a skilled nursing facility (or any other type of residential facility) in Grays Harbor or Pacific counties, and you cannot satisfactorily resolve it yourself, call Amber Garrotte at 360-538-8877/1-800-801-ys be the “resider0060, Garroaa1@dshs.wa.gov. Amber is the Regional Coordinator for the Long-Term Care Ombudsman Program. She, with a cadre of pretty amazing volunteers, specialize in helping to smooth the way with facilities: solve problems, prevent problems and generally help to make lives in facilities better.
The most important person in these equations will always be the “resident” – Your person. Anytime that doesn’t seem to be case, something is wrong.
Mark Harvey is the director of Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.