Category: Help

New York Nursing Homes: Almost All Have Disease. What About Your State?

This one tool shows current data on COVID-19 cases for nursing homes.

nursing homes

When my dad needed a skilled nursing facility to rehab from a traumatic injury, my first call was to a few friends who had first-hand experience with local facilities. My second action was to visit in person. However, I should have started with the data. 

Data is even more important during COVID-19. While nursing home residents make up just 1.2 percent of the United States population, they account for about 40 percent of Covid-19 deaths, according to the New York Times.

This one tool can help inform your decision. Propublica, an independent nonprofit newsroom, offers an investigative tool to discover reported deficiencies, including COVID-19 cases, within nursing homes. 

Propublic excerpt:

Some of the homes have been cited for putting residents at “immediate jeopardy” of harm or death, our analysis showed.

And many of the affected homes have been previously written up for violating federal standards. That’s true in California, New Jersey and New York.

We introduced this resource in 2012 as a way to search through tens of thousands of nursing home inspection reports to find problems and trends.

You can easily compare the nursing homes in your state based on how many times they have been cited for violating infection control protocols in the past three inspection cycles (roughly three years). We’ve also added data from The Washington Post on homes with COVID-19 cases. 

The Nursing Home Inspect Tool shows this dashboard:

The dark red states show the highest rate of infectious disease rates in the nursing homes. Click on New York on the “Infection-Related Deficiencies” map and you get the report below, showing that 90% of all nursing homes in the state have had at least one case of COVID-19. 

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ProPublica’s reporting tool also shows that some nursing home chains seem to have higher rates of cases, as well. New Jersey’s CareOne facility had a consistently higher percentage of cases than other chains in the state. 

nursing homes

Looking at these numbers may inspire us to consider more in-home care options—or at least to let data play a part in our decision.

 

The ONE Local Secret to Finding In-Home Care

nursing home

Who wants to be in a nursing home or assisted living facility? My dad certainly didn’t. 

But I couldn’t quite figure out how to manage and afford the care that he would need at home. At the time, I couldn’t quit my job to provide that care myself. Maybe I should have. But that’s another story.

When searching online, it is hard to find an unbiased source. It turns out that it may have been more possible than I imagined to find home health care with the community resources already around me. Drumroll, please . . . this is the one unexpected source of local homecare referrals, even in these crazy times. 

Call your local hospital and nursing home social workers.

Ask them for homecare referrals—even if your senior is not in the facility currently. Sounds simple, right? But it’s a gem.

Social workers can provide the following facilities:

  • A referral for home health services like physical therapy (covered by Medicare for a limited time.)
  • A referral for a homemaker evaluation. The agency will send someone to your senior’s home to discuss services that are needed. After an authorized agency makes their free evaluation, your state may provide caregiving services at no cost. 
  • Their “preferred provider” list of caregivers (which you would pay for out-of-pocket.)

After narrowing your list, use Medicare’s checklist to interview each agency.
Their list includes questions like:

  • Do you have staff available at night and on weekends for emergencies?
  • Can you explain what my insurance will cover and what I must pay out-of-pocket?
  • Do you do background checks on all staff?

Also ask specifically about the sanitation and protection protocols they use during COVID-19.

Blessings as you help you senior well in these challenging times.

 

 

5 Warning Signs that Your Parent Needs Assisted Living

looking for spoiled food in the refrigeratorHe careened around the grocery store aisles driving the scooter they provided. I followed, picking up fallen cans and apologizing to shoppers who jumped out of his way.

My 80-year-old father was a home chef who was thrilled to put the dinner of his choice in his basket: ribs, asparagus and potatoes.

Sadly, those same ribs, asparagus and potatoes were molding in his fridge two weeks later.

Why didn’t he cook them? This really struck me because he loved to cook. Looking back, there were many reasons that all came down to . . . he just needed more help.

I think too, he was pretending that he was more capable than he truly was. We didn’t know that in the next year he would develop dementia and live in a hospital ICU, a nursing home, an assisted living memory care unit and a senior group home.

Look for these warning signs in our own senior’s home. Your elderly mom or dad may need more help than they are letting on.

Environment

  • The yard or house is not maintained.

  • There’s nothing to eat in the house.

  • The fridge contains expired or spoiled food.

  • Potholders or pans contain burn marks or a burning stove is left unattended.

  • There are multiples of the same item–10 bottles of ketchup?

  • Your senior has traffic tickets or the car has dents.

  • The car’s warning lights are on–gas, oil, check engine.

Social

  • Your senior stops doing the things they used to enjoy.

  • Your senior is spending days without leaving the house.

  • Your senior would benefit from someone checking on them every day.

  • Your senior complains of feeling lonely or abandoned when you are away.

Financial

  • Piles of mail in various places.

  • Unopened personal mail.

  • Increased thank you messages from charities.

  • Letters from banks or creditors.

  • The mail is unopened or bills are unpaid.

Up Close

  • Your senior is unsteady, wobbly, dizzy or very weak.

  • Your senior is looking unkempt, skipping showers, forgetting to shave.

  • Your senior has gained or lost weight, potentially having difficulty with cooking or shopping.

  • Your senior refuses to take medications or seek medical treatment.

  • Their personality has changed, become irritable or quiet.

  • To do lists that never seem to get done.

  • The house is overly cluttered.

  • Your senior is recovering more slowly from injuries or surgeries.

Cognitive

  • Your senior misses appointments, gets lost, forgets important information.

  • Your senior has difficulty performing familiar tasks.

  • Your senior substitutes unusual words

  • Your senior forgets recently learned information.

  • Your senior puts items in illogical places.

  • Your senior loses initiative and becomes passive or lethargic.

  • Your senior has trouble following directions.

Is it time to have a gentle conversation with your mom or dad about assisted living or in-home care?

Find templates and comparison tools for that housing or in-home help with the Digital Social Worker tool. It is full of curated links and to help you compare in-home care, a nursing home or assisted living options.

If you want the Warning Signs Checklist from above, download it here.

Now may the Lord of peace himself give you peace at all times in every way as you help your senior in their waning phase of life.

How to find a walker and wheelchair for cheap (or free!)

With the help from the nursing home physical therapist, I determined that Dad needed the following items at his new home, a memory care assisted living facility.

We found all these items for a total of $125. Follow these steps and see if you can dig up a free walker or wheelchair!

  1. Call your local Center for Independent Living. My local center is called FREED Center for Independent Living and they have a “lending library” of walkers, wheelchairs and other assistive devices. They didn’t have a wheelchair for me but they gave me a walker, a shower bench and a toilet seat riser.
  2. According to Medicare, Medicare Part B (Medical Insurance) covers power-operated vehicles (scooters), walkers, and wheelchairs as durable medical equipment (DME) if the doctor treating your condition submits a written order stating that you have a medical need for a wheelchair or scooter for use in your home.
  3. Look on NextDoor.com. I didn’t think of it for a wheelchair, but did get a $500 composter from a neighbor for free.
  4. Look on your local Craig’s List. We purchased a wheelchair from a nice woman who bought it for her husband and didn’t need it anymore. But we didn’t know to ask for adjustable arms,which leads me to the next point.

Be aware of the adjustable features you may need. Many doctors and hospitals offer a free “fitting session” for a wheelchair or walker.

And a final tip . . . the seat really needs a cushion if your senior is sitting in it for any length of time.

Now may the Lord of peace himself give you peace at all times in every way as you help your senior in their waning phase of life.

*We may earn a commission for products recommended, but we only mention products that were truly important for our father.

The Best Way to Be Ready for a Fall

The very day my dad was set to move into a charming little rental house, he fell in my bathroom and broke his hip. As the paramedics were arriving, I asked my teenage son to search online and print out a healthcare power of attorney form. 

Of course, getting this form signed had been on my to-do list. The current form listed his ex-wife who lived in a different state.

We found one, printed it, and asked the paramedics to be the two witnesses required. (Apparently, they are not allowed to do that.) At the hospital, we ended up asking my dad’s roommate and his wife to sign as the witnesses. Two complete strangers!

I am part of the sandwich generation. I work and have children and young adults I’m raising. I am an educated professional, and yet I didn’t know where to look for this form. Unfortunately, this form was necessary to use for my father many times in the next year.

Is this the right form?

It can also be called a Durable Power of Attorney for Healthcare, Healthcare Proxy or Living Will. Even though the titles for the document vary, advance directives give directions and responsibility to make healthcare decisions if someone becomes unable to do so. An advance directive gives an older adult a voice in their health care should they become too sick to make their wishes known, stating what kind of care they do or don’t want. This can make it much easier for family members to make tough health care decisions for them.

You may be in one of these two situations…

  1. The older adult is independent, but you are the one who would step in should there be an emergency
  2. You are already in a caregiving role for an older adult 
  • For those with independent older adults:

Here’s your assignment: Find out where the power of attorney is and what it says. However, you don’t want to send a message of “you aren’t in your right mind” or “you haven’t prepared well” or even “I’m taking over.” 

Try a strategic approach to this question, like the following:

 “I have a new benefit at work and they’ve given me an assignment of making sure I understand the health management wishes for those I love. I am curious about your healthcare power of attorney. Can you tell me if you’ve done that and if so where I could find it should I need it?”

If they are willing, ask how recently it was completed and if it has the required signatures. It’s a perfect time to hear about their wishes. If you really want to level up, the person responsible for carrying out those wishes should make a copy of the POA.

  • For current caregivers: 

If you don’t already have a healthcare power of attorney paperwork completed for the older adult it’s important to do. Why? According to the American Bar Association, having this completed allows you to do things like:

  • Talk with the medical team about treatment choices. Ask questions and get explanations, so that you can understand the patient’s medical condition and treatment options as much as possible.
  • Asking for consultations and second opinions from other doctors.
  • Consent to or refuse medical tests or treatments—including life sustaining treatment in many, but not all, cases.

You don’t need to contact a lawyer to get this form. However, if the older adult has not chosen a medical decision maker already and they are not able to make their needs known you will need to get an attorney to establish who has the DPOA. The National Academy of Elder Law Attorneys is one resource.

You can get a free power of attorney version for your state at Prepare for Your Care or through the American Bar Association. Or Search online: Durable Power of Attorney form for (insert name of your state here). The form itself will outline which signatures are required in your state.

Lastly, make sure you can find the healthcare power of attorney when you need it.

  1. Place a copy of the healthcare power of attorney in a secure location (firebox or safety deposit box)
  2. Place a copy of the healthcare power of attorney in a folder by your door, ready for an emergency. If you want a stylish medical document planner to place it in, the Ways & Wane GoKit is a great solution.
  3. Take a picture of it with your phone and organize it in an “Emergency” folder in your Photos.

May you joyfully prepare so that you can calmly navigate this waning stage of life.