June 17th, 2011 at 1:00 pm
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The nursing home transition: what to expect

by Isabel Fawcett, SPHR

Some caregivers don’t talk much about the transition period between an elder living at home and eventual placement in a nursing home. The silence among some in the caregiving community may speak volumes about the challenges so many of us caregivers may encounter in transitioning our elders to nursing homes.

The occasional silence reminds me of some women who conveniently skip the topic of labor and delivery, choosing instead to focus on the joy of new life and bonding with their newborns. What about labor and delivery? What about making it into the nursing home? Both circumstances can be painful life transitions, sometimes even to an extreme. Both require major patience and lots of work. Yet, both circumstances may bring a sense of relief to all parties when all is said and done.

The nursing home transition: 3 things to expect

If you’re wondering what to expect when you transition your elder(s) to a nursing home, a few things come to mind.

1. A difficult conversation.

For some caregivers, broaching the topic of moving to a nursing home with an elder is the most difficult challenge. Be prepared by talking it through with a confidant or family member first. Allow someone else to play devil’s advocate to your position. If possible, ask a non-family member who is also an elder about his or her views on nursing home placement. If nothing else, you should gain a different perspective to think about before you approach your elder.

2. A tangled financial web.

Some caregivers experience a nightmarish tangle of co-mingled finances which may leave a caregiver in debt after an elder is no longer able to manage his or her finances. Does your elder have mounting bills? Try to assist your elder in debt reduction by paying down as many bills as possible prior to nursing home placement and certainly long before your elder’s health has started to decline.

Additionally, the elder may experience a spending down period. Spending down period. If your parent or loved one is not financially destitute or independently wealthy, “spending down” to Medicaid may be inevitable. Contacting an experienced eldercare attorney–even only one time–for expert and objective legal counsel can help clear the caregiving cobwebs. You shouldn’t be alone when it comes to navigating the sometimes tricky Medicaid and Medicare maze.

Remember, elderlaw attorney costs are not cheap. Save ahead of when you need to hire an attorney, and let your elder know legal counsel can help protect their best interests as they age.

3. An initial transition period.

Today, there are differing viewpoints on whether to visit your elder within the first few weeks of nursing home placement. Some nursing home staff may ask family members not to visit during the initial transition period for an elder. Take the time to decide whether it will be easier or more difficult for your elder to adapt to life in the nursing home without you being there every step of the way.

Where, and, how do I even begin to look at eldercare issues?

Planning ahead is sound advice. Develop your eldercare strategy while there is still time. Consider starting or joining a support group for caregivers even if you are not yet a caregiver. Listen to the stories and ask as many questions as you need to achieve greater clarity. In the end, you don’t want to be surprised if your elder is hospitalized and discharged to a nursing home. It helps to stay on top of your elder’s medical conditions and ongoing health challenges to avoid unpleasant surprises.

If you do, you should be able to see the handwriting on the eldercare wall.

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