September 25, 2017

9-20-17 As Seen in the Democrat and Chronicle - Riding the nursing home placement 'merry-go-round' by Richard A. Marchese, Esq.

The call came in on a Monday night around 8:00 p.m. from my brother Steve.  Mom had fallen at her home (for the fifth time in three months) and could not get up.  For the last three years, Mom had been slowly declining cognitively. She had significant short-term memory deficits and emotional swings. Interactions that occurred ten minutes ago were quickly forgotten. Mom’s inability to remember conversations, meetings, etc., was getting dangerous.

Mom was in a very ornery mood when my sister and I arrived.  She could not get off the floor and would not let us help her. She told us, "get out of my house and leave me alone!"  We told her we were not leaving, and pleaded with her to let us help… all to no avail.  We called for an ambulance. My sister, who is very close to Mom, was crying. I looked at my brother and we just knew -- this was it.  Our journey going through the nursing home placement process for mom, something I’d feared, was about to begin.

Mom was checked at the hospital. No broken bones, but significant bruises. The attending doctor indicated that she would be kept for a day or two to make sure that she was fine, but that she could not be safely discharged home. A skilled nursing facility was the only safe discharge option.

Now on to the skilled nursing facility placement merry-go-round.   Besides her modest home, Mom had little, if any assets. How would we get her into a “good” nursing home?   The discharge planner at the hospital dutifully listed twenty area nursing homes and asked us to “pick five.” She would start making calls to these facilities. As an Elder Law attorney, my family naturally looked to me for guidance. I knew that placement for patients of little or modest means is difficult, and at this transition phase, money was a key determining factor.  

The transition process from hospital to nursing home is an emotional roller coaster. As each facility gets crossed off the “list,” anxious family members wring their hands.  How can we as a society allow a process that defeats efforts to keep mom or dad at home, and avoid nursing home placement, via this dreaded "list"?

We must all be strong advocates for our elders and demand that transitions, at all stages, take place in a humane, safe, and dignified manner. We owe that to our parents, spouses and loved ones -- and to each other.   

Mom has now been at a nursing home for over a year, and has adjusted well. The staff is kind, patient and caring. We feel blessed that Mom is in a safe and secure environment. Monroe County has a wealth of resources in the field of elder care, and professionals in the field who are more than willing to help. You will find these professionals at the annual Monroe County Elder Law Fair and Public Hearing, to be held on October 16th at Temple B’rith Kodesh.  To register for the event, please call 585-371-8429