Shopping For A Nursing Home

Have you ever done that? The process is interesting in some respects as well as educational. I visited five places in the immediate area and presented my needs or should I say Dad's needs. What I learned was that it's tough to get a bed if it's a quality facility. Further to the point, these care facilities are picky. They seem to want only a certain clientele. This is because of what they are allowed to do by law and how some care insurance policies are structured.

Some places do only assisted living. They may well have memory care facilities, but they only want people that do not need much in the way of supervision. They like independence in their residents, but they do not like it when they try to escape. Did you know that if a patient may require the assistance of more than one care worker, they can not live in an assisted living facility? Patients with this requirement must go into long term care.

Further to the point, if your insurance policy is an older policy, it will most likely only cover long term care. It cannot be used for assisted living with only some exceptions. Many care policies also have a 45 day waiting period where the insurance carrier pays nothing. Some places want a down payment or earnest money. There are damage deposits involved on rooms too just like apartments. In all, it seems to be a very profitable business, so it's no wonder it's so heavily regulated.

My Dad is going to need two things. Skilled care to recover from his hip surgery and then long term care for his worsening Alzheimer's. I have determined that an assisted living situation would not work for him. He is going to need all the help he can get. When searching for a nursing home and when there is a need for both of these care levels, it is also very difficult to find an adequate place that can do both. By this, I mean that a facility may have beds available for skilled care, but not long term care after that. Much of this is a waiting game.  Doing both of these at the same facility is optimal for the patient, but many times is not possible because of room availability.

I have chosen a facility close by for the skilled care Dad will need. It is my hope after he is back on his feet (with a walker), that a bed will open up for him in long term care. If there is a room available, Dad will have to go through an evaluation to determine if he is a flight risk. If he is deemed a flight risk (called elopement), then he will have to move to a secured facility. It's required by law apparently as are many other things in that business.

Whether any of this happens at all is going to depend on Dad. Since his surgery yesterday, he has refused to get out of bed and sit in a chair. He has not been eating to regain his strength. He is a bit dehydrated and he is sleeping quite a bit. All of this magnifies his Alzheimer's symptoms. He is sun-downing and it's not pretty.

Today, the physical therapist got tough with him and cranked up his bed to sit him up. They did manage to swing him around, but they could not move him to the chair. He refused to cooperate.

I had to tell him today that he would die in bed if he did not get up and start using that new hip. This is no exaggeration. The orthopaedic surgeon said that the mortality rate in the first year for hip surgery patients is 50% and it's because the patients refuse their therapy, refuse to participate in their recovery.

There is a great deal of pain and soreness involved (as well as stubbornness). I understand this, but if he wants to survive and have some quality of life, he is going to have to fight. I am not sure he understands the consequences and it's most likely because of his Alzheimer's. He is not a coward. I know this. I grew up with him. He taught me not to fear pain; that it's a part of life. He has apparently forgotten this for himself.      

If you want to pray for him, pray that he will get up. It's what he needs to do right now.