Depression...

I often get the question, wouldn’t my loved one be more depressed living in a skilled nursing facility?  In the community often times individuals become isolated and that attributes to their depression.  FYI 20% of elderly living in community have depression.  Depression is often mistaken for normal aging, but that is incorrect.  Some symptoms include: complaints of aches and pains, feeling of sadness or loneliness, interference with ordinary daily activities, weight loss, and lastly confusion and memory loss.  Skilled Nursing Facilities and even assisted livings are designed to give individuals social interaction which we all crave/need for our well-being. Interaction with others occurs during meals, activities, with roommates, and even in the beauty shop.  Living within a structured environment with set meals and activities, gives someone a reason to get up in the morning! 

When is the right time for skilled nursing???

Q: What are signs that my loved one needs skilled nursing services?

A: Here is a list of the top needs potentially requiring skilled nursing facilities.  We use the phrase MIAMI DAWN.   

M: Memory Loss

I: Incontinence

A: ADLs (Activities of Daily Living)

M: Medication Administration

I: rehabIlitation

D: Depression/Isolation

A: Ambulation/Falls

W: Wound Care

N: Nutrition

Your loved one may have one of these needs or all.  Each facility is designed to coordinate their care based on their individualized needs.  The most prominent problems seen in the skilled nursing setting are related to memory loss, falls, medication administration, rehabilitation, and depression.  

Also, when in doubt, speak with professionals: doctors, care givers, home health, etc.  This is a difficult situation and a decision should not be entered lightly.  

-Brooke

Solving Problems...

No facility is perfect, not even mine :) and there are bound to be problems that arise.  With that being said, how do we approach the issues, how do we resolve, and at what point is it time to make facility changes?  Communication is key.  During the admission process the facility should lay out the ground work of what you can expect from them, this includes: care provided, meal services, activities, amenities, etc.  This is the perfect time for you as the family to lay out your expectations of the facility.  I always tell my staff, I cannot expect you to read my mind, so I always lay out my expectations upon hire, that way there are no excuses.  This goes the same with laying out expectations to facilities.  I can only speak about my own, but our intentions are always to do our best, and knowing your expectations gives us the best chance at excelling.  Does laying out expectations exempt you from potentially having problems, unfortunately not!  So, if a problem does arise what is the next step.  I always tell family members to let us know immediately.  Make an appointment with the department that it pertains to and speak directly to the supervisor, or set up a care plan meeting to discuss with the entire management team in charge of your loved ones care.  Some problems should be resolved immediately, others may take time as new processes are put in place.  I always say give it a week and if the problem does not resolve then speak with the Administrator.  It is important that you make everyone aware of the problem.  The Administrator is in charge of the entire operation, and the what is or isn't happening as it should.  One great thing about my facility is that we have video cameras in the hall.  I can confirm or deny most complaints related to call lights, not checking on a loved one, who was working, etc immediately by reviewing the video tapes.  One thing to remember is to give the facility the benefit of the doubt.  Your loved one may tell you things that is half true, or true based on their reality.  Make sure you investigate and find out the facts.  For example, if a resident has just had a procedure and is in extreme pain, if they ask for more pain medication and it takes them 10 minutes to get the medication, because of the level of pain, it may feel like one hour.  Another thing that I have witnessed is residents/patients attempting to put guilt on their loved one by telling them incorrect information.  This does not mean do not believe your loved one, it just means, get to the bottom of the situation.  If the facility has cameras like mine, ask to review with the administrator, come visit at off hours to see if what they are telling you is true.  If you have done all this, nothing is getting better, and you are first hand witnessing the injustices it is time to move your loved one.  Everyone deserves the highest quality of life!!!

Medicaid...How do I qualify for Long Term Care Medicaid

Being in long term care myself, I am blessed with tons of resources to help explain the difficult world of Medicaid. Today my facility Conroe Health Care Center hosted a community event with a presentation by Elder Law Attorney John Dantche.  The presentation was over the Ins and Outs of Medicaid and protecting your assets; this is strictly in reference to long term care.  Here is some great information he gave us that I wanted to share with you!

Medicaid Eligibility for the Nursing Facility (aka long term care or skilled nursing facility)

Maximum Income:
Individual- $2,094
Couple- $4,188

What constitutes income:
Basically this is anything you receive benefits on or payments such as: social security, pensions, annuities, wages, dividends, and retirement benefits.

Maximum Amount of resources:
Individual- $2,000
Couple- $3,000

What constitutes a resource:
Anything that can be exchanged for cash value such as: bank accounts, property, life insurance, stocks and bonds, etc.

What can be excluded for eligibility:
Homestead
Life insurance with face value of $1500 or less per person
One vehicle
Burial spaces for the individual, spouse, and close relatives

Protected resources amount for a spouse in the community
$22, 728 Minimum- $113,640 Maximum (does not include resources under the excluded list)

Some other information to know is that they must be a resident of Texas, be in a medicaid contracted long term care facility for a minimum of 30 consecutive days AND meet Medical necessity which is determined through the assessment process. 

There are so many individual situations, so if you have any questions please feel free to ask.  If I do not know the answer I will find out for you!  I hope this information clarifies about what SOME of the qualifications are for Medicaid application and approval.

Conroe Health Care Center