From Nursing Home to Home

August 20, 2010
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A recent article in the AARP Bulletin discusses the growing trend of nursing home residents regaining their independence. In part, the growth is happening because more state and federal programs are designed to help them do it. According to the National Center for Assisted Living, spending for home and community-based care rose 81.5% between 2001 and 2007, while Medicaid spending for nursing home care rose 9.8%. A federal program that encourages states to use Medicaid funds to transition nursing home residents to independence received a five-year, $2 billion extension in the health care reform bill.
Making the transition from nursing home to independence is a complicated journey. Some communities, such as Philadelphia, have counselors who assist nursing home residents in making the transition. Some seniors need to start from scratch, getting new identification, setting up bank accounts and finding places to live. Often they need to adapt apartments for their needs, find furniture and household items, and care in the home. Nursing home residents who are on Medicaid are usually able to transition that assistance to help in the home; the main question is whether the senior can receive the level of care and services that the senior needs if the senior moves into the community. Life care planners, such as Oast & Hook’s Carey Raleigh, can assess the senior’s current circumstances and provide recommendations regarding whether such a transition is advisable. They can assist with finding resources in the community to support a return to independence.
Experts recommend that seniors considering a move from a nursing home to the community ask these questions:

  • Do you want to live independently? A senior must be motivated to overcome the obstacles to independent living.
  • Are you physically able to live on your own? Mobility is a key element of independence.
  • Can you afford to live outside of a nursing home? Elder law firms can assist in researching various funding options.
  • Is in-home care available? A life care planner can assist in compiling a list of needed services.
  • Can you find appropriate housing? Issues such as access, safety features, security, kitchen or dining facilities should be considered and vary with health and mobility.
  • Does the home have everything that you need? You will need items such as emergency contacts, a telephone, kitchen equipment, and personal care items.
  • Does your community have necessary medical services? It is critical to identify this in advance, and if possible, contact providers in the community to ensure that services are available.
  • Do you have the skills needed to live at home independently? This may include everything from preparing meals, shopping and paying bills, to showering or bathing.
  • Do you have transportation available? Many communities have transportation programs for seniors.
  • Do you have social support? Senior day care, activities in senior housing, religious programs, and visits from family can prevent isolation if returning to the community.

Transitioning from a nursing home to the community will not work for everyone. The key is to assess the current situation and potential options, research available support, anticipate unexpected circumstances, and plan well in advance of a move. Life care planners and elder law attorneys can be key advisors in this process.
The attorneys at Oast & Hook can assist clients and their families with their financial, estate, long-term care, life care, and special needs planning issues.

Ask Allie

O&H: Allie, we’ve heard about animal heroes and their human families. Please share with us a story about an animal hero.
Allie: Sure! In 2007, a 16-year old cat named Winnie was selected as Pet of the Year by the ASPCA because she saved her family from carbon monoxide poisoning. A gas-powered water pump was extracting water from a recently flooded unventilated basement. The pump was releasing carbon monoxide throughout the house because the pump was near the home’s intake heater vent. Winnie had been snoozing in the fresh air of an open window, sensed something was amiss, and started howling. She nudged her human mom, Cathy, with her nose, pulling Cathy’s hair and meowing loudly. Winnie kept running up and down Cathy’s body. Cathy woke up, feeling very dizzy, tried to rouse her husband Eric, and was able to call 911 on the telephone. Emergency responders arrived quickly and got Cathy, Eric, and their son Michael out of the house and to the hospital. The fire department aired out the house with industrial fans, which did not please Winnie. Winnie hid safely in a closet until her family arrived home. Winnie received her award at a special ceremony in the ASPCA’s Rainbow Room in Rockefeller Center in New York City. In an ironic twist, Winnie had Cathy to thank for saving her life when she was a one-day old kitten. Cathy found Winnie beneath some floorboards in her parents’ barn. She and her husband fed Winnie milk from an eye dropper, and their cat Harley kept Winnie warm. Winnie has thrived in the home ever since. Winnie returned Cathy’s favor. “If it wasn’t for her waking us up, we’d all be dead,” Cathy says. “She’ll always be my lifesaving little baby.” What a great story! Time to look out the front door and see who is visiting today. See you next week!


Oast & Hook attorney Letha McDowell will speak on the topic of elder law at the monthly meeting of the Norfolk Retired Employees Association from 10:30 a.m. to 11:00 a.m., Friday, August 27th at the Titustown Recreation Center located at 7545 Diven Street, Norfolk, Virginia 23505. For more information on this organization, please visitwww.norfolk.gov/retirees.

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