Telling It Like It Is

Nursing Home Rating System Worrying Nursing Home Industry

The Centers for Medicare & Medicaid Services (CMS) has released a new nursing home rating system on its website to help make choosing a nursing home easier for senior citizens and their families.

The 5-star rating system used for all 15,800 U.S. nursing homes that participate in Medicare or Medicaid, similar to rating systems for hotels and restaurants, has some nursing home operators worried about how their business will fair with this new rating system.

The ratings are based on health inspection surveys, staffing information and quality of care measures, such as the percentage of residents with pressure sores. The nursing homes will receive stars for each of those categories as well as for their overall quality. Only 10% of nursing homes received the highest five-star rating, and 20% received just one star in the first round of ratings. Which nursing home is your parent or grandparent living in and what rating did it receive?

Now the general public can know which nursing homes got a low rating and which received the highest rating of 5, but of course there are those in the nursing home industry desperately trying to poke holes in the rating system from the get-go by saying the system is “is poorly planned, prematurely implemented and ham-handedly rolled out”.

“What you have with the five-star system is a very well-thought-out way of summarizing all of that information that was available on the earlier site with new information. This allows you to do a much more direct comparison in a user-friendly way” said Charles Phillips, a professor of health policy and management at Texas A&M Health Science Center School of Rural Public Health in College Station. “The old site had a lot of information, but the information wasn’t necessarily terribly usable by the average consumer. You knew if the facility was above or below the state average, but you didn’t know what that meant”.

Families caring for elderly parents have a weighty responsibility trying to deal with providing needed care and attention to elderly parents, and the struggle to find quality nursing home care weighs heavily on the hearts and minds of caring families. Many family members incorrectly assume good quality nursing care and they often don’t know what questions to ask when trying to choose a nursing home, and that’s where this rating system can be an important educational tool for families.

Alice H. Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform, said consumers should consider the star ratings, but not solely rely on them when comparing nursing facilities. “Our initial reaction is that consumers should probably avoid any facility with a one- or two-star rating and even a three-star rating unless people they trust convince them that the rating is inaccurate or unfair,” she said. Her organization also issued a press release warning that nursing homes may appear in the ratings to give better care than they actually do.

“There are other quality-of-life issues they are very concerned about: the atmosphere, cleanliness, ratio of nursing professionals, the ability to go visit. None of that is reflected in what gives this a five-star rating”, said Debra Greenberg, a senior social worker at Montefiore Medical Center and Albert Einstein College of Medicine in New York City.

The decision to put a family member in a nursing home is very stressful and emotionally charged for many families. Anyone considering placing an elderly parent in a nursing home should talk to the local nursing home ombudsman and take the initiative to physically go and visit each nursing home facility being considered several times (unannounced) in order to get a real first-hand look inside the nursing home.

Some families are intent on taking care of elderly parents themselves, with the help of programs that offset some of the financial stress and hardships, rather than placing their mother or father in a nursing home. The decision as to whether to put mom or dad in a nursing home or not is a personal one, and the general public has the right to know as much as possible about how nursing homes are rated and why each nursing home received either low ratings or high ratings in order to make the best possible decision for their parents and family.

Medicare’s Nursing Home Compare

Posted in Aging, Elderly, Family, Health, Men, Women on December 19, 2008

Tags: Tags: caring for aging parents, Nursing Home Care, Nursing Home Compare, Nursing Home Rating System, taking care of elderly parents

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Taking Care of Aging Parents as a Family

Caring for aging parents can be challenging and difficult at times, but it is also an honor and privilege to do so, as well as a God-given responsibility for everyone in the family. “But if anyone does not provide for his own, and especially for those of his household, he has denied the faith and is worse than an unbeliever”. (1 Timothy 5:8 New American Standard Bible)

Taking care of the needs of elderly parents can also put a strain on marriages unless clear boundaries are set and adhered to, along with getting the supportive help and assistance of all siblings, children and grandchildren. Not only is it important and necessary to care for aging parents, but it is just as important to care for the needs of your own immediate family, such as the husband/wife relationship and that of any children.

The aging parent/child relationship cannot and must not supersede the relationship between husband and wife as first priority, as this goes against the marriage vows spoken before God and witnesses to “leave and cleave unto each other”, thereby creating needless stress and strain on the marital relationship. It is extremely important to understand the difference between caring for needs versus wants, as taking care of elderly parents can often lead adult children to become enablers of their own parents without realizing it.

Some elderly parents can be very difficult to deal with, perhaps even controlling and manipulative, in a selfish attempt to dictate the lives and activities of family members. Some may even claim they are unable to care for basic needs such as fixing themselves a sandwich, when in reality they are fully capable physically and mentally, but choose to expect family members to cater to their every want and whim.

What is an Elderly Parent?

How do you know when your aging parent is in need of help? What signs are there to indicate it may be time to step in and help your parents? Specifying a particular age to signify an “aging” or “elderly parent” would be meaningless, because each person is different in their abilities and health as they enter their advancing years. One elderly parent may be in their early 60’s when needing help, while another parent may not need help until well into their 70’s or 80’s.

Becoming keenly aware of a parents ability to fulfill the basics of living such as bathing and grooming, preparing meals, caring for household chores, doing laundry, remembering and paying bills as needed, shopping, driving skills etc, are all telltale signs of whether a parent may be in need of some assistance.

Caring for an elderly parent encompasses responsibilities from the very basic needs of living, to dealing with physical and mental health problems (such as Alzheimer’s or Dementia), insurance and long-term care, where a parent will live when no longer able to live alone, discussing the parents wishes and desires if incapacitated or unable to make coherent decisions, and much more.

Talking With an Aging Parent

While it is certainly advantageous and recommended for a parent to make plans for their own care before an emergency or serious health problems occur, adult children must often take on the weighty responsibility of caregiver before becoming fully informed of everything involved with caring for an aging parent.

It is then necessary for the family, especially grown adult children to have a family meeting with the parents to ask questions well before an emergency situation arises, gather and save necessary documents (financial, insurance, wills, etc) regarding what needs there are or will be at some point in the future.

• Who will be the primary caregiver?

• What role will others in the family play in caring for the parent or Grandparent?

• What can teenagers and younger family members do to help?

• Are there any signs that some help is needed now? What are they?

• What responsibilities can be shared, and by whom?

• Is there a need to supervise medications, shopping, doctor visits, etc?

• Is there a list of assets and their value? If so, where is it?

• Is there a will, a living will, medical directive, power of attorney? If so, where?

• Location of birth certificates, social security card, marriage and/or divorce certificates, education and military records.

• Is there a private pension, what is the amount, is it directly deposited? Where?

• Are there Social Security payments? How much? How is it deposited?

• Is there a list of all bank accounts, CD’s, safety deposit boxes, IRA’s, stocks, etc? Where?

• What debts are there? Mortgages, credit cards, car payment?

• Is there adequate medical insurance? Long-term care insurance? Medicare? Medicaid? Prescription plan?

• Has anyone consulted with an elder-care attorney?

• Can the elderly parent live alone? Where will the parent live if unable to live alone?

• What about an Independent Living or Assisted Living facility, or a Nursing Home?

• What medications are being taken, and in what dosage? By prescription or over the counter?

• Are there any prepaid funeral expenses? Prepaid burial plot? Are there any specific funeral arrangements desired?

• What are the parent’s wishes regarding when to issue or agree to a “Do Not Resuscitate” order, also known as a D.N.R.?

• Is an Obituary notice in the newspaper desired? How much does it cost? (Some newspapers offer this as a complimentary service, while others charge hundreds of dollars for a two-inch block of text).

• Is there a preferred funeral home? Should there be a viewing? Who will deliver the eulogy?

• Is cremation desired? Are there any specific wishes regarding the funeral service?

These are just some of the many questions that must be asked and respectfully discussed with the parent, allowing the aging parent to retain as much as control as possible over their own care and needs. Educate yourself on legal, financial and medical matters that relate to your parent and the aging process prior to having the family meeting, being sure to include information and facts learned to the discussion.

While you may feel somewhat nervous about discussing death with a loved one, you may be surprised to find that most elderly people are not afraid to talk about it and will appreciate your willingness to carry out their wishes.

Helping Aging Parents as a Family Unit

The entire family is responsible for caring for the numerous and sometimes difficult demands of an aging parent, including young members of the family. Too often this responsibility is placed solely on the shoulders of one adult child, while others in the family shirk their duty to be supportive and helpful in the process.

Baby Boomers are now caring for their parents, in what has been called the Sandwich Generation, while at the same time trying to care for their own children, household chores, jobs and marriages. Regardless of how far away from their parents that adult children and grandchildren live, each member of the family needs to do everything within their power to help care for the needs of Grandma or Grandpa.

Making regular phone calls, sending cards and letters, scrapbook collections and photo’s of fun and happy times, occasional gifts “just because” or to say “I love you” are all things even younger children and teenagers can do to help support the family’s caring for the elderly grandparent. Distance is no excuse to leave all the responsibility to the sibling living closest to the parent.

Think of all the various household chores that are necessary in your own home, and that many families share in, to keep a home clean and in good working order. All of these and more are required to care for elderly parents and grandparents too. Teenagers and younger children can help Grandma and Grandpa with dusting, vacuuming, doing laundry, cleaning bathrooms, calling on the phone, drawing pictures and cards, playing board games, etc according to their individual abilities. Helping in these ways allows grown adults the time to care for more difficult and time-consuming responsibilities like heavy yard work, car repairs and maintenance, grocery shopping, making sure bills have been paid, etc.

By working together as a family, being supportive and helpful in caring for the many needs of the elderly parent, families will have the joy and pleasure of knowing that their efforts were greatly appreciated by the aging parent or grandparent, as well as knowing that they fulfilled the requirement to “honor your father and mother” while they were alive.

Related Post:

Can I Get Paid to Care For a Family Member?
Nursing Home Rating System Worrying Nursing Home Industry
Caring For Our Elderly Parents
Taking a Bite Out of The Sandwich Generation

Posted in Aging, Children, Death, Elderly, Family, Health, Marriage, Men, Parenting, Relationships, Religion, Teenagers, Women on March 23, 2008

Tags: Tags: baby boomers, caring for aging parents, caring for elderly parents, elderly parents causing strain in marriage, questions to ask elderly parent, sandwich generation, signs elderly parent needs help, taking care of aging parents, talking with an elderly parent

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