Nursing homes and long-term care facilities have always been required to report all COVID-19 cases to state and local public health officials. But until recently, they were not required to share such information with federal health officials or make the information public. But that has changed.
Since May 17th, every nursing home in the U.S. was required to inform its residents and their families within 12 hours of a confirmed COVID-19 case. Further, they had to provide current and past COVID-19 information to the Centers for Disease Control (CDC) and Prevention and also make the information public.
But before this new requirement was implemented by the Centers for Medicare and Medicaid Services, there were some unsettling news reports outlining the devastation caused by the coronavirus in nursing homes in the United States:
· The New York Times reported that one-third of all U.S. coronavirus deaths were nursing home residents or workers. Many are suggesting that this number is too low and it’s closer to 50%
· The Connecticut Mirror reported that “nursing home deaths account for more than half of all COVID-19 fatalities in Connecticut”
· The Kansas City Star reported that 70% of Johnson County coronavirus deaths are in nursing homes
· The Star Tribune reported that Minnesota nursing homes accounted for 81% of COVID-19 deaths and are continuing to take in infected patients
The decision on which nursing home or long-term-care facility is gut-wrenching enough and one that requires online research, multiple site-visits, enormous patience and the willingness to ask a lot of probing questions. But let’s explore how to broach the subject before that decision is even reached.
Make a Plan to Discuss
A discussion for moving a parent (or anyone else) to a nursing home is best made when everyone is healthy. Once stricken by illness or frustrated by the loss of mobility and freedom, an older parent may not understand questions or state details of their wishes. Lack of a plan often ignites family arguments without even knowing what the parent would really want.
These talks should also go beyond just the money to include the parent’s future independence and decision-making regarding finances, health care and other subjects as well as basic preferences for day-to-day living.
Finances are Not the First Topic
Decide what to tackle first. This may be the entire agenda of the initial talk and may be brought up because you notice mom or dad moving slower, forgetting more or looking ill. Jumping directly into bank accounts, wills and powers of attorney usually stops the conversation cold. Instead, talk about health and lifestyle issues and then, when everyone’s comfortable, wade into finances.
Explain why you want to discuss finances. In some families, a successful financial discussion takes several tries. Don’t get angry or discouraged: many parents think this conversation threatens their way of life and they fear judgment or losing control of their lives. Keep trying to start the conversation until it catches. Ask up front what topics are okay and which are off limits. Once comfortable, your mom or dad might open up on the off-limits topics.
Remember, It’s Not About You
· Send questions beforehand. This gives your parent a chance to prepare and the opportunity to say if they are unready to address certain areas. Basic topics: where important papers such as a will are kept, how household expenses get paid, how to reach doctors and specific needed medicine, an advanced health care directive and a funeral plan. None of these asks about dollars and cents, but instead focus on how your parent lives today and on plans that are already made.
· Offer to get professional advice. Your parents’ financial professional – if they have one – is a great place to start, as that person likely knows their situation and about any decisions already made. A financial professional can also suggest legal documents to put in place and ways to make sure both parties can access accounts to pay medical and household bills.
· Plan a caregiving strategy. Discuss mom or dad’s preferences and trigger points for various stages of heath care. Nearly everyone wants to stay at home, but you must talk about how much you can do at home as a caregiver and when services such as home
health aides, geriatric care managers or assisted living start.
· Discuss what happens with their home. The equity in your parents’ home may become a way to pay bills. As homes are both major assets and emotional focal points, address what mom or dad wants to happen to property – and under what conditions.
· Have a family meeting. Once you know the framework of a plan and various roles and decision points, bring all interested parties together. You and your mom or dad can revisit the conversations and let everyone know the game plan. Family members may have questions or alternative ideas – or they may feel hurt if they were left out of the process.
The truth is that if you wait too long to plan, the likely result will be anger and fear. And you never want to be reactive in your planning, because then your options are limited.
Again, a plan is best made when everyone is healthy.
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This article was prepared by RSW Publishing.
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