Taking a loved one out of a nursing home is not legally impossible, but it can definitely be a logistical challenge. There is also the emotional heft when making the decision and the impact it can have on your loved one in the facility.
Jump ahead to these sections:
- Can You Remove a Loved One From a Nursing Home at Any Time?
- How Can You Remove a Loved One From a Nursing Home?
Some families have reconsidered leaving their loved ones in nursing homes, given issues with staffing and a history of improper infection control. While a nursing home may not be ideal, it can be equally difficult to find an alternative. With all those things in mind, you may have already gone through the emotional ups and downs to make the decision to take out your loved one. So now what do you do?
Can You Remove a Loved One From a Nursing Home at Any Time?
Yes, you can move a loved one from a nursing home at any time, but there are some things to think about before making a final decision. Nursing home care is intensive and intended for people who have no other option for medical care. Although a move may be against medical advice, you do have the right to make that decision.
On the financial front, most nursing home residents are on Medicaid due to the high cost of care. To be eligible for Medicaid, a person’s income and assets have to be below a certain state-mandated level. If you are not moving your loved one to another Medicaid-certified facility, you will have to figure out how to pay for care in another setting.
How Can You Remove a Loved One From a Nursing Home?
Moving a loved one from a nursing home should be done with extreme care and caution. The last thing you want is to exchange one situation for a worse one. We will walk you through the process so you can make an informed decision and make the move as prepared as you can be.
1. Examine your reasons
If you haven’t already thought about this, consider asking yourself: what are your reasons for getting someone out of a nursing home? For some, that may be infection protocols at nursing homes and if your loved one is at severe risk of contracting a dangerous virus like COVID-19.
Nursing homes have been disproportionately affected by COVID-19 with surging infections and an increase in deaths. To mitigate the spread, most nursing home communities have prohibited families from visiting their loved ones. As a result, families are taking people out of nursing homes to protect them from infection and to see them regularly.
Other reasons for taking someone out of a nursing home are the following:
- Poor care or neglect resulting in physical or mental decline
- Your loved one wants to leave the nursing home
- A lack of social interaction
- You are moving out of state, and there is no family to oversee your loved one’s care
- Your loved one has recovered sufficiently to consider a less restrictive level of care such as assisted living
2. Problem solve
You may want to try and resolve some issues at the nursing home if you can. Being involved and voicing concerns might change things for the better, not just for your loved one but for others at the home as well. Consider contacting the director of nursing on care issues and the activities director on the lack of social interaction.
If inadequate staffing is contributing to poor care, there could be nothing you can do. However, make an effort to solve problems by notifying the appropriate people about your concerns. Give people a chance to improve things for your loved one. If they don’t know what the problems are, they can’t address them.
3. Make a report if necessary
Inadequate staffing is no excuse for poor infection control and deficient care. If you are unable to resolve problems to your satisfaction, make a complaint to the Ombudsman program and the department of health.
Your efforts may not change the status of your loved one’s care but could make a difference for other residents and families.
4. Evaluate your loved one’s condition
In your haste to move a loved one out of a nursing home, it is easy to overlook the consequences of such a decision. For someone who is medically fragile, a move could be detrimental to their health. If your loved one has dementia, the stress of a move might not be worth the confusion, trauma, and anguish it could cause.
Try and get other medical opinions about such a move. Ask the providers at the nursing home to give you specifics on the care that your loved one will need. Some of this will be in your loved one’s medical record, but you will need a clear picture of how much help your family member requires. Make sure to get answers to the following:
- Does your loved one need help getting to the toilet and assistance with bathing?
- Do they need help transferring?
- What specific nursing needs do they have?
- Are there special dietary requirements?
- What about IV medications or catheter care?
- Are bed sores an issue and will you need an alternating air mattress?
- Is there special medical equipment that you need to consider?
5. Talk with your loved one
Have a conversation about your thoughts and reasons for considering a move. How will you handle it if your loved one is adamant about not leaving? Try to be respectful and compassionate while reaching a consensus about the potential move. Talk through the process you have in mind so that there aren’t any surprises.
In the end, your loved one has the right to refuse to move. You can’t force someone to do something against their will. If you have guardianship of your family member, you have the legal authority to force a move, but carefully consider the emotional and psychological ramifications.
6. Have a plan at the ready
If you are choosing another nursing home, do your homework and make sure you pick a good one. Get recommendations from other people and look online for any reviews or complaints before deciding. Make a visit to obtain see for yourself how the staff interacts with residents, the level of cleanliness, and a sense of the general ambiance.
If you are not moving your loved one to another nursing home, what is the alternative and who will pay for it? It is crucial that you address your loved one’s complex medical needs when looking for an alternative. In-home care along with temporary home health nursing is a start. Also, if your loved one has sold their home to pay for care, where and with whom will they live?
Be aware of the temptation to jump in with family caregiving. Family caregiving is a time-honored tradition, but once you get started it can take an emotional and financial toll. Bringing a loved one home sounds compassionate, but consider the costs related to home accessibility, medication management, transportation, meals, and medical care.
Depending on the circumstances, assisted living could be another option, but if there are add-on costs for extra care in addition to the base rate, the price could be in the thousands per month. Or, an assisted living facility may decline to accept your loved one if they need too much care.
7. Make the move
Preparing to move someone out of a nursing home takes some time. You want the transition to go as smoothly as possible. A checklist of items to take care of before the move will ensure success. Here are some things you’ll want to have on that checklist.
- Copies of all medical records including history and physical, including all therapy evaluations and notes.
- Double-check the medication list to make sure it is accurate.
- Arrange for outside primary care physician services if your loved one is not going to another nursing home. Securing a primary care physician could take a little time, so try and accomplish this before the move out. You may be surprised at how soon your loved one will need those services.
- Arrange for medical equipment like a wheelchair or another mobility device.
- Have an Emergency Response System in place.
- If you are moving a loved one out of state, you will need to arrange medical transport. Also if your loved one is on Medicaid, they might need to apply for Medicaid in the state they are moving to. The receiving facility should be able to assist with that process.
8. Have a contingency plan in mind
The fact is, you may have to move your loved one back to a nursing home if the following occurs:
- The care you have arranged is not adequate to safely meet your loved one’s needs.
- Cost of care is prohibitive.
- There is an additional injury or worsening of an existing medical condition.
- Family caregiving is unable to continue to provide care.
How to Get Someone Out of a Nursing Home
Much like getting your loved one into a nursing home, getting them out will take some time and planning. While it won’t be easy, as long as you and your family member have decided together about the right course of action, you can make sure to advocate for them to the best of your ability.
Sometimes that may even mean looking at the unpopular option, or something that your loved one may initially dislike. Keeping your loved one’s needs in mind will make you the best advocate you can be.
If you're looking for more caregiving resources, read our guides on self-care for caregivers and self-neglect in aging adults.