Changing nursing homes is not easy. Regardless of the timing, it can be fraught with unexpected challenges. That being said, changing nursing homes is possible. Change is disruptive for everyone. It is easy to get lost in the details, but don’t forget your parent’s emotional and psychological well-being as you go through the process.
Jump ahead to these sections:
- What to Consider Before You Change Nursing Homes
- Steps for Transferring or Changing Your Parent’s Nursing Home
Our guide will help you think through what you may want to consider before making a move and then taking the transfer steps.
What to Consider Before You Change Nursing Homes
If you are thinking of changing nursing homes, make sure this is the right decision for you and your parent. In light of some of the serious nursing home problems related to the COVID pandemic, you want to make a safe, well-reasoned, and thoughtful decision.
There might be other options to consider before committing to a transfer. Just because your parent is in a nursing home now doesn’t mean they have to stay there indefinitely. Much depends on their physical and mental status and whether there is the possibility of a less restrictive environment. Here are some questions you’ll want to have answered before making any moves.
Are these problems unsolvable?
If you are moving your loved one due to poor or inadequate care, have you made every effort to solve those problems? One complaint, in any long term care setting, is unlikely to get results. You have to be persistent and insistent.
If your parent is having difficulties with aide care, then speak with the aide supervisor. A common complaint in nursing homes is long response times from aides due to inadequate staffing. If there are nursing problems, go to the director of nursing. If there are therapy issues, go to the director of therapy.
Go all the way to the director of the nursing home, if it is necessary. If you still aren’t getting the results you want, it might be time to change. Consider a report to your state’s ombudsman program or the state health department. By making a report, you also help future families avoid similar problems. In some cases, the ombudsman will make an investigation prompting the nursing home to make changes.
What is the medical status of your loved one?
For very frail people, a move might be unsafe. Evaluate your loved one’s medical status by talking with their physician or the nursing home physician who is overseeing their care.
Ask about the physical, emotional, and mental consequences of a move. If the transfer has the possibility of lasting trauma or worsening of a medical condition, you may want to reconsider.
Is assisted living an option?
There are distinct differences between assisted living and a nursing home, but assisted living might be worth reviewing. Has your loved one recovered enough to live safely in assisted living with supportive care? Or can you see if there is a Medicaid Waiver program for a return to assisted living? Depending upon the state, some of these programs support nursing home residents in assisted living communities. Check with your state Medicaid Waiver program to see if your parent qualifies.
Ask for an evaluation by an assisted living community to see if admission is a possibility. If your parent is close to being accepted, consider private duty care as a way to offer more support. Talk with the admissions staff at the assisted living community to determine what kind of care is needed for your parent to be accepted.
Is there a better nursing home available?
Before rushing to find another nursing home, are you sure there is a better one available? By doing your homework, you can choose a nursing home that addresses your concerns and avoid the issues that you are currently facing.
Do your due diligence by checking with state oversight programs like the ombudsman and state health department to get the facts on any nursing home under consideration. Don’t forget to ask about their visitation policy, which could significantly impact your ability to ensure good care.
If it doesn’t look like another nursing home rises to the top of the list, continue working with the current one to see if you can resolve issues. If necessary, hire a private caregiver to be your eyes and ears, report back, and provide additional care.
Steps for Transferring or Changing Your Parent’s Nursing Home
The first and most crucial step to take in moving your parent to a different nursing home is to be very involved. Uncertainty about the decision, concerns about safety, and its effect on your parent can create emotional upheaval for everyone involved. In general, families who are involved see better results than families who aren’t.
1. Talk to your parent
Moving a parent can be traumatic. This can be even more so if they have cognitive impairment and are confused by having to move. A move can have lasting physical and mental health consequences. Consider the possibility of trauma before deciding to make a move. Here’s what to keep in mind when talking to a loved one about a transfer.
You will want to involve your loved one in the decision-making process if possible. Frame the discussion in a collaborative way that seeks your loved one’s opinions and thoughts. If your parent adamantly refuses to move, your family will have to decide whether to overrule their objections. Is the care so bad that it is worth creating an adversarial relationship with your parent? Talk about the situation with other family members.
When talking, try to explain your reasons. If your family member doesn’t have a cognitive impairment, they will probably understand and accept those reasons. When people are in a vulnerable position, they may accept poor and inconsistent care without complaint. Try to reassure your loved one that you have made every effort to find a better place and that you will be with them every step of the way. Provide emotional support and comfort.
If your family member has dementia, you may have to tell them repeatedly why they are moving. If possible, wait until closer to the actual move before talking with your loved one so that the anxiety does not overwhelm them. Moving someone with dementia can be very traumatic. Talk with the staff at the receiving nursing home about strategies to make the transition smoother.
2. Establish good communication
You know the saying, “what can go wrong will go wrong.” Keep that in mind, and don’t leave anything to chance. Even though transfers are a process that nursing homes are accustomed to, don’t assume there will be good communication between facilities. The last thing you want to have is the incomplete transfer of vital health information.
Consider asking for copies of the following:
- care plan
- the history and physical
- medication list
- therapy notes
- aide schedule
If for some reason the information does not get passed on, you have it and can send it on. If your parent is on Medicaid, double check that the nursing home is Medicaid certified.
3. Ask about infection control and pandemic protocols
Ask about the number of residents who have tested positive for COVID and what the safety protocols are. You will also want to inquire about visitation restrictions. If you are unable to visit after your loved one moves, that could potentially increase their anxiety. If visitations are prohibited, ask about video conferencing options and staff availability to assist with this. Check with the state Ombudsman office and state health department about safety complaints and infection control issues at the nursing home under consideration.
If your parent has dementia, it is also crucial to find out about the discharge process. It is becoming more common for nursing homes to “evict” their residents without proper notice or acceptable reasons, even if required by law. Talk with the nursing home about discharges and under what conditions they can ask a resident to leave. Get this information in writing.
4. Advocate for your loved one
Being an advocate is the best way to ensure good, safe care for your parent. Not only will you have more information at hand, you can also recruit other family members so you don’t have to do it alone. Others can help you to come up with a plan on how to share responsibilities. After making the transfer, these suggestions can help hone your advocacy skills so that you can keep an eye on your parent, especially if visits are restricted.
In particular, if there are care issues, keep track using a program like Google Docs so that the entire family can participate. You will want to have specifics handy when speaking with nursing home staff about any problems.
You will also want to call or video conference your parent weekly, at the very least. Observe their demeanor and mood. Take a look at their physical appearance and check to make sure they are clean and well-groomed. Ask about how things are going.
Lastly, being a squeaky wheel is good, but try not to be rude or annoying. Nursing home staff work very hard in difficult conditions. Sometimes a bit of praise will get you better results than being angry, but be persistent.
How to Change Nursing Homes
It won’t be easy, but you’ve got this. It is not easy to make a big change to address the well-being of your parent, especially when it comes to something like long-term care. Make sure to approach the situation with an eagle eye and an advocate’s demand for what is best for your parent. Cushion your efforts with compassion and care, and you will make a successful transition.
Sources
- “State Waivers List.” Medicaid.gov, www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/index.html
- “What to do if Your Nursing Home is Pushing for Discharge and You Don’t Agree.” American Council on Aging. www.medicaidplanningassistance.org/nursing-home-evictions/