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    Rethinking Home Care: When Is The Right Time To Re-Evaluate? By Lance A. Slatton

    By Lance A. Slatton


    Providing care for a loved one at home can often be a rewarding but challenging journey. While many families aspire to keep their loved ones in a familiar environment, there may come a point where re-evaluating the caregiving situation becomes necessary. Recognizing when it’s time to reconsider home care and explore facility-based care is a crucial aspect of ensuring the well-being of both the caregiver and the individual receiving care. But this decision can also raise numerous questions. 


    To make this process a little easier, we have pulled together a list of the top five things to consider when rethinking home care and making the transition to facility-based care.


    Medical and Care Needs


    You may consider rethinking home care when your loved one’s medical and care needs surpass your capability to provide home-based services. If the complexity of required medical treatments, monitoring, or assistance with activities of daily living exceeds what can be provided at home, transitioning to a facility may be necessary. 


    Regular assessments by healthcare professionals can guide this decision. Factors to be considered include deteriorating health, increased dependency, or the need for specialized care. Facilities often offer a more comprehensive range of services and skilled medical support when home care is no longer an option.


    When exploring facility-based care, it is important to evaluate the current and anticipated medical and care needs of your loved one. Facilities vary in the level of care they provide, ranging from assisted living to skilled nursing care. Ensure that the facility can meet the specific requirements of your loved one, including medication management, therapy, and any specialized care.


    Cost and Financial Planning


    Re-evaluating home care costs when there’s a significant change in your loved one’s health can be daunting. You’ll need to assess financial resources regularly to accommodate unexpected expenses or changes in care needs. If your loved one’s condition progresses, making home care impractical or insufficient, it may be time to reconsider facility care options. 


    Periodic reviews, especially during life events such as retirement or changes in income, can ensure financial plans align with evolving care requirements. Stay informed about available assistance programs and insurance coverage to optimize financial arrangements for sustainable and quality care. Regular financial check-ins provide flexibility and adaptability.


    Understand the costs associated with facility care, including monthly fees, additional services, and potential future increases. Explore available financial resources, such as insurance, long-term care policies, or government assistance programs. Consider the long-term financial sustainability of the chosen facility and how it aligns with your family’s financial situation. Medicaid is a benefit for qualifying individuals based on the state that they reside in and keeping in mind that each state’s Medicaid coverage is different depending on the state you reside in. With that said Medicaid is a benefit that should be discussed with an Elder Law attorney to fully understand the ramifications of choosing that route. When seeking a Long-Term Care facility your options may be limited by ones with Medicaid beds available. With Medicare, individuals will be allowed up to 21 days as an in-patient in a Long-Term Care facility. There will be co-pays associated with exceeding your allotted Medicare days of coverage in a Long-Term Care facility. Oftentimes, families believe that Medicare and Medicaid will cover these in-patient stays in facilities and that is not the case. There are limits, restrictions, and requirements for both. 


    Location and Accessibility


    Consider the location of the facility and its proximity to family and friends. Accessibility is essential for regular visits and emotional support. Additionally, assess the facility’s environment, amenities, and overall atmosphere to ensure it aligns with your loved one’s preferences and lifestyle.


    Social and Recreational Opportunities


    Examine the social and recreational activities offered by the facility. Social engagement is crucial for emotional well-being, so ensure that the individual has opportunities to participate in activities that match their interests. Facilities with a variety of programs and outings can contribute to a higher quality of life.


    Quality of Care and Reputation


    Before transitioning to facility-based care, it is important to research the reputation and quality of care provided by the facility. When assessing facility care quality and reputation, scrutinize online reviews, testimonials, and inspection reports. Families can visit the Medicare website and review ratings and reviews by Medicare for facilities’ safety, quality, and patient satisfaction. There are also reports of any infractions and penalties that facilities may have faced. 


    Conduct on-site visits to observe cleanliness, staff-resident interactions, and the general atmosphere. Inquire about staff qualifications, training, and their approach to resident care. Speak with current residents and their families to gather first-hand experiences. Visiting the facility in person and talking to current residents and their families can provide valuable insights.


    Research the facility’s compliance with regulations and any history of violations. Seek recommendations from healthcare professionals and local agencies. A facility with a positive track record, satisfied residents, and a commitment to regulatory standards is more likely to provide quality care and a supportive environment.


    Final thoughts


    Deciding when it’s time to transition from home care to facility-based care is a complex and daunting process. It requires careful consideration of your loved one’s evolving care needs, safety concerns, your own well-being, social aspects, and financial implications. By approaching this decision with compassion, open communication, and a focus on the best interests of your loved one, your family can navigate the transition thoughtfully and ensure that the most appropriate and supportive care is received. 


    Before making any decisions, it’s advisable to consult with healthcare professionals, social workers, and financial advisors who can offer personalized guidance based on your specific circumstances and needs. Additionally, involving your loved one in the decision-making process, to the extent possible, is essential for ensuring their comfort and satisfaction with the transition. When the time comes for a loved one to make the transition from home to a facility, there are a lot of emotions involved, and it can be a difficult time not only for the individual making the transition but also for their family and friends. If they are still competent and aware of what is taking place, it is important to be patient and understanding during this life-altering transition. They most likely have lived in their home for many years surrounded by familiar items and treasured memories (and some of those items can be brought to a facility). A good piece of advice that can help soften the move is sitting down with them and explaining that they are loved and that things can be replaced, but people can’t be. Then explain that this transition is being considered for their own comfort and safety and that the care and support that they now need can no longer be provided in the home. There is always the possibility, if they recover or if their health improves, that they can return home when it is safe for them to do so. 


    Lance A. Slatton CSCM is a healthcare professional with over 18 years in the healthcare industry. Lance is a senior case manager at Enriched Life Home Care Services in Livonia, MI. He is also host of the podcast All Home Care Matters, a podcast and YouTube channel. By subscribing to All Home Care Matters, you will gain access to a wealth of information and tips that can help you provide the best possible home care for your loved one. Lance writes a monthly column on McKnight’s Home Care website and he was named a 50 under 50 for 2023. Lance’s brand new book, The All Home Care Matters Official Family Caregivers’ Guide, is a road map for family caregivers from the start of their caregiving journey to the end, and everything in between. Lance can be reached at [email protected].