The scouting motto to ‘Be Prepared’ is also a great motto for those of us who are caring for an aging parent. No matter what interventions we put into place to help and protect them, you still may be faced with a crisis situation which ends in a trip to the hospital.
First you need to prepare for this eventuality. (See: In Case of Emergency) You can do things now that will help you in navigating the hospital encounter should it come to pass.
The next thing that I would encourage you to do is to consider and plan on the need for nursing care after a hospital stay. It may be that the medical condition of your parent after the hospital admission is unstable or tenuous enough that Mom or Dad may need to have some post acute care for a time. This may be for ongoing medical treatment for an illness, such as pneumonia, or may be for therapy to help them return to their former level of functioning. This can also, unfortunately, turn into a permanent situation.
Because of the turmoil that surrounds the crisis of the illness or injury leading to the trip to the hospital, it is to your advantage to know beforehand what the ‘plan’ might be for post acute care.
Once your loved one is in the hospital there will likely be a social worker or case manager assigned to begin planning, even from day one, for the discharge. If Mom is going to be unable to return to her prior living situation, you will be asked where you would like for Mom to go after the hospital stay. You may be asked to make a relatively quick decision about this without much opportunity to go and visit the different facilities that are being offered to you. And if you are not able to designate where you would like for Mom to go, they may have to make arrangements with a facility that you are not familiar with. The case worker will help you find and identify facilities that are able to take an admission. Most facilities have liaisons that come to the hospitals to meet with the patients and their families, but I still feel that this can put you in a position to be making a decision while under pressure!
As my father was beginning to have more frequent falls (some with some pretty spectacular injuries but no broken bones!) and his dementia was clearly advancing, I suggested to my mother that she needed to start visiting some local facilities so that she could make a determination about where she would want him to go if and when the need arose (I was thinking fall resulting in broken hip??). With the help of my brother, she visited the facility up the street from her and they were able to decide that they felt good about that particular location. The residents looked clean and well cared for, the nursing staff they met was responsive to their questions and the facility looked well maintained. I had prepped them with some particular things to ask and look for before they went.
Though the plan may have been to check out a few other options, as luck would have it, before that could be done my father was in the hospital.
When asked by the case manager at the hospital, we were able to indicate to them where we would like for Dad to be sent after his hospital stay. Since my mother and brother had recently been to the facility and made some ‘pre-arrangements’ there, we were able to drop back in and make final arrangements for Dad to be brought to that facility when he was discharged from the hospital.
I can’t tell you what a relief that actually was in the middle of the crisis moment! To nothave to feel that you are scrambling to make arrangements while in the middle of dealing with the actual crisis is a huge gift to yourself.
If you have an aging parent I would encourage you to plan ahead a little bit. Visit different facilities and get information. Talk to the staff. Look at the residents to see if they appear to be well cared for. Drop in unannounced. Research the facilities survey results (Medicare site: Nursing Home Compare) which will tell you what types of deficiencies the facility was cited for on the last visit by the state. Ask questions!
Allow your loved one to participate if that is possible and let them have as much input as you are able to. Find where they (and you) feel the most comfortable. Think about things like location and how easy it will be to get there for visits. All of these things will make the transition smoother for all involved.
Remember, a nursing facility is never going to be home. This is not going to be one-on-one care. No matter how lovely the facility may be, be realistic in your expectations and focus on finding the best possible place for your loved one.
Then you will be prepared if and when the time comes.