Nursing home care does not have to be exclusively administered in a nursing home. In some cases,you can bring the nursing home care into your own home.
When Harriet’s husband of 40 years was rushed to the hospital, she was informed that he was suffering from congestive heart failure and had only six weeks to live. The hospital recommended placing him in a near by nursing home where the staff could keep him comfortable in his final days. Initially, Harriet agreed, thinking she had no other options. The facility was accessible by public transportation, but Harriet figured it would take at least an hour and a half every day to travel to and from the facility, time she would prefer to spend with her husband, Sam. She was also certain that no nursing home staff could care for him with as much love and commitment as she could.
Harriet spoke to the hospital doctor about her concerns. The doctor explained that Sam needed special equipment to maintain his comfort, but did not need staff with specialized training. As he put it in his own words—Sam’s care was not rocket science–a smart person could be trained to monitor and take care of him. The most difficult part of caring for Sam would be the extreme amount of time and the intensity of care he required; not many families were up to the task of caring for someone 24 hours a day. Other families had tried it and had ended up bring their family member back within a few weeks. It can be an exhausting task no matter how much they wanted to do it.
Nevertheless Harriet decided to give it a try. She researched her options and learned that Medicare would cover the cost of the required durable medical equipment including a hospital bed, a wheel chair, oxygen and oxygen equipment, a commode, a patient lift, medical gloves and other medical supplies.
She consulted Con Edison on how to rewire her apartment to sustain the medical equipment and registered the equipment with the manufacturers. She purchased an emergency generator in case of a power outage and ordered standing shelves to hold all necessary medical supplies. She moved all this into the L shaped dining room/living room area of her one bedroom apartment and turned it into a care center.
One big hurdle was staffing. Harriet had limited money so she decided to hire privately. She was able to get qualified referrals through hospital personnel and friends. Each applicant was interviewed extensively and references were checked. When she finally selected her staff, she set up a series of training sessions. Then she scheduled her team for round the clock assistance.
Finally Harriet ordered transportation and brought Sam home where he lived another nine months. Occasionally the hospital staff who had counseled her dropped in to see how she and Sam were doing. They were astonished at the quality of his care. Harriet says the months they spent together were worth all the hard work and she never regretted her decision.
This is not a plan everyone should attempt, but for a person with enough dedication, perseverance, organizational skill and commitment, care for someone at home is an option. Harriet was able to meet the expenses of the required equipment because she was aware of Medicare’s durable equipment program.
Harriet was also fortunate that she was able to hire her staff privately. For people who do not have the financial capabilities to pay a staff, Medicaid can offer assistance through the government‘s Consumer Directed Personal Assistance Program (CDPAP).
CDPAP is a program that allows chronically ill or physically disabled individuals with medical needs (including the elderly) to choose who takes care of them rather than go through official channels. Even better, the caregiver is paid by Medicaid. The program which was rolled out in New York in 1995, allows a patient or her family to hire, train and supervise the caregiver. What makes the program particularly attractive is the recruit does not necessarily need to be a professional; He or she can be a family member as long as he or she is not the parent or spouse.
Another big advantage is that the recruit is permitted to perform skills not usually permitted by unlicensed staff. These tasks can include treating wounds, suctioning trachs, intravenous feedings and other medically necessary tasks.
Before a person can participate in the program, a doctor must request services to the local social services district. A nurse makes a home visit and determines the amount, frequency and duration of services.
Medicare Part B Durable Medical Equipment program and Medicaid’s Consumer Directed Personal Assistance Program are two programs that can allow those families with commitment and perseverance to develop a personalize program that can keep a loved one at home even in the most trying of circumstances.
Often families believe that when a loved one’s condition reaches a certain level of severity their only recourse is to place them in a nursing home and let staff take care of them. However with the assistance of the federal government’s health care programs, some families are able to keep loved ones at home, taking a personal role in caring for them in the final days. Many times, as Harriet will tell you, this is a blessing they never regret.
Know someone who can use this information?—Pass it on!!