In This Issue

	Nursing Homes in Georgia
	If you answer yes to any of these questions, Hurley Elder Care Law can help
	Life Care Planning Goals
	The 2007 Hurley Elder Care Law Handbook of Resources

Nursing Homes in Georgia

	Your mother has just fallen and broken her hip. She is in the hospital recovering from surgery when the discharge planner speaks to you and says “Your mother is going to have to go to a skilled nursing facility for rehab. If she recovers well, she may be able to go home, but if she doesn’t she may be in a nursing home permanently.” This is truly difficult news especially when you are in a state of shock. What do you do, where do you turn, how will you pay? The task can seem overwhelming. The discharge planner will help to make initial contacts with facilities in hopes of finding a rehab bed, but do you know if the facility is good, do you know if the facility will take your mother’s Medicare supplement, do you know if this is a place where you may want your mother to be long term? These are all things to consider and there is usually a very short time frame in which to make a decision. First, we will take a look at some of the things to consider when choosing a facility.
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If you answer yes to any of these questions, Hurley Elder Care Law can help.

		Has the elder been diagnosed with a mentally or physically debilitating disorder such as Alzheimer’s, Parkinson’s, ALS, stroke or a decline in functional capacity?
		Is the elder isolated due to the recent death of a spouse, or have family that either lives too far away or is too busy to provide adequate care?
		Is the elder soon to be discharged into a care facility or currently receiving in-home care?
		Does the elder have a variety of healthcare providers and need coordination and advocacy for quality care?
		Does the elder seem unusually concerned about costs of medication and services, indicating he or she may be having financial troubles?
		Does the elder have assets that fall between $50,000 and $400,000 – enough to finance a short stay in a care facility but not enough for an extended stay?
		Does the elder have a spouse whose financial needs must be considered in light of the elder’s medical condition?

Life Care Planning Goals

1. Meeting the elders’ immediate health care and long-term care needs.
2. Making sure the elder/family is making good health care and long-term care decisions.
3. Helping the elder/family sort through the maze of their long-term care options including residential options.
4. Identifying and accessing public benefits and resources to pay for care should the elder meet the qualifying criteria.
5. Help with asset management, including the burden of home ownership and personal property.
6. Providing the entire family the peace of mind that comes from knowing their loved one is monitored by a team that combines legal and financial expertise with specialized knowledge of the elders’ physical, mental and emotional health.
7. Ensuring the highest level of independence the elder can achieve, while ensuring safety.

Nursing Homes in Georgia

Selecting a Skilled Nursing Facility Selecting a nursing home can be a very time consuming and frustrating process. However, if you have a list of things to look for, the course of action can be easier. Here are some tips that may make the process of finding the right facility easier: Visit several different nursing homes before making a choice. Each nursing home has unique qualities and you may prefer one over another. Making a good choice is important since you would like for your loved one to be as comfortable as possible. Visit the nursing home at least twice at different times of the day. This way you can meet different staff members and see if a consistent routine is followed. Look at the cleanliness of the facility. Is there an overwhelming urine smell? Remember a slight odor is not always bad since nursing facilities handle incontinent persons. Ask what social activities are provided for the residents. How often are the activities held? Are their special activities for clients with dementia? Is there a daily exercise program? Is the food attractive, and appealing? Are the meals appropriate to the resident’s needs, i.e. low fat, diabetic? Are the staff levels on the weekend sufficient? You can also check to see how many deficiencies that a particular facility had at its last inspection by going to www.medicare.gov. Once a facility has been chosen, it is very important that you attend the assessment and care planning meetings. These are the methods that staff members use to get to know a resident and plan to meet that person’s individual needs while living in a nursing home. The more input that you provide, the better your mother will be cared for. How to have a Meaningful Visit with a Loved One in a Nursing Home: Visiting a family member or friend in a skilled nursing facility can be a difficult experience, especially if your loved one has Alzheimer’s disease or some other form of memory loss. Conversation is often one-sided, and family members generally struggle with how to fill the time. When it is time to leave, the person you are visiting may become agitated. Successful visits begin before you enter the facility. You should take a few minutes to slow down and shut out the pace of the outside world. You may even want to have a conversation starter with you like a flower, a photo, a favorite fruit or even a small pet. Timing is everything in a nursing home visit. Family members with Alzheimer’s disease are usually at their best in the morning. Late afternoon may result in fatigue, anxiety, and confusion. One strategy to consider is to arrive about 30 minutes prior to a meal or scheduled activity. That activity offers a convenient way to end the visit as your loved one goes off to his or her next event. Alternatively, you may choose to participate in the activity or meal with your loved one to provide something meaningful for the two of you to do together. During your visit, you and your loved one can view a photo album or listen to familiar music. You can take a walk around the community or a car ride to a favorite location. Reading aloud from a book or short, simple stories or poetry can be meaningful to some family members. Allow your loved one to reminisce, even if you have heard the same story many times before. A visit does not have to last for hours. In fact 30-45 minutes is more than sufficient for those with dementia. If leaving is difficult, find an activity, nearby friend or staff member to occupy your loved one so that goodbyes can be quick and painless. Though the visit does not have to be long, employees in the facility know which residents have the most guests, and the residents with the most guests typically get the best treatment from the staff. We will next look at the basic options for paying for the skilled nursing facility. Paying for a Skilled Nursing Facility Most nursing homes in Georgia cost between $60,000 and $75,000 per year. Obviously this is a huge expense. There are four basic ways to pay the cost of a nursing home including: Private Pay with funds from the individual or their family. Long-term care insurance. Veterans benefits Medicaid, which is a joint state and federal program that pays the cost of a nursing home if certain asset and income tests are met. Additionally, it is true that Medicare will pay for the full cost of a nursing home stay for the first 20 days if your mother was first in a hospital for at least three days and then transferred directly to the nursing home. If the patient is making progress with their medical condition, the next 80 days may be paid with a deductible of approximately $124 per day as the co-payment for 2007. Qualification for Medicaid to pay for the nursing home is based on some fairly strict tests on the amount of income that you have and the assets that you can keep. The laws and policies pertaining to Medicaid change frequently, as such, it is important that you check with an Elder Care Law Firm for specific answers to questions. In general the primary exempt assets for a client are: The home as long as the equity is no greater than $500,000. Household and personal belongs such as furniture, clothing, and jewelry. One car. Burial plot for the family member and his or her spouse. Retirement accounts if the account is receiving the required minimum annual distribution or if owned by the non-Medicaid qualifying spouse. Cash not to exceed $2,000. All other assets are not exempt which includes a second car, checking account, CDs, stocks, and other assets. The current maximum income for a Medicaid recipient is $1,869 per month. References One good place to start is with a list of nursing homes in your area and the Web sites and phone numbers that provide information on quality issues. A list of skilled nursing facilities can be obtained from the Georgia Council on Aging at (404) 657-5343 or http://www.gcoa.org or the Alzheimer’s Association at (404) 272-3900. Another good reference is the “Nursing Home Compare” section of the Medicare website at www.medicare.gov to find detailed information regarding past performance records of all nursing homes nationwide. At third good reference is the State of Georgia Long Term Care Ombudsman at (404) 371-3800. This office acts as an advocate for nursing home residents and will know about complaints that have been made about specific skilled nursing facilities. Their website is www.georgiaombudsman.org.