To Place or Not to Place – Part 1

Caring for an elderly loved one can be a long road, especially if there is chronic illness involved. As the condition progresses, care needs increase. When the care needs exceed the family’s ability to manage, do you hire outside caregivers to provide care and services where your loved one is living today? Or do you place your loved one in a long-term care facility knowing that COVID will limit your ability to see them?

How do you decide? Where do you start?

We posed this question to Debra King, a licensed clinical social worker and one of the elder care coordinators at Takacs McGinnis Elder Care Law. Debra has guided thousands of families through this very situation.

Debra acknowledges that the decision to place a loved one is never easy. “These days, you have to consider the impact of COVID on the placement,” she said. “Once you place someone, your ability to see them or to touch them will be very, very limited.”

That’s why many families are now thinking twice before making the decision to place their loved one in an institutional environment. Most older adults want to live in familiar surroundings for as long as they can. Bringing care into wherever your loved one is currently living is one way to accomplish this, but this solution is not without its drawbacks. While some older adults might welcome professional caregivers, others resist. “You have to start by assessing the current situation,” Debra advises. “What care does the person need? How safe is the home? How easily can the person get around?”

Once you know what you need in the way of care, cost is typically the next hurdle. Home care can be expensive, often far more so than care delivered in a facility, and it’s not always covered by Medicare. “If you bring care into the home, someone needs to oversee it,” Debra explained. “Whoever supervises the in-home care team will do that on top of their other responsibilities in life. And whatever needs the professional caregivers can’t meet will need to be handled by a family member.”

Relocating a senior to a long-term care facility is an option many families choose when their loved one needs more care than they can provide at home. The move can be challenging during normal circumstances, and it’s even more difficult during a pandemic. “Your loved one will go into quarantine for two weeks, which means they’ll be isolated in a room with little contact with anyone,” Debra explained. “After the quarantine period has ended and your loved one has tested negative for COVID, they can move into the general population, but you still won’t be able visit them. Most facilities aren’t even allowing outdoor visits now because the COVID rate is so high. Facetime or window visits are the only option. It’s important to think though how your loved one might cope with the isolation.”

Some families vacillate between the options as they weigh the pros and cons of each; some caregivers know right away that their loved one needs to be placed in a facility. They are very clear that they can no longer meet the person’s needs at home. Some will start with home care and then move the elder to a facility when the needs become too great.

Debra notes a surprising silver lining in the COVID cloud: fewer people are placing their loved ones in long-term care facilities, which means placement is easier than normal. “Nursing homes are offering deals,” Debra reported. “Transfers between facilities and from one level of care to another are also easier. It’s all because they have the availability. They need to have their beds filled. This is good news for families.”

The placement decision can be agonizing for family caregivers, but elder care coordinators working in Life Care Planning Law Firms can make the process easier. “We have decades of experience with the facilities in the Nashville area, and we know the employees at all of them,” Debra added. “We can give good feedback on what you can expect at each facility. No matter what you decide—to place or not to place—we can help you do it with more confidence and peace of mind.”

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