By Howard S. Krooks, Esq., CELA, CAP and Mrs. Gladys Krooks
At the outset of this new blog series, let me state that I’m an experienced elder law attorney with over 30 years in professional practice devoted to elder law and trust and estate matters, representing seniors and people with special needs and their families in connection with asset preservation planning, planning for disability and long-term care, and Medicaid/government benefits planning.
So, with a long history of advocacy in this field, you would think that I would have had some advantage or greater insight when it came to assisting my own mother when she developed the need for long-term care after experiencing some major health issues. After all, this is what I do. I counsel my clients on how to deal with nursing homes and assisted living facilities. I work to make sure my clients receive the benefits they deserve through Medicaid and/or the VA Aid & Attendance program.
However, when it came to helping my own parent through the system, I found that the sheer complexity and amount of time it took for things to be addressed were daunting, if not completely overwhelming – not just for my mom, but for me and my siblings. I wondered how someone without my three decades of experience could make it through this traumatizing ordeal. If I’m confused, then it must be much worse for others. That’s where this blog comes in. I thought if I could provide some helpful commentary and tips on how to navigate through the long-term care system, based on my own experience coupled with my professional background, it might prove to be helpful to others.
As I said above, my mom has experienced some serious health issues recently. I live nearby and have always been available to assist her, but she lives independently and maintains her own home. She was in a facility during the summer of 2019 and then discharged too early, only to end up back at the hospital emergency room two days later. She also went to a long-term care facility and experienced quite a few concerning issues. This blog will discuss some of those issues (without naming names) and offer a few suggestions as to how we overcame them. My mother is my co-author and has generously agreed to share some of her experiences so that others don’t have to go through some of the things that she saw or had to endure.
Some of these issues are not miniscule. When your loved ones are sick or disabled and in need of around-the-clock care, and you entrust a nursing home, rehab center or assisted living facility to provide that care, the last thing you should have to worry about is if their basic needs are being met: Are they receiving the correct medication(s), the best, most nutritious food for their condition, proper bathing and grooming assistance, proper treatment for their medical conditions and comprehensive assistance with basic activities of daily living? It’s not always what you think or expect.
For example, my mom experienced mistakes in her medication management (receiving incorrect dosages and getting her meds at the wrong times or not at all); she was brought the wrong food for her condition; and often had to fend for herself or self-advocate when an unanticipated need arose. For instance, an aide came to her room to change her diapers early one morning. Mom told her that she didn’t wear diapers, and the aide replied, “Oops, I have the wrong room.” Another morning at the crack of dawn, a nurse came in, woke my mom to draw blood and was brutal in how she treated her. Mom complained to the administration, and they had to tell that aide never to come back to her room again.
While my mom is fully capable of speaking up for herself and even chasing down the nurses to get what she needs, other patients, particularly those with some cognitive impairment, are not able to do this. You assume facilities like this are on top of medication management, for instance, but we found you really can’t assume anything. Patients without advocates are often at a facility’s mercy. Any mistakes made might not be caught until the situation becomes dire, or worse, too late.
In addition, we found that there often is a disconnect between the various doctors involved in overseeing the patient’s medical care and the facility, and sometimes communication can be quite poor between the facility and the patient and the patient’s family members. It comes down to this: Without a full-time advocate who knows what to do, the long-term care system can be highly confusing if not utterly chaotic.
As an elder law attorney, I admit things were much more complicated and tougher than I anticipated. With all of these things happening with my mom, I found it challenging to be her advocate from a time-management perspective, including time out of the office and time needed to assist her or follow up with the facility and doctors, and insurance coverage issues. I can’t imagine the process if I lived a few hours away or in another state. You can’t be a responsive, true advocate and effective family caregiver unless you are local and available. If you can’t be there for your loved one and devote the time necessary, you really need a local professional care advocate (known as a geriatric care manager).
There are a great many excellent care advocates out there today, particularly here in South Florida. Be sure to vet them carefully and find out exactly what their expertise is and how many patients they have assisted before you hire one. Elder law attorneys are also a great resource to assist you in this process and work hand in hand with care advocates to assist clients.
In our next post, we’ll discuss some of the issues that my mom experienced at a South Florida long-term care center and what we did about them.
The information contained in this article has been prepared by Elder Law Associates PA, presents general information, is for informational purposes only, and is not, nor is it intended to be, legal advice. Before acting on any of the information presented, we advise you to consult an attorney for advice regarding your individual situation.