Getting Mom or Dad Out of the Nursing Home
Employ "Operation Breakout from the Nursing Home" to spring your Mom out of the old folk's home or liberate your Dad from convalescence care.
By Clare Absher RN, BSN
Need help finding care?
Need help finding care?
Whether your parents have endured a short stay or an extended visit in a nursing home, it is not uncommon for them to vehemently protest staying any longer than necessary. You may hear comments such as: "I hate it here" "I'm desperately home-sick" "They treat me terrible" or still worse "I'm going to die alone in here." It should come as no surprise that institutional living is often an unsolicited, if not dreaded, lifestyle for many of our parents. Furthermore, nursing home placement may have been forced upon our elderly loved ones as a result of circumstances that are no longer relevant.
Very likely your family will view a breakout from the old folk's home in a positive light with regard to your parents' overall welfare. Our elderly loved ones' convincing claim that returning home will bring them great joy can drive us to facilitate this move. The question is whether it is realistic for your parent(s) to age in place, how to ensure they are safe and secure in their home, and how to elude re-admission to the nursing home.
Utilize our Three Phase Planning Guide to help your family plot the course for nursing home liberation. Deliberate, strategize, prioritize, and hopefully opt to commence with "Operation Breakout from the Nursing Home."
My nursing experience, along with my own family caregiving experiences, lends me to advise families that mindful decision making and thorough preparation is key to making this transition successful. Attention to details are fundamental when adapting the home with safety equipment to enhance mobility, prevent falls, and provide security. Undertaking major modifications such as installing ramps, elevators, walk-in showers and widening doorways may be necessary prior to your folk's "escape" back to their home. Arranging in-home care services in advance is paramount, with full acceptance and responsibility of hiring outside help on the part of your parents. Long-term financial planning must include budgeting for home ownership costs and in-home care services.
Phase 1: Meet with Your Family
- Discuss all the pros and cons of moving your parent home. Consider the logistics of whether your parent can be safe, secure and adequately cared for at home. Get all the family members on board and emphasize the team approach.
- Determine the best location for your parent to live; whether it is returning to their own home, when feasible, or moving in with another family member.
- Assign specific family duties to get everyone involved in the process, taking into account individual strengths and weaknesses. Determine the family member who is to be the primary caregiver and those for relief.
- Notify the nursing home director, your parent's physician and other health professionals of the plan to take your loved one home. Employ the nursing home social worker for advice and help with discharge planning.
- Designate one family member as the contact person for communicating with health professionals for purpose of sharing information with the rest of the family. Schedule regular family updates via phone, email and meetings.
- Make a budget for accommodating in-home care services, mortgages, utilities, maintenance, and healthcare. Allocate private funds via savings, pensions and IRAs. Explore possible long-term care insurance and VA benefits when applicable.
Phase 2: Prepare the Home Environment
- Ensure entry walkway is uncluttered, has secure railings on both sides (if needed) and is well lighted.
- Replace outdoor stairs with ramps when stairs become too difficult to negotiate.
- Widen doorways to accommodate walkers and wheelchairs when needed.
- Ensure indoor stairways also have railings on both sides, walkways are free of clutter and everything is well lighted. Install a home elevator when it is the most sensible option.
- Supply a cell phone with handy pre-programmed important contacts and/or a land line with a phone that has large number pads for easy communication.
- Install a reputable home security system for safety.
- Contract with a credible medical alert company for emergencies.
- Be certain that there is adequate lighting throughout the house and install nightlights in strategic locations.
- Furnish the home with chairs/sofas that enable safe transfers to get up and down or purchase a recliner with an auto assist seat lift. Adapt seating with furniture risers and use additional firm cushions to raise the seat level when needed.
- Remove all non-skid resistant rugs and runners from entire home.
- Store prescription and over the counter medications safely and be certain they are clearly labeled. Use pill boxes and alarms to improve medication compliance.
- Lock up valuables, important papers and documents and have system in place for safe mail retrieval and bill paying.
- Reduce clutter on kitchen counters and be certain dishes, pots, utensils, and outlets are within easy reach.
- Identify which bedroom is nearest to bathroom for safety especially at night and/or furnish a bedside commode as needed.
- Install grab bars, safety frame, raised toilet seat on commode, security pole beside commode and add a reachable toilet paper holder.
- Ensure safe transfer in/out of bed and remove bed frame if the bed is too high. Add bedside railings or a security pole beside the bed when needed, or rent a hospital bed.
- Install grab rails or tub bars in shower/tub when extra safety support is required.
- Provide a tub bench or shower chair for use in tub/shower along with hand held shower nozzle and a rubber tub mat (or non-skid strips) in tub.
- Install a walk-in shower when it is the safest option to avoid risk from falling.
Phase 3: Arrange In-Home Care and Explore Community Resources
- Be positive that your parent or elderly loved one fully accepts that in-home care is mandatory (NOT optional) if they are to return home. Stress the importance of enlisting caregivers to help make the transition home a success.
- Weigh out the pros and cons of hiring private caregivers versus an in-home care agency. Note that independent hires may be less costly and the only option in remote areas. Home Care Agencies supervise employees, perform background screening, manage payroll, taxes, and worker's compensation. Agencies also supply back-up caregivers as needed.
- Consult with our online home care directory to identify agencies in your area and request help of our nurses to match your loved one's care needs.
- Research local home care agencies in your community. Interview them on the phone and then in person to gain a sense of trust and compassion.
- Request a meeting with the agency representative at the nursing home with your loved one prior to discharge to establish a contract and devise a plan of care.
- Be sure the plan of care details schedules, caregiver preferences, consistent caregivers, and all expected duties and responsibilities. Address schedule changes, cancellations, emergency procedures, and back-up caregivers.
- Contact local Senior Centers to learn more about resources that are available in your community that might be beneficial to your loved one
- Explore what if any adult day care options are in your community. Arrange adult day care on a full or part-time basis and/or to supplement in-home care.
- Explore transportation and Meals on Wheels services via your local Area Agency on Aging.
About the Author
Clare Absher is a Registered Nurse with 41 years of experience. Most of her experience is in home health serving as a caregiver, educator, patient advocate, and liaison between families and community resources. She has also worked in acute care, assisted living, and retirement settings. She is passionate about helping families care for their elderly loved ones at home.