Issues in Long-Term Care

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By: Scott Gwartney

I recently received a call from an acquaintance who was aware that I frequently battle with long-term care facilities.

Her request was familiar: My mother is no longer able to live in my home, and needs long-term care. How do I go about searching for the best place to meet her needs? She wanted to keep her mother safe, and it was implicit that she didn’t want to need my services after there was a disaster. She wanted to do all she could to prevent a disaster that needed legal attention. I was glad to do my part to help ensure this dear lady was placed in an appropriate facility, able to meet her needs.

We first discussed the differences between Assisted Living Facilities (ALF) and Nursing Homes. Assisted Living Facilities are often more pleasing in appearance, but provide less care, and usually require someone to pay a hefty monthly bill. In contrast, nursing homes provide more care, Medicare will usually pay for the initial period of rehabilitation, and Medicaid may (or may not) be available to pay for long-term care. I explained to my friend that a doctor’s assessment would be necessary to ensure that the lesser levels of staff in an ALF would be able to adequately care for her mother. The majority of the claims I have handled against ALF’s involve a facility that has accepted (or retained) a resident when that resident no longer qualifies for ALF care. When this happens, ALF staff are placed in the difficult position of providing care to a resident that is beyond what was intended in the ALF setting.

I also explained my long-term care facility tour test looks for Smiles, Smells and Staff.

When visiting a facility, one would expect to find lots of smiles amongst staff and residents if the facility is running well and meeting the needs of their residents and staff. When walking the halls of a residential facility, one should not encounter pervasive, unpleasant smells, as this indicates that staff are not attending to the most basic needs of their residents. Finally, there should be a ready presence of staff, engaged in loving patient care, ready to assist and answer questions. A facility that does not pass the Smiles, Smells and Staff test should be avoided, as these are the marks of underlying issues that result in the horrible claims of neglect that we so often encounter in our cases.

Finally, I advised my friend to take notes once her mother moved to long term care, and work with other family members to make sure that her mother had plenty of visitors who communicated with the family about their observations. I also recommend a collaboration with the families of other residents to check-in on one another’s loved ones and report back. The way we handle the most vulnerable of our citizens is a mark of the most compassionate of society. Do it well!