VA Nursing Homes- Help wanted!

Nunya, BSN · Feb 20, 2021

https://r.search.Yahoo.com/_ylt=AwrJ61bZjjBgGmcA9q5x.9w4;_ylu=Y29sbwNiZjEEcG9zAzEEdnRpZAMEc2VjA3Ny/RV=2/RE=1613823834/RO=10/RU=https%3a%2f%2fhealth.usnews.com%2fbest-nursing-homes/RK=2/RS=Ag2cheI7p7wrDNsRCkAPsiWE4Bs-

And...

https://r.search.Yahoo.com/_ylt=A0geK.dCjzBgNn0AHnNx.9w4;_ylu=Y29sbwNiZjEEcG9zAzQEdnRpZAMEc2VjA3Ny/RV=2/RE=1613823939/RO=10/RU=https%3a%2f%2fnursinghomerating.org%2f/RK=2/RS=H1fFp3HH6XqhGGs5njecsVNqCf4-

I used a govt site but u can't remember which one, sorry. Just made sure you Google individual homes when you find some you like and look at the comments and the most recent ratings on safety etc. Do not trust anyone when they recommend one without looking at the ratings yourself, I was looking for a memory care unit for my Dad and one place mentioned another place that was on the state watchlist. She lost a lot of points right there in my book. Get her on the VA home waiting list now, before you even look at it, as it's likely to be long. After you've looked at tenured then go look at the facility. Many only have 1-2 RNs, and mostly on days. They're required (at least in FL, not sure if it's federal law) to have three number of staff working that shift prominently posted. Sounds like she only needs memory care now but I would advise one that has long term care with it as it might come to that, and ask if she would have priority. They can, and will, refuse readmission from a hospital if they decide for whatever reason they can't continue to care for her. Look at what you'll have to pay for in addition to the room, food, and care. Adult briefs, how much meds will cost cuz they'll get them from somewhere other than where she's getting them now, cable TV, phone etc. How does it work with outside doctors; one place had podiatry come in once a month so that was easy, other places they have to be taken to. And who will take them, the facility or your parents? Look at activities, do they have a lot? Holiday parties, Happy Hours? Even if she doesn't participate a robust activity program shows that they're more likely to help her find something she likes. My Dad liked the Friday Happy Hours...music, finger foods and he got a beer, and my mom liked going to. Are they open to visitors 24/7, and nowadays what are their Covid rules? Look at the rooms themselves, are they like many semi-private hospital rooms where you walk past one person's bed to get to the other, or are the beds on opposite sides of the door so more privacy? Windows? Single or double rooms? Can she bring her own furniture to make it seem more like home and for her to have familiar things around? Is PT/OT available if she needs it? What's the food like, will she have choices? Snacks? Can your parents bring food in for her, is refrigerator space available?

And finally, have your parents thought about having her stay with them? There's pros and cons but one big pro is that it'll probably be cheaper. One big con is household disruption. Good luck, there's a lot of things to look at.

CharleeFoxtrot, BSN, RN · Feb 20, 2021

On 2/16/2021 at 4:25 PM, mrsmrs12345 said:

Hi,

I'm a nurse in NY and I'm trying to help my parents look at nursing homes from afar for my grandmother in IL who has rapidly advancing dementia but no other medical issues other than mild osteoporosis. She's eligible for VA benefits so we want to explore all options starting there but it's super overwhelming. Does anyone have any suggestions about how to begin looking/how to tell which ones will be good? She's near Chicago if that helps. I'm not sure if we can give names but I'd love PMs or any info that might be helpful.

Thanks!

I'm currently a case manager in primary care, so I run across this scenario quite a bit. First suggestion would be to take a deep breath and begin to jump through the hoops needed for the VA. The process can take 4-6-8 months but in the end those benefits can be a game changer.

As far as distance placement for living arrangements I refer dilemmas like yours to https://www.aplaceformom.com/

It's a free resource, the nurses that vet the living facilities are quite knowledgeable about the areas they cover, and can help point the way. Like anything else, do your homework on any facility they might recommend. They also have information on local AFC homes, which might be an option, as a lot of them are quite nice and have a more personal atmosphere than a larger facility.

The biggest problem with having a loved one in a facility far away from family support is coordination of care. I've seen this turn into an absolute nightmare for families. Is there support for her that would be local to Chicago? Able to check on her regularly and be the front person for care coodination? If not then consider moving her in close proximity to family that is willing to take up that burden.

YMMV, just my 2 cents. Best of luck to you and yours!

amoLucia · Feb 20, 2021

Both PPs, Nunya & Charlee offer excellent advice. As a retired LTC/NH RN, I can see their experience coming through. I will most heartily agree that you start your quest AS EARLY as poss! Rule of thumb - anything federal takes FOREVER!

But I do have concerns re your Dad and the distance bet you & them. What happens if his health/status were to make a sudden decline? He sounds healthy now, but ... Could you manage their needs long-distance? Esp something sudden & unexpected & needing IMMEDIATE attn. Might DUAL placement be an option ASAP? He wouldn't have to travel to visit her and he would be a point of familiarity for her.

Make sure all their legal, health and financial affairs (ie will, POA, AdvDir) are in order as much as poss NOW. As time progresses, competency can become problematic and those issues become more so.

I have known pts who had legally appointed Guardians/Trustee (or some such title). There might have been family but they were absent or non-caring. But it sounds like you want to be involved, so these are just some suggestions to make your concerns more manageable for you.

In a nutshell, start EARLY and get the financial details squared away (that freq is the biggest handicap).

Good luck to you and your folks.

mrsmrs12345, ADN, RN · Feb 21, 2021

Thank you SO much for your replies!! Im going to share this information with my family so we can brainstorm using this as a jumping-off point. We are exploring any and all options.

thanks again!