Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients – Conclusion

Our current health care reform has several provisions to incentivize states to expand at home care, but there is still a strong “institutional bias” that requires states to fund nursing homes, but makes the payment of nurses for at home care optional.   Despite the savings, participation in  a new Federal pilot program that promotes at home health care is optional for states.

Another trend that has been found is that the population in nursing homes is changing to those who are either sicker, or more economically disadvantaged.   Those with the ability to pay, are moving to assisted living facilities.  Those who do not have as great a medical need (i.e. Healthier, but still in need of assistance) are also better served in more independent living facilities.  This new movement creates a nursing home population that is more disadvantaged both from a medical and a financial perspective.

NPR reports that “By federal law, people who face going into a nursing home must be told about alternatives. But in Miller's study in one state, nearly 30 percent of younger people in nursing homes said they weren't told about options. Often doctors and other health care providers just don't know what's available — and recommend a nursing home instead.”

Many times, when younger people chose to not to into a nursing home, it is at the expense of family members.  These family members provide care at no cost to the state.  While the state gets a free pass, the care giver family members can bear a huge burden in terms of  health, time and stress.

There are alternatives for many younger people to nursing home care.  With an experienced legal advocate by your side, you can also consider independent living facilities.  Many severely disabled people still live full and rich lives, not even in a facility, but with at home care.  It will frequently take an experienced attorney to protect your rights, and to help you determine what care is most appropriate for your situation.

 

We welcome hearing from you if you or a family member has special needs, and is looking for alternatives to nursing homes, or looking for ways to protect your family financially from the costs of long term care.

Call one of elder law attorneys at Cohen & Oalican, LLP Boston, Andover and Raynham.

Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients - Part 2

 

One of the main reasons cited for this movement of younger people into nursing homes are the budget cuts most states face in Medicare and Medicaid.  In the long term, it is more cost efficient to care for a younger person in their home with part time caretakers.  However, in the short term, this is a more expensive way of treating patients, as the caregivers need to be hired and trained.  In the budget crunch most states are experiencing, short term funding takes priority over long term spending.   Younger people are being moved into nursing homes earlier, as in the short term, this is a more economically viable way of treating them.

According to a study by the AARP Public Policy Institute, the cost of at home care is about a third the cost of providing care in a nursing home or institution.  Many states, however, simply do not have the funding for at home care in their Medicaid programs.

One of the most telling quotes about the movement of younger people to nursing homes is:

“Over the past 20 years, federal laws and policies have established a civil right to get long-term care at home. But NPR's investigation found that is only sporadically enforced.

More than 60 percent of what states spend on long-term care for the elderly and disabled goes to pay for people — like Michelle Fridley — to live in a nursing home. The amount spent on home-based care has grown steadily, but not nearly enough to meet the need. Nationwide, there are some 400,000 people on state waiting lists for home-based care, double the number 10 years ago.”

Frequently attorney’s like our firm, that specialize in caring for the elderly, and those that have long term care needs, must be engaged to support a patient’s right to at home care.  In 1999, the right to at home care was clearly established in the Supreme Court, in the “Olmstead Case”.   In that decision, the Supreme Court stated that the unnecessary institutionalization of people with disabilities is  a form of discrimination.

 

To be continued…

Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients - Part 1

We heard the other day on National Public Radio, that one of the fastest growing populations in Nursing Homes is not the elderly, but rather adults   aged 31 TO 64.

These patients that are victims of disease, accident, health failure, or mental health problems.  Many of these new patients could be cared for at home, or assisted living facilities, but are instead finding themselves in the Nursing Home System.  Young people aged 31 to 64 are the single fastest growing population of nursing homes.  This population has grown roughly 40% since 2000.

This report underscores the fundamental need for legal advocacy when considering nursing home care, or alternatives to nursing home care.

You can see the full report here.

http://www.npr.org/2010/12/09/131912529/a-new-nursing-home-population-the-young

 

All too often, people think of nursing homes as a repository for the elderly, and disability attorneys like Cohen and Oalican as being entirely elder law.  There is a huge sense of accomplishment for us, however, when  we can use our skills and help young people, and their families, to live a fulfilling life, perhaps outside of institutional care, and despite their disadvantages.  We have long been involved in special needs trusts to help protect family’s finances when there is a young (or younger) family member with special needs.

 

To be continued….