Guardianship Responsibility, Medicaid Planning, Elder Law.

Elder care for a loved one is a serious responsibility. Like most things in this world it is a complicated. Specialists like an elder law attorney or guardianship lawyer are a valuable resource and can help you. Ultimately the decision to pick the best facility possible for your loved one will be yours to make.

Elder Care Planning

The truth of the matter is that all types of nursing homes exist. Good, bad, and ugly, and everything in-between. Armed with a little knowledge, you should be able to at least make an informed decision that can give you the best possible odds of making the right decision. Guardianship of a loved one is an important responsibility. Here are some guide lines to help you make an informed decision:

• Buy more time. Most nursing home admissions happen after a brief hospital stay. This is usually the cusp event that brings immediate needs to the foreground. If the patients is a Medicare recipient, appeal the discharge to with the hospital’s administration. This should give you two more days. Use this time to gather some human resources. If you do not already have on consider contacting a Medicaid planning attorney. Also use the hospital’s resources. Talk with nurses, doctors, social workers, and administrators. Ask questions and get information.



• Use the Eldercare Locator Hotline. 1-800-677-1116. This agency can give you a list of local long-term-care facilities and the contact information of your local Eldercare ombudsman. While an ombudsman should not (and are not allowed) to recommend on facility over another, they can answer specific questions about staffing, problems, and administration turnover.



• Close to Home is best. Start your search with the facilities closet to your home. It will be more convenient for you to visit. The staff is aware of the residents that get regular visitors. Residents with regular visitors get better care.



• Site Visit. This one is important.

• Pop in unannounced during regular business hours. You will get a better idea of the workings of the facility. Ask for the administrator and request a tour.


• Ask about the ratio of caregivers to residents. Request a copy of the staffing schedule.


• Do you smell any bad orders (urine, feces, or other)?


• Is the facility clean?


• Go into a bathroom. Evaluate overall cleanliness for sure, but what you are checking for is hot water. Lack of hot water is one of the most common nursing home complaints.


• Are the residents in the right places? Seeing residents in activity areas, dining rooms, and outdoors is good. Seeing residents being changed, dressed, or toileted is a sign that the facility does not respect the residents right to privacy or dignity. Also are restraints being used? Restraints might be needed in a medical situation, however a good facility works to meet needs using restraint-free methods.


• Tour the kitchen. A respectable facility should have no problem with this request. Is the kitchen clean? Does it smell good? Are dry good stored correctly? Look in the refrigerator. Are cold foods stored correctly? Is there a dietitian on staff? Do they keep a list of residents food allergies and likes/dislikes? Is fresh drinking water accessible? Dehydration is a special risk for the elderly in nursing homes.


• Inspection Survey. Long-term care facilities should have be able to provide their most recent inspection survey. The report will list the most recent violations found by state inspectors. It is important to remember any inspection is a snapshot of the day and time of the inspection. On any given day, a facility could have more or fewer violations. An inspection may not be representative of the overall, long-term health of a facility. Often violations are corrected on-the-spot prior to the inspector leaving the facility. Read the report carefully . weight the severity of any violations and question the administrator about how they where corrected.

Continuing Needs

Once you have selected a facility and your charge has been admitted there are some things you can do to ensure proper care.

• Get involved! Join family and residents council. Each facility should have one. These groups ensure proper care and treatment for all residents. If you do have the time to become an active member get a schedule and sit in on as many meetings as you can.


• Visit often! Each resident will have a patient care plan. This document outlines all of the care requirements including dietary needs, medications, and rehabilitation directives. The most important thing you can do to ensure proper care of your charge is to visit often and monitor that the patient care plan is being followed.

Elder Law Attorneys Discuss Medicare

In this era of recession, doom and gloom economic new has become the norm. Good news, even a little can be comforting. Average premiums for Medicare Part D will fall slightly in 2012.

The Rising Cost of Medicare

Medicare Part D is a federal program to subsidize the costs of prescription drugs for Medicare beneficiaries. It was enacted in 2003 and went into effect in 2006. Average premiums have not fallen since 2007. In a move to protect their profits insurers set prices high. Premiums fell when the actual costs was lower than expected. Premiums have been on the rise every year since.

Medicare Costs Lower in Boston

The heavy reliance on the use of generic drugs and competition among insurers are the main cost control factors. In a recent study Harvard Medical School and Brigham and Women's Hospital, found that the program had resulted in lower costs for some medications used to treat some common conditions. The study found that in Boston, Medicare Part D reduced health care spending by almost 10 percent.

Medicare Planning

It is important to remember that this is an average of many plans in many regions. So when people are planning for Medicare that some people in some regions will actually see a premiums rise in 2012. So take some time with your Medicare planning, evaluate plans carefully. It is important to note that the enrollment date come earlier this year. It begins October 15th and ends December 7th.