NURSING HOMES: Protecting Your Loved Ones

1. NURSING HOMES: Protecting Your Loved Ones Yao O. Dinizulu, Esq. AUGUST 19, 2006 www.dinizululawgroup.com (800) 693-1LAW (529) (312) 782-4117

2. Agenda • Types of Nursing Homes • Kinds of Nursing Homes • Modern Epidemic • Nursing Homes Statistics • What is the Right Choice? • How affordable are nursing homes? • What are your Rights? • Where to Go from Here? www.hmdattorneys.com 1(800) 693-1LAW

3. NURSING HOMES: WHY ARE WE HERE? Purpose: Many nursing homes are repeatedly found to be in violation of basic standards where a significant portion of minorities are being taken advantage of and are being treated improperly. Many of these violations go unreported. Consequently: Considering the increasing high numbers of minorities, that are likely to spend time in a Nursing Home I would like to educate the public on; 1)How to detect the need for and plan for a love one to enter a Nursing facility; 2) How to choose and pay for a stay in a Nursing Home;and 3) How to protect a love one who is in in nursing Home. www.hmdattorneys.com 1(800) 693-1LAW

4. Who does this effect the most? • Baby Boomers • Account for 76 million of today’s population • In Illinois alone, Baby Boomers account for more than ¼ of the state’s working population; exceeding 2.9 million individuals • Estimated 2 out of every 5 Americans will need long term care at some point in their life • By the year 2008, 54%of the working population will be engaged in the caring of an elderly individual according to a U.S. Department of Labor prediction • More than 1.3 million people in the United States face every year have to make decisions about extended care for themselves or for their family www.hmdattorneys.com 1(800) 693-1LAW

5. Types of Nursing Homes The quality of care you or a family member will receive depends primarily on how the nursing home is run; the determining fact often times leads to the ownership of the facility. There are two types of nursing homes: • For-Profit- Owned by large corporations with shareholders where many of the important decisions are madeby the Board of Directors (BOD) and the stockholders. • Non-Profit- Established by churches or community action organizations that are attempting to fill a need in their communities. www.hmdattorneys.com 1(800) 693-1LAW

6. For Profit Homes For Profit Homes • In 1998 governmental inspections of 13,693 nursing homes, showed that for profit nursing homes were cited 46.5% more often than non-profit nursing homes by inspectors for deficient care. • This same study showed a disturbing trend where for-profit facilities had lower staffing of registered nurses and licensed practical nurses per patient at a rate of 31.7% lower than non-profit nursing homes. www.hmdattorneys.com 1(800) 693-1LAW

7. Race may be a Predictor • Nursing Homes with minorities are more likely to be cited by the government for quality deficiencies. • These disparities have roots as far back as the 1930s when African Americans could only access public institutions while white Americans received care at private institutions. • AA uninsurable because of race • 1935 Social Security Act passed and only funded private inst and thus fostered segregation in nursing homes. • Study of 96% of all federally certified Nursing Homes showed that minorities are more likely today to be admitted into facilities with numerous deficiencies. www.hmdattorneys.com 1(800) 693-1LAW

8. The Effects of Cost • Minority elders face multiple barriers when they become ill. • Economic –include affordability of private insurance, medicare restrictions and premiums, and Nursing Homes preferences for private pay. • Typical stay in a Nursing 2.6 years at a cost of $52,000 annually. • Cost projected to be $190,600 by 2030. • 2020 minorities aged 65 and older will represent 23% and by 2050 this will increase to 36%. www.hmdattorneys.com 1(800) 693-1LAW

9. How do I pay for extended care? There are three ways to pay for nursing homes: • Medicare- is a Federal Health Insurance Program designed for adults aged 65 or older and those individuals under 65 who have been administered disability benefits for at least 24 months. • Medicaid- is a federally funded program designed to be administered by individual states in order to alleviate the expenses of medical care for lower income individuals requiring assistance. • Long term care insurance- is designed to offset the expensive costs of a nursing home stay. www.hmdattorneys.com 1(800) 693-1LAW

10. Facts about Medicaid • Medicaid pays for nearly half of the nations total costs associated with nursing facilities and specifically includes costs for long term care. • In order to be insured under Medicaid, you must be below the poverty level to qualify. • Dwindling Assets – must dwindle assets to qualify for public aid during statutory period. www.hmdattorneys.com 1(800) 693-1LAW

11. The Difficult Choice • Most families struggle with the choice. • Lack of financial independence by family members to provide care. • Need for fulltime care. • Not placed in a Nursing Home could result in devastating injuries or death. www.hmdattorneys.com 1(800) 693-1LAW

12. The Three Signs Of A Need • 1) Injury -- 2) Illness – 3) Cognitive Decline • Injuries- are when a person is recovering from some physical ailment like a broken hip. • Illness- like Glaucoma bringing loss of sight could permanently alter functionality. • Cognitive Decline- like Alzheimer's presents an obstacle where confusion and memory leave persons vulnerable to dangerous situations like not turning off stove or closing the door. • These are signs where love ones may need to intervene. www.hmdattorneys.com 1(800) 693-1LAW

13. Common Signs of Decline • Common signs of functional decline are: • a)spoiled or improperly stored food, • b)improper preparation of food(burned or undercooked items), • c)uncompleted tasks, • d)difficulty communicating, • e)obvious decline in home cleanliness, • f)repetitive questioning, • g)evidence of improper pet care(empty food dishes, soiled cat litter), • h)decline in personal hygiene, • i)unpaid bills, • j)repetitive confusion about day of week and time of day, • k)strange behavior reported by neighbors and friends. • If you or a loved one suffers from the above mentioned indicators, seek the professional opinion of a physician. www.hmdattorneys.com 1(800) 693-1LAW

14. Kinds of Nursing Homes • There are three kinds of nursing homes: • Long term care facilities- Also known as skilled nursing facility handle a wide range of services for individuals over a prolonged period of time; Residents usually require 24 hour care • Intermediate care facilities- Services rendered are general medical care needs that consist of rehabilitative and recuperative care • Residential care facilities- Residents are capable of functioning and can maintain some degree of independence www.hmdattorneys.com 1(800) 693-1LAW

15. Making the Right Choice When and if the times comes when you have to think about extended care for yourself or for a loved one, making the right choice is key to happy living • You must decide what kind of care is needed (kind of nursing home) • What type of home; profit or non-profit Once you have answered these questions, now it is time to do some research on the homes that are on Your potential list www.hmdattorneys.com 1(800) 693-1LAW

16. Making the Right Choice • Visit their website • Look for is the general level of service • Do the staff members appear competent and happy with their jobs • Look to see if the residents are being treated with respect & are well groomed • Are the residents freely walking about or are they confined in their rooms • evening, or night? • Are the rooms are adequate in size and clean • Do the residents have personalized portions of their rooms? • Are the halls in the facility wide enough to allow wheelchair? • Are there wheelchair ramps for entry and exit of the home? • Resident lounge area- activities for the residents • Is there is a daily schedule of events? (Are there activities for patients that • cannot leave their bedrooms?) • Are there volunteers that visit the home? • Dining area and menu. • Shower and bath area well maintained? • Are the bathrooms and showers close to bedrooms? • Does the toilet have a call button in close proximity? Are there grab bars? • Is their a physician is available for emergencies? • Does the home has a contractual relationship with hospitals? • Ask some of the residents about their experiences and opinions Your Check List www.hmdattorneys.com 1(800) 693-1LAW Id.

17. Protecting Your Loved Ones The first step is recognizing the warning signs indicating Nursing Homes Abuse: Physical • Open wounds, cuts, bruises, welts, and/or skin discoloration or deterioration • Dehydration • Malnutrition • Loss of weight • Burns Emotional • Sudden change in behavior • Emotionally upset or agitated • Extremely withdrawn or non-communicative • Unusual behavior (sucking, biting, or rocking) • Confusion or dementia www.hmdattorneys.com 1(800) 693-1LAW

18. Protecting Your Loved Ones Neglect • Poor personal hygiene • Withholding medication or over-medication • Incorrect body position • Lack of assistance with eating and drinking • Unsanitary and unclean conditions • Dirt, soiled bed, fecal or urine odor These and many other warning signs often go unnoticed by family members. The worst thing to do is to ignore your suspicions. Even the smallest change can be an indication of a much more serious problem. Don't be afraid to ask questions. Make sure your loved ones are receiving the care they deserve. www.hmdattorneys.com 1(800) 693-1LAW

19. Special Attention • One major source of concern is the development of Pressure Ulcers or Bed Sores. • Pressure ulcers, also known as bed sores, can almost always be prevented or successfully treated.  It is important that an at risk resident be maintained with proper hydration and nutrition.  A resident confined to (or allowed to remain in) a bed or wheelchair who cannot be relied upon to turn or reposition themselves must be turned or repositioned by staff every two hours.  Pressure relieving mattresses and special mattresses that automatically reposition the resident every two hours are also used. www.hmdattorneys.com 1(800) 693-1LAW

20. Closing Please remember: “You spend your health trying to gain wealth, you then spend your wealth trying to keep your health” “The more physically, emotionally and financially prepared you are, and the more in control of your own life, the better off you and your family will be.” www.hmdattorneys.com 1(800) 693-1LAW