looking for recommendations on nursing homes in Cary and or companies who come in and help individual in their home (Fayetteville: insurance)

[kellygand4]

my mom is very sick with COPD and her health is declining. She currently lives alone but has been in the hospital with heart problems,pneumoniawe are currently not eating at all. I'm not sure if she needs a nursing home at this point or somebody to come in and help her with her daily activities. doctors aren't being forthcoming with information or recommendations. I'm looking for some really good recommendations of nursing homes in both Cary and Clinton NC. also if anyone else has gone through this what they would recommend according to what has happened with their parents and/or patients in this condition.

[poppydog]

So sorry you're going through this. Is she in the hospital now?

There are three levels of care. Independent Living, Assisted Living, and Skilled Nursing. If she's in the hospital the doctors and social workers will most likely make a recommendation for her based on their assessment of her closer to the time of her discharge. They need to get her stabilized first and see what she can do for herself. They will assess her "activities of daily living" such as bathing, eating, etc, and make a recommendation based on that. There are certain criteria she has to reach for each level. They may recommend physical therapy or occupational therapy to help her regain her strength. Medicare will usually pay for 100 days of rehab following a 3 day hospitalization (at a rehab facility or maybe in-home care). You might want to talk to the social worker at the hospital about that if she's currently in the hospital.

If she's not in the hospital it sounds like she might be a candidate for Assisted Living. You can also get in-home care if she would prefer that and is a good candidate. I think you will get better care in Cary, but there are a few good places in SE NC, too. I'm not that familiar with Clinton specifically, but I know there are good places in Lumberton. Surprisingly there aren't very many great places in Fayetteville.

We had my mom in a CCRC (continuing care retirement center) in Chapel Hill, that offers all three levels, independent, assisted, and nursing. Obviously you hope you'll never need the nursing home, but my mom did progress through all three levels and it was very seamless and super helpful.

I have an aunt now who has moved out of her home at 91 into independent senior living, but she has had some setbacks recently that landed her in the hospital and is now looking to find an assisted living facility. With the CCRCs (which are expensive, but mom had savings) you're never put in the position of scrambling to find the next level of care.

[danmcb26]

I own a healthcare recruitment company that specializes in this field. Obviously, if possible, staying home is the best option. It depends on the level of care she needs. If she just needs assistance to go shopping, to drs appointments, and those types of tasks, call comfort Keepers. The specialize in non medical type stuff. If she is terminal, you may want to consider getting a referral for a hospice from your moms doctor. They are reluctant to refer because they lose the patient and money, but if you think she is declining and has 6 months or less to live, being comfortable at home is how I would want it to be.

[Sal_M]

Originally Posted by poppydog

So sorry you're going through this. Is she in the hospital now?

There are three levels of care. Independent Living, Assisted Living, and Skilled Nursing. If she's in the hospital the doctors and social workers will most likely make a recommendation for her based on their assessment of her closer to the time of her discharge. They need to get her stabilized first and see what she can do for herself. They will assess her "activities of daily living" such as bathing, eating, etc, and make a recommendation based on that. There are certain criteria she has to reach for each level. They may recommend physical therapy or occupational therapy to help her regain her strength. Medicare will usually pay for 100 days of rehab following a 3 day hospitalization (at a rehab facility or maybe in-home care). You might want to talk to the social worker at the hospital about that if she's currently in the hospital.

This is not 100% correct. Skilled Nursing Care or Rehab as many called it is generally provided in nursing homes. Yes, under Medicare you get 100 days. BUT only the first 20 days are paid in full by Medicare. Days 21-100 there is a copay that I believe is $155 and change per day. There are con-insurances that cover the co-payment but not all policies do. The other caveat with rehab is that you must have a skilled need to remain covered by Medicare. Physical and Occupational therapy are skilled needs but once you meet all your goals, you need to be discharged even if it only day 20. There are other skilled needs, like wound care, etc.

The other type of care at a nursing home is Long Term Care. Medicare does not pay for Long Term Care, Medicaid does or you can private pay. People who need 24 hour nursing care, qualify for Long Term Care. Some people start out at a nursing home for rehab and then convert to long term care if their situation is such that they can't return home.

Poppydog is right that to be admitted for Rehab under Medicare you need a 3 day qualifying stay at a hospital. To be admitted for Long Term Care you can come from home or the hospital, or another
facility.

Assisted living is typically private pay and not many will accept a person on Oxygen. Is your Mom on Oxygen.

OP, you can get 24 hour care at home too but it can be expensive if you are private paying. I do not know if your Mom is on Medicaid, if so there are some options in the community but they can be limited. Medicaid generally will not pay for 24 hour care at home b/c they pay for a nursing home.

Is your mom still making her own health care decisions, if so maybe the two of you meet with or call her doctor to discuss her needs and a social work referral. If she is still in the hospital as for the social worker to come up and see you. I would imagine they want to talk about Discharge options if she lives alone and her health is declining.

If you chose nursing home care or if she needs it at some point my best advise is the following; choose a place where you/family can visit, it makes a difference to your mom and her care. You can research nursing homes on the CMS.gov website. They post the results of each facility's most recent recertification survey (they are surveyed annually by the State). Also, visit, take a tour, observe the staff and residents. Is the facility clean are the resident's clean. How is the staff/resident interaction.

Sorry to put so much in one post, I do not mean to overwhelm you. Good luck to you and your Mom.