Ethical Issues of Rehabilitation & Assisted Living Facilities

All of a sudden Mom, Dad, or a family member’s health has changed prompting a move from independent living to assisted care. You thought about this being a possibility; knowing their time could arrive and somehow you would be there to assist them.

The speed of their health declining has completely caught you off guard and now it is high noon and time to quickly dive in. Looking for a map to navigate or an instructional playbook?

Guess what? They don’t exist and many issues, ethical amongst others, abound starting a choking cessation. Gasping for air, you scream out begging for assistance and insight.

After multiple falls in the last eighteen months my once proud and very independent 90 year old mom went from her home directly for a six day stint in the hospital. After she stabilized my wife and I in concert with two brothers selected a rehabilitation facility close to our home.

A steep learning curve began. Consider the following:

1)     Who pays for rehabilitation? In the U.S. & specifically Minnesota Medicaid will in conjunction with an existing insurance company pay for up to twenty days; in some cases 100% coverage is provided but each rehabilitation center is different. Get clear & honest answers.

2)     What happens if Mom or Dad experiences a new setback? My mom did and went back to the hospital for round two after using up sixteen days of her allowed stay. We were told by the social worker assigned to us that a reset would happen and mom would start day 1 of new coverage after spending three marvelous days in the hospital.

This turned out not to be the case and we would pay out of pocket for each day she spend recovering prior to securing an assisted living facility. We didn’t think this was ethical; clearly this individual was way off base.

3)     Meanwhile, we were scrambling to visit numerous assisted living facilities relatively close to our home that could meet mom’s daily needs. They aren’t cheap either. Most start around a minimum $3K per month for a one bedroom or studio apartment and do not include ongoing rehabilitation services or other nursing assistance. What funds do your parents and or you have to afford this? It is vital to run the numbers. Having a power of attorney for banking purposes and or a durable power of attorney in place is essential if mom or dad become incapacitated.

If you have questions I would advise consulting with an attorney practicing elder law. Some facilities are only private pay and others have an elderly waiver which can kick in when mom, dad, or family members have burned through most of their assets. Then a local county with backing from your state can contribute to the individual’s living situation.

4)     Fraud is rampant in this area and family members must keep track of all expenses prior to elderly waiver assistance and or military service benefits kicking in. Unfortunately, there are unscrupulous and dysfunctional families who are not ethical and aggressively help themselves to mom or dad’s savings. Do know that local counties, your state, and yes Uncle Sam can come back via claw backs and demand repayment.

Mom moves into her new assisted facility within five minutes of our home on Friday. This brilliant, independent, and loving mother has accepted her new circumstances and lived a sensational life. While she acknowledges her dependence on a staff she has not yet met, outside nursing services, the needed support of her family (she’s been a widow for 36 years) it is incumbent on us to make sure she receives the daily attention and support she deserves. Things never magically happen.

My friends please remember this: respect, consideration, and courtesy matter a lot. Treat others fairly, decently, and equally.

Build your moral compasses carefully and always monitor them daily.

You know the battle cry: do your best each day. No one can ask more or less from any of us.

All the best/blessings, Mark

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