It was March of 1984 when the envelope arrived in the mail from the New York State Department of Health. I stared at it for five minutes before opening it to find the results of my Administrators exam. Upon opening it, I learned that I had become the latest person to be licensed as a nursing home administrator in the State of New York.
Like most things in life, it was a lot simpler back then to run a nursing home and to access care. Despite all that has happened in 34 years, I have never seen such dramatic changes in our long term care system as what I have seen over the last 18 months. The best advice I can give to the public about navigating these complex changes is to take some time, before you or your loved one needs nursing home care, to get familiar on a basic level of how it works.
There are lots of people out there who claim to be experts in elder care planning but fall far short of having the background and expertise to be able to fully inform their clients. Far too often I see attorneys, financial planners, insurance brokers, clinicians, specialists, and yes, even bothers-in-law that don’t have all the facts. In my many years in this profession, I have seen countless examples of well-intentioned individuals creating unintended situations of distress for patients and families. Having trust in any one of these people is not enough these days.
There is a factor of competence that is not possible for just one of these folks alone to possess with the complexity that I am seeing in today’s world of nursing home care. All of the disciplines that I mentioned above have to work together. Each should gather information and options in their particular area of expertise and then collaborate in order to sort out and deliver a reliable plan for an individual faced with an unexpected need for extended post-hospital care.
Life is full of risks. Some individuals are more tolerant of risks than others and we have all become accustomed to this. The frustration in the risk equation comes when we don’t have all the data and facts needed to properly weigh our decisions and then we find out later that we have a problem. When someone becomes incapacitated or in need of 24-hour care, the window for planning has closed. This is one area where you don’t want to make a mistake.