What Are Your Care Options?

Question: My mother was recently hospitalized for injuries received when she fell out of bed at the nursing home where she resides. The hospital is telling me she is medically ready to be discharged back to the facility. I no longer feel confident in the care provided at the nursing home. Do we have any options?

Answer: We all want to believe an environment exists in long-term care services where the first priority is what’s best for the patient. The reality is that payment sources and regulations sometimes dictate how decisions are made. These factors create stress for all involved, including the patient, family, and health care professionals.

The hospital has both an ethical and fiscal responsibility to closely monitor any patient receiving care. It is challenged with balancing the need to provide appropriate medical care and being cognizant of the limited financial reimbursement for that care.

Once it is determined the patient no longer needs the level of care provided in an acute hospital setting, the goal is to expeditiously discharge the individual back to a rehabilitative, long-term, or community setting (whichever applies).

Families should openly communicate with hospital discharge planners when hospitalization first occurs. Be honest about your concerns relating to the incident when your mother was injured. If this was a result of neglect or abuse, the Department of Public Health should be involved to formally investigate the incident and determine responsibility. During this process, discharge planners can work with you to pursue alternative placement.

If the only space available is where your mother previously resided, don’t be completely discouraged. Closely monitor the environment after your mother returns to the nursing home. Request a family meeting with a representative from the Long-Term Care Ombudsman Program. This person can advocate for your mother and alert facility staff about your concerns and reservations. And, there is always the option of transferring your mother to another facility once an opening occurs. After meeting with the ombudsman, you may continue to believe it will be in her best interest to request a transfer, or you may find the accident was an isolated incident and your concerns for future care are lessened.

You can reach a Long-Term Care Ombudsman by calling Mystic Valley Elder Services at 781-324-7705.