The 72 Hour Crisis

By Janice Martin, Owner of Senior Liaison of Central Florida

It is completely understandable that we wish to remain in our homes rather than moving to senior living. Our home is our sanctuary where we are protected from the dangers and uncertainty of the outside world. It’s where we (mostly) have control of making our own decisions and have independence. A number of people will tell me emphatically that they will NEVER move to assisted living or a nursing home and plan to die in their own home. I support this 100% whenever possible. But I also understand that there may come a time when this is no longer possible.

Just like the promise to “never put me in one of those places,” and the belief that you will remain in your home regardless of the situation, it is often made when the possibility of future needs are not fully appreciated. There may come a time when a person’s care needs, safety, or physical and emotional toll on the caregiver are too great. Although your desire is to avoid it – if that time does come, I urge you to be prepared.

The situation that often presents itself is when an individual has been living in their own home with minimal care needs. Everything is going along fine until one day a significant event occurs. It could be a stroke, a fall, a diagnosis, or an accident, and suddenly your plan is no longer an option. The person is sent to the hospital and then transferred to rehab. The rehab social worker connects me with the family and I’m told that this person now needs 24 hour care and cannot be safely discharged home. I speak with the family, and they tell me that the person is nowhere near their “100 days” and they’re not ready to talk about options until they see how much progress is made with therapy.

What is misunderstood is that the 100 days are not guaranteed, and the rehab has no control over the discharge date. It is completely determined by the Medicare provider and if your loved one is on an advantage plan, it can be sooner than the family believes is a safe discharge. I have received many phone calls from families telling me they had a care plan meeting with the rehab at 2:00 and told it could be a few weeks until discharge. Then at 5:00, social services receives a notice from insurance that the person is being discharged in 72 hours and crisis ensues.

If you have made no preparation for the next step and your loved one is not safe to return home and/or needs 24 hour care, you now have less than 72 hours to find a place that has availability, visit it, do the paperwork, arrange for a mover, schedule transportation to the new community, and try to breathe. AND, that discharge date could be on a Friday, Saturday, or Sunday when many assisted living communities don’t allow for admissions.

I encourage you to consider that alternatives to returning home should be discussed on the day of admission to the rehab. Ask the social worker to connect you with a company such as Senior Liaison of Central Florida to help you navigate all options available to you and to locate a good assisted living if that is what is recommended. If you merely talk about assisted living, or discuss the different kinds of assisted living based on care needs, visit assisted living, or have an assisted living come to do an assessment, you are not obligated to make a move or even a decision at that moment. But at least you are taking some control of the situation that will go a long way to reducing everyone’s stress when the discharge date is looming in front of you.

If your loved one is determined to return home and insists on 24 hour care, the cost can be staggering at $30 an hour. Consider the math…$30 times 24 hours equals $720 a day! That’s $5,040 a week; $21,600 a month vs. about $4,200 for an assisted living studio apartment with care.

Therapy can be continued in the assisted living community through Medicare as an outpatient. Communities generally have a physical therapy room with equipment, or a therapist can go to their room to provide therapy. The discharge planner at the rehab can provide orders for home health which includes physical therapy, occupational therapy, speech therapy, and additional nursing services. The agency is always patient choice and based on the Medicare provider.

The sooner there is a discussion about assisted living, the more options you will have. A move to assisted living does not need to be a permanent decision. It can be a temporary transition or a stepping stone to get stronger before returning home. Assisted living contracts can be ended with just 30 day’s notice. The decision to return home too soon can result in a relapse or another fall that could land you back in the hospital or rehab far too soon. The goal can certainly be to return home, but it’s important that it is done wisely and safely. Please consider that your current situation may not always be realistic and begin the discussion now.

Janice Martin is an author, educator, and specialist on senior living options and the owner of Senior Liaison of Central Florida Inc. She assists families in locating senior options and communities and has written “The Complete Guide to Assisted Living: Everything You Need to Know Before, During, and After a Move.” This award winning and #1 best seller is available on Amazon.com in paperback and eBook. For more information, call 352-477-1866 or visit www.seniorliaisoncfl.com.

Senior Liaison of Central Florida

352-477-1866 | seniorliaisoncfl.com
seniorliaisoncfl@gmail.com