Nursing home evictions! Triple Yikes!

[timo2]

In an internet search, this is not the only article. There was NPR articles, LA Times articles, lots of talk about something I was totally unaware of.

from the article "Nursing homes are increasingly evicting their most challenging residents, testing protections for some of society's most vulnerable, advocates for the aged and disabled say. Those targeted for eviction are frequently poor and suffering from dementia, with families unsure of what to do, according to residents' allies"

Nursing homes turn to eviction to drop difficult patients

[Ally]

Our close friend, who is a doctor who has nursing home patients, said that is happening when a patient is aggressive or injures a patient or staff. I had no idea.


Sent from my iPhone using Early Retirement Forum

[NW-Bound]

Wow, when dementia hits me I hope to remember to be nice to people.

Are these difficult people just thrown out on the street? Don't they become ward of the state? The state does not want or know what to do with them either?

Darn, here's another downside to being a curmudgeon. You get to live under a bridge.

[poorcarver]

I presume if you have dementia then you don't know. Perhaps freezing to death under a bridge beats years in a home. I figure on drug overdose when brain is failing much more than it is.

[RobbieB]

Makes sense to me.

What, you put my Father next to a person that injured his last room mate?

Starts calling attorneys...

[48Fire]

Doesn't surprise me. We spend a lot of time at MIL assisted living facility, often spending 3 or 4 nights at a time. While her care is generally very good, I can see the business side, and I can see how marginal residents would possibly be not as valuable to their profit.

[rodi]

MIL is in a memory unit. Some of the residents wander.... into other residents rooms, etc... It's a tough situation. MIL was shoved by another resident - but she'd wandered into his room in the middle of the night. I can see both sides... both folks involved get confused easily. If it escalates... I can see the one or the other residents being kicked out. From a logistics point of view- I hope it's not MIL.

[MichaelB]

Moved the thread into the health forum.

Back on topic, I can see this happening, with more than one cause. Many assisted living facilities do not have separate, dedicated memory care units, and for those that do, the units have a fixed capacity. If someone living in an ALF has mild dementia, and it progresses, they will try to keep the person in place in the ALF side, and move her / him to the memory care unit if the person 1) is a risk to himself, 2) is a risk to others, 3) will wander, or 4) requires constant care. If any of these happens and there is no space in the memory unit (or there is no memory unit) the resident has to go. This is unfortunate but unavoidable.

A patient with dementia that has run out of money and is on Medicaid runs a greater likelihood of being forced out if any of the previous conditions are present, even if only slightly, as there is a clear financial benefit to the facility. This is unfair but a reality. My guess is that a person in this situation is less likely to be relocated if he / she has a strong advocate, like a family member, that is actively involved, but most residents in ALFs don't have one.

The most difficult situation is when a person suffers from dementia and becomes violent and abusive toward others. They need to be relocated to a facility that can deal with that. It must be very difficult for family to see and accept that in a relative.

I haven't seen any breakdown of data that looks at this issue and analyzes it with this perspective. It did happen to a relative, and was an important consideration when we chose an ALF for DM, who suffers from Alzheimer's Disease.

[Senator]

I myself was almost evicted from a nursing home.

I used to visit my father, and bring him a few beers to enjoy when I was there. A fellow resident asked for one. I figured what the heck, he is a neighbor, sort of. No different than what I would do at home.

Evidently, there are patients in nursing homes that should not have alcoholic beverages... So I almost got evicted.

Once I offered one to the staff, they let me stay. (the last sentence is a joke...)

[JoeWras]

Quote:

Originally Posted by NW-Bound Darn, here's another downside to being a curmudgeon. You get to live under a bridge.

Well, a family member who was the worst curmudgeon ever became the happiest, kindest person on earth when dementia set in.

You never know.

This eviction problem is one reason I'm uneasy about CCRs. There was a thread on this forum last year about CCRs being able to kick you out if you break bad. That's a concern, considering all the up front money.

[Sunset]

This is a negative aspect for LTC insurance, because once you are kicked out, I'll bet they stop paying.

[athena53]

So, where DO the disruptive/dangerous patients go? There used to be state mental institutions to house people who couldn't live in society but most have been closed down. And I don't know a lot about Alzheimer's, but couldn't the right mix of tranquilizers work?

[jfn111]

There was a famous wrestler here in MN, Vern Gagne, that ended up with dementia. He killed his nursing home roommate with some kind of wrestling move.
I know they ejected him from that facility but they were able to find a memory care unit that could handle him.

[MichaelB]

Quote:

Originally Posted by athena53 So, where DO the disruptive/dangerous patients go? There used to be state mental institutions to house people who couldn't live in society but most have been closed down. And I don't know a lot about Alzheimer's, but couldn't the right mix of tranquilizers work?

Alzheimer's is not mental illness, it is a physical disease that affects the brain. Really, there are very few truly dangerous patients, it is much more common - but still not the norm - for someone to be disruptive. What they need is a facility with a memory care unit. This is where access is carefully controlled, all patients are monitored 24/7 and the staff is trained to deal with those suffering with AD.

[braumeister]

My mom was kicked out of her assisted living place after she wandered into someone else's room in the middle of the night for the third time and started complaining that she couldn't find the bathroom (it was next to her bed).

They were good enough to keep her until there was an opening in a memory care place (a month or two as I recall).

The memory care facility was nice, but WAY more expensive. They were also very frank about it up front that they accepted no insurance -- private pay only.

[youbet]

Quote:

Originally Posted by Sunset This is a negative aspect for LTC insurance, because once you are kicked out, I'll bet they stop paying.

Generally, if you have LTC insurance you're less likely to be kicked out. Ditto for private pay. The issue is most frequent where the client is troublesome (lotsa costs and aggravation for the NH) and is on Medicaid, especially in a state where Medicaid reimbursement is very low.

From the article OP posted:

Quote:

Rather than a long-term Medicaid patient, many facilities would prefer to fill a bed with a private-pay resident or a short-term rehabilitation patient, whose care typically brings a far higher reimbursement rate under Medicare.

[O2Bfree]

My dad was evicted from three adult homes because he became unruly and exit-seeking. The last one happened two days before Christmas, which left us scrambling through the holiday to get him into a secure place that handled dementia/Alzheimer's cases. Not a good holiday that year.

He lasted only about a month there. Wouldn't get out of bed and quit eating. Can't blame him. I'd hope to be lucid enough to do that in his situation.

[braumeister]

Quote:

Originally Posted by O2Bfree . Wouldn't get out of bed and quit eating. Can't blame him.

A surprisingly common way for people to end it. My mom did the same.

[athena53]

Quote:

Originally Posted by braumeister A surprisingly common way for people to end it. My mom did the same.

DH calls it "face-to-the-wall syndrome". We've both seen it in elderly relatives who saw nothing good ahead. Not a bad way to go.

[NW-Bound]

Quote:

Originally Posted by JoeWras Well, a family member who was the worst curmudgeon ever became the happiest, kindest person on earth when dementia set in. You never know...

Interesting. I have heard a theory that dementia just accentuates your trait; if you were a mean person, it turns you into an unbearable person. And that seems to be the case that I have observed in some people.