A crisis often triggers the move to a nursing home.
One elderly woman, for example, got pneumonia and ended up in the hospital. After her treatment she was still a little too weak to return to her own apartment where she lived alone. She was moved to a nursing home to recuperate. She got better but wasn’t released.
Her son lived far away in another state and felt she was safe in the nursing home. She ran through her savings, about $30,000, and then applied for financial help from the state. It was then that a case worker determined that the woman could live at home with some housekeeping help. She was finally sent home to live on her own again.
Now there is an Illinois law to prevent mistakes like that from happening. Since 1997 anyone going into a nursing home must be pre-screened or assessed by a case worker to determine if a nursing home is the only suitable living arrangement. The case worker tries to find out if the person can live alone, or maybe live alone with some help. The assessment also provides a chance to explain the different living options available to seniors.
“Nursing homes are not always the answer,” says Jan Costello, spokesperson for the Illinois Department on Aging in Springfield. “Many seniors and their families don’t realize services can be packaged to help them stay in their homes.”
The state isn’t just being a nice guy here. The law came about because Illinois is trying to put a lid on the escalating cost of nursing home care for the elderly.
Typically, seniors enter a nursing home with some assets but quickly run through that money and apply for public aid to foot the nursing home bill. For example, the Illinois Department of Public Aid spent nearly $1.2 billion in 1997 on nursing home expenditures.
The theory goes that keeping people at home, even with some outside help, is far less expensive than paying for full-time nursing care. (The average monthly bill at a nursing home is about $3,000.)
Results from the program’s first year look promising, though state officials say they’re taking a closer look at all the numbers.
In 1994, for example, there were 100,000 admissions to nursing homes statewide. In 1997, the first year prescreening was done, there were about 50,000 nursing home admissions. Of the 95,000 assessments done in Illinois last year, 50 percent of the individuals went to a nursing home. However, only 40 percent were expected to be long-term residents.
Universal prescreening of nursing home admissions is done in several other states. Illinois’ program has several differences, though.
Here, case workers are based in the hospitals. That way they can have more face-to-face interviews with seniors. In other states, much of the prescreening is done over the phone, which may increase the number of nursing home admissions.
Illinois also does a follow-up interview in the nursing home if the person has been sent there to recover from an injury or illness.
“That means we freeze the person’s apartment and everyone’s expectations. Everything remains in place,” says Jean Blaser, manager of long-term care programs at the Illinois Department on Aging. “We have a good track record of getting people home.”
Don’t think the state decides where you live, though. Keep in mind that although the assessment before entering a nursing home is mandatory, the ultimate decision about whether to move into a nursing home or not is left to the individual and the family.
The assessment process itself is short, about 45 minutes. A social worker uses a questionnaire to determine how the person functions alone. Can the person get around and fix meals? Is nearby medical care available? How about transportation?
If the elderly person decides not to enter a nursing home, case workers can provide the names of local agencies to help.
Also, some people may qualify for the state-sponsored Community Care Program. This program provides housekeepers who can assist with meals, cleaning and personal care. The program also offers adult day care and companions.
To qualify, a person must not have assets of more than $10,000 (excluding a home, car and personal furnishings). And if your income is below the federal poverty level, the state will pay the entire cost of the service.
Resources
The quickest way to get information about a nursing home assessment and the community care program is to call the Illinois Department on Aging’s Senior Help Line toll-free at 1-800-252-8966, Monday through Friday, 8:30 a.m. to 5 p.m.
The department also has free brochures describing their services. The Senior Help Line can also provide the names of local agencies that offer meals, housekeeping and handyman services.
The Illinois Department on Aging also has a handy booklet for seniors that outlines state and federal programs for the elderly. Many of these programs are designed to help seniors stay in their homes. Call the department for a free copy. Or write: Senior Help Line, 421 East Capitol Avenue, 100, Springfield, Ill. 62701-1789.
Home products
Here’s an appliance note for seniors remaining in their own homes. Senior Friendly, an independent research and product-certification firm, tested 10 microwave ovens and said only four qualified as easier-to-use for people 50 and over: Samsung model MW 5470 W, Kenmore model KM-68380, Sharp model R-420AW, and Panasonic model NN-S667BA.
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Jane Adler is a Chicago-area freelance writer. If you have questions or information to share regarding housing for senior citizens, write to Senior Housing c/o Chicago Tribune Real Estate Section, 435 N. Michigan Ave., Chicago, Ill. 60611.
