weighing home care vs nursing home care

[Guest NoriB]

As part of the process of Medicaid planning for my 65 year old husband, who is currently in a skilled nursing home for sub acute rehab, I am wondering at what point can a stroke survivor be cared for at home? Medical professionals and social workers have all told me that he cannot presently be cared for at home, but I would like to hear from caregivers and stroke survivors.

 

My husband has dysphagia, cannot speak audibly, has a PEG, being currently tube fed every 4 hours around the clock, meds must be crushed and given through the PEG, cannot manage bathing, dressing, toiletting, and transfers at maximum assist. I would have to agree that he cannot be discharged to home within a few weeks.

 

The PEG and the round the clock feeding seems like a good reason he should be cared for in a nursing home, but how have people managed to deal with this at home?

 

Everything else seems to be in within the realm of home care, with adequate CNA help, and RN visits to handle daytime feeding. But what about feedings during the night?

 

When he had his first stroke 3 years ago, he could not do very much on his own, but his speech and swallowing were intact. I work full time, so it was difficult, but it was manageable. And after about 4 months, we were able to dismiss the CNA. 2 years later, he was walking with a quad cane and virtually independently living on one floor in the house. Of course, if he came home with all of these needs, I would probably succeed in achieving total caregiver burnout, even with professional home care.

 

I am really torn about this, because of the financial hardship facing us in making him eligible for Medicaid. Extended home care will also have a financial impact, but at least we won't have to spend down our assets and possibly my pension.

 

I've also been told that while he is in a facility, he has the upper hand to stay there. Since he is currently in one of best facilities in DC, if he were discharged to home, and then long term nursing home care became necessary, he might not get back in to this place, and some of the DC facilities are less than satisfactory.

 

Would appreciate feedback on what was manageable with home care, and what is best taken care of in a nursing home. Thank you.

 

 

 

 

 

[merichsen]

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