18 Sep Hundreds of Thousands of Older Adults and Younger People with Disabilities are living in Nursing Homes only because that is where Medicaid drives them

  Thousands of elders are living in nursing homes despite lack of need, many against their will.   Many elderly patients get admitted to the hospital with profound weakness due to their acute and chronic medical conditions and they will leave the hospital with profound weakness from their acute and chronic medical conditions. In most situations, these patients will be too weak to take care of themselves.  They will need extra help with their activities of daily living either from family or from trained home health care representatives. Patients who cannot safely return to the community often need to transition through a nursing home (with skilled nurses) before returning home. Hundreds of thousands of older adults and younger people with disabilities are living in nursing homes only because that is where Medicaid drives them. They have no clinical need for skilled nursing care, and, if better elder care options were available, many could be living in other settings, including their own homes. For most elderly folks, giving up their independence and being forced into a nursing home is their biggest fear.  Nobody can ever force you to go anywhere you don't want to go, as long as you have the capacity to make your own medical decision.  Your doctor can't force you,  your nurse can't force you, even your powers of attorney can't force you.  If your family is telling you that you have to go to a nursing home or skilled nursing facility and you don't want to and you have the capacity to make that decision, no matter how poor that decision is, you have the right to go home against everyone's wishes. Related Posts They May Be Out Of The Closet, But Many LGBT Seniors Are Facing Aging Alone. Bulletin: 20,000 Elders to Lose Their Home Care Under Medicaid And Be Forced to Stay in Nursing Homes Lessons From The Front: What Nursing Homes Should Learn From Covid-19 Medicaid Medicaid—the joint state/federal health care program for the very poor—sends frail older adults to nursing homes even though they often are the most expensive and least appropriate option. And, as COVID-19 has taught us, they can be a high-risk setting for many. The Kaiser Family Foundation reports that as of Aug. 20, more than 70,000 residents and staff of long-term care facilities (including nursing homes and some assisted living facilities) have died from the pandemic. This is a complicated story, so let’s unpack it by first describing Medicaid long-term supports and services (LTSS) and then looking at nursing homes. States must provide people who have few financial assets, very low incomes, and high levels of personal care needs with long-term care. But Medicaid is required to provide care only in nursing facilities. States can apply for one of many special waivers that allow for care in the community. And every state has at least one. Indeed, more than half of Medicaid LTSS dollars are spent on care in settings other than nursing homes. But the level, quality, and definition of that care vary widely among the states. Many states provide only a few hours...