Putting mom in nursing home; should I start interviewing now?

Do it now !!!

Another thought. If the great Insurance is Long Term Care (LTC) policy then they will cover help at home. I had a neighbor who had this and it was very successful for her. She was able to stay in her home until she passed. But please remember neither Medicare or Medicaid will NOT pay for Nursing Home/Assisted Living living. Everything I have contacted for Mother is self pay. Fortunately she was able to do this. Good luck and remember to communicate with your Mom so you are Both prepared for what is to come.

Consider assisted living if she is in good shape. Look at nursing homes too if you like. Nursing homes are usually Medicaid and assisted living is private pay.

Check on filial responsibility laws in Pennsylvania. Be very careful on what you sign, how you sign it and how that insurance policy may fit into the equation. See an elder law attorney to learn about Pennsylvania law and how this may effect the decision.

Please clarify what her “excellent insurance” is. How you proceed may depend on that answer.

Interesting question. First answer, if you do for see your Mom requiring a Nursing Home, she will have to qualify for that need. Another words her health will need to be such that a NH is required. Otherwise I'd begin looking at Assisted Living. This can be available before she needs complete nursing care. I would check out just exactly what her insurance will cover to pay NH. In my state I have found that Assisted Living is not covered by Medicare or Medicaid - it is Self Pay.

Second, if your mother qualifies for Nursing Home someone will still have to be "Power of Attorney" or "Medical Power of Attorney". That being said someone will need to be sure that all of Mothers' needs are met and she is cared for correctly. That meant for me all her needs were met and appropriate. My Mom could not do this for herself any longer when we (yes I have siblings) that she needed a lot of care and got her into Assisted Living. Mother was 92 when this became necessary. Her reaction to every medical and living needs was "NO". and this was a big problem. Being a "caregiver" has many levels of work.

Being the only child can be difficult and time consuming when caring for an aged parent. Good luck and be sure you double check everything. And starting your search for the best available option for your mother now is a good idea. Yes interview, visit, etc. is a good approach.

Keep in mind when you see these places, it’s not the same as living there! PS: None of these places are a holiday inn.

I assume there is no Power of Attorney for Mom? You need FIRSTLY to get That in Order, dear. Very important. It does not Hurt now to Begin your Beguine of Inquiring to see who takes Who, What, Insurances, Etc.....MOST would need to do a Spend down until Mom would qualify for Medicaid and if she has not the Funds, It would Come into Play right Away. If she is Over the Limit for Medicaid Now, Do a Five Year, Dear, Look Back and in Order to Not Raise supsicions, Do everything accordingly with your Spend down.

Don't make any assumptions about what insurance will cover. Check and double check. You may not have the choices you think you have.

I agree with what was previously stated if she is mentally all there and you are using her insurance she should have a say in where she would live. Just as you get a say in where you live. But, if that is not the case and you have the luxury to do so then yes you should start shopping around keep in mind all nursing facilities are not equal and tend to be understaffed and it may be worth looking at the salary of the aides and the job requirement. Being able to pass a drug test is the minimum in some of these places. The amount people are paid tends to correlate with the amount someone cares about their job and in this case your mom.

bigsispjt: Why are you jumping right to Nursing Home care? Do you think that she requires that high a level of care already, when in fact she may not?

Start doing your research. Then come up with your top three places and go visit them. Then make another visit and take your mother with you. Tell her it's for "future reference" so that if the time comes when one is needed "down the road," that she will be part of the decision-making process.

I did this with my father. When the time came, I placed in him the one that he said he liked best. The transition was fairly smooth.

YES! Even though in-home care has basic advantages IF you have hired a very reputable service; there are services to help you find the nursing facility OR ASSISTED LIVING GROUP HOME.
In-home care cannot touch or administer any medications your Mother is most likely having to take on a daily basis and different times of the day. The caregiver is not licensed to do this as 99.9% are CNAs working toward their RN degree.
Caseworkers who specialize in your situation are fantastic.
My fear just as so many of us have regarding the sad fact of the elderly being physically abused, YOU NEED TO HAVE THE COMFORT 1ST, THEN YOUR MOTHER'S.
I feel so blessed the caseworker who helped me (my husband was deeply involved too), took us to visit an assisted living group home. THE MOMENT I WALKED THROUGH THE DOORS, I KNEW I WOULD NO LONGER BE AFRAID FOR MOM AS WELL AS MY STEPFATHER.
I live out of state as well as my brother. I have 2 siblings who still live in the state but do not visit Mom; one sister has never visited as far as I am aware. The mgr and I are in constant contact, she sends pictures to me, the contracted doctor's PA contacts me regarding every exam.
This home just had their surprise State inspection and once again the State gave them a perfect score. Be sure you ask to see their scoring certificate from the State.
I visit Mom/Stepfather every month and I have NEVER seen any situation of abuse. This home doesn't even have that nursing home "SMELL". They even allow the residents to have their pets reside there too.
Again you need to feel comfortable first, ask questions even with residents who may be there due to physical disability. I can sleep knowing I've placed my Mom in wonderful hands. Mom's youngest brother visits 1-2 times a week so I have extra eyes.

Yes... start now while you have the luxury of time on your side. Check out nursing homes, assisted living, long term skilled nursing facilities, board and care homes, etc.... You never know what type of facility you will need and when you will need it. It gets very emotional and the more information you have gathered, the better situation you will be in. Visit different places, create a file on each of their brochures, create a spreadsheet. New places are always popping up, at least where I live. Keep an eye out in the newspaper for advertisements; keep an eye out when you drive around running errands and you will probably notice a place that you haven't noticed before. Tour them now so you get an idea of what is out there. When the time gets closer, you will need to revisit these places again but you will have a good "starting point" and hopefully the stress will be less. Also, check out the state databases. They have a wealth of information on citation and inspection reports for the facilities; this information is eye opening (and gut wrenching) but will also help with your decision.

Why jump right to Nursing Home. She would probably not need a Nursing Home unless she has medical need for one.
If she is caring for herself an Independent Living Facility or Assisted Living might be right. If she has memory problems or if there is a chance she would wander off then Memory Care might be better for her. And these would cost less than a Nursing Home.
You need to determine at what stage you will place her, what is it that would trigger that decision for you? It might be very possible that if she has no medical problems, and has no dementia she may not need any facility. (My grandma took care of herself well into her 90's it was cancer that killed her)
Talk to an Eldercare Attorney and get things in order now.
If there is a possibility that she would need Medicaid down the road now is the time to find out what can be done to make the transition easy. Many facilities will take a longtime resident that had been "Private Pay" if they go on Medicaid. So look for places that will allow the transition. There are many very nice places that will not accept Medicaid and if you select one of them she would have to be move if she had to go on Medicaid.
Ok...I just read your profile and (should have done that first) I see that she is now in Independent Living. Does the facility where she is have Assisted Living? Does it have Memory Care? If so she can transition from one to the other without a drastic move.
Discuss with the Director as to what would happen IF she did need more skilled care. Do they have the ability to do that? Many places have Rehab on site and if they do take rehab they may very well be able to handle the skilled nursing if she should need it.
And she may never need skilled nursing care and your search may not be necessary.

YES - amass your files as to what each has to offer - I made up a work book & rated them on the tub room [1 place called it the spa], cleanliness, access to staff, interaction with residents by staff etc 

Red flag was a huge glorious & impressive lobby but small tight spaces for residents because that means they are all show

Factor in how far a drive it is for you - my mom was moved closer so that towards the end I was able to go 4 minutes to see her many times a day whereas before she was 40 minutes so I could only get to see her several times a week - quite frankly the closer it is the better - she doesn't need to know how close so when you take her there go a longer route

Nobody puts on their bucket list 'I was to go to a NH' so she'll always say she doesn't want to go - good for you for knowing your limitations from the outset - my mom would go to 10 activities plus religious ones a week & she bloomed with something to do rather than just watching TV all day

My mom was in 2 NH - one had tile floors but noise level was higher the other was carpeted in halls & bedrooms which was quieter/calmer - however every few months they would move everything to shampoo the carpets so she couldn't use her room for part of that day but they let me know in advance so I could visit with her during most of the 2 to 3 hours they were working on her room so really no problem - hope this helps

See an eldercare attorney if she is not already on Medicaid. You most likely do not have a choice--or much of one--as beds are full, and the facility must accept her.

Inform yourself of the various options in your community and read reviews. Most of these places have sales reps that are happy to meet with you. Some will pressure you to put your mom on a waiting list, even make a deposit before she is ready. Age alone is not the deciding question.

You say she has "excellent insurance"? Consider an "Adult Family Home". There are more & more of these. Check with her insurance, to see if they pay for this.

Also, does her "excellent insurance" pay for in home care? She says, she doesn't want to go to a NH? I don't blame her. I would not either.

I say, as a caregiver myself, people want to remain, in their own homes. That's what I do. In home care, with an agency. That can be pricey, though

"When the times comes" as you say, her dementia may significantly increase, thus her care increase.

Do your research. I can't stress this enough. You may get a "perfect pitch" from some of these, "institutions" but dropping in, unannounced, is the best way to get a feel of, what the care is.

Talking to children, of their parent. How is the care?

Good luck, my friend

Are you sure she cannot eventually start with a AL facility? I haven't read all the answers but from the few I have you have been given excellent advice. As far as AL facilities go she most likely will start off as private pay. You pay the facility and then submit expense for reimbursement. There generally is a period they review the situation. Then once approved they should back pay. Also the number of ADL vary from state to state. It was different by about 1 from NY to SC. She will need at least some in order for a LTC policy to approve her. They will also review which is a pain but a good facility knows how to respond to insurance in order for payment to continue. A NH is generally the last step. She might adjust better in an AL facility but you don't want to do that too soon as it will eat up funds needed in the long run.

She will adjust better to this big change if she is involved with the decision. Have you considered getting aides to help so she can stay at home? Hopefully if she has difficulties with caring for herself in the future she will agree to any adjustments that need to be made. You don't mention if she is living alone or with you. Make sure that all of the paperwork is in order now, Power of Attorney, Living Will, make sure you know her medical wishes and end of life wishes. I know people who put all assets in their own names years before their parents needed nursing homes (there is a look-back period). You may want to consult with an attorney if you don't have these things in place.

Read up on the different types of care: continuing care at home, independent, assisted, memory care, skilled nursing. Also the terminology ADL (activities of daily living) and how it applies to level of care. Visit every type of facility you can.

No idea how far off this placement might be, but keep in mind places you research and visit now may not be the best at the time you’re looking at your mom moving in. NH’s are often corporately owned and experience being bought, that can change things quickly. A good sign is how stable the higher paid staff, such as director of nursing and therapists are, when they’re long term and stay it tends to show a more positive place. But anyplace you feel good about now will need to be reevaluated before actual placement. Best wishes, this is never easy

Here is a link to the Medicare site which offers ratings on Nursing Homes based on inspections that were done and allows you to compare several at a time: https://www.medicare.gov/nursinghomecompare/search.html

Good luck to you - it's a daunting exercise but if you're prepared and ask the questions that are important for you and your Mom, you will feel better about your decision.

All the answers below are excellent.
I would add that visiting the facility at different times of day and night to see if what the "interview" process reveals and real life are the same. Many facilities have a beautiful brochure and will give you a tour of the best rooms available. But what you get may not be what you see.

BUT, from past experience, real life differs greatly. At night, the number of staff drop dramatically, Also nurses may be LPNs, not RNs. (Any LPNs, please don't take offence, the amount of training makes a real difference.)

Also, many high school students are convinced that medical care is where the jobs are and go to school to become an aide, with plans of completing school for their nursing degree, but life gets in the way. Marriage, babies , school debt and never go any farther then an aide. Many don't like their jobs but are stuck because they thought they would continue their education and it didn't work out.

With this said, there are many caring aides, LPNs and others but to find a facility that has all of this on each is a stretch.

I would suggest visiting places and asking questions now. I found in many cases the nursing homes that are part of a continuing care give priority to those already living there in independent or assisted living. If you find a place that looks good, ask to be put on a wait list. Also, look at inspections and ratings on the Medicare site under nursing home compare.

We are interviewing LTC facilities now for my FIL and the main thing I've learned from caregivers on the AgingCare forums is: go prepared. Have a list of questions of everything you can think of and then schedule a meeting with the admissions officer. There is so much to know and so many levels of care they'll go over that you won't be able to remember it all (or will be doubting yourself as you try to remember what you think they told you). I have six pages of questions and ask them all, from 'how do we pay?' to 'how often are fire drills conducted?'

At the very least if you don't go with questions, take a notebook with you. Record the name of the facility, date you visited/called, names of people you talked to, and their phone numbers for follow up questions.

You say that mom has 'excellent insurance' but it might be that not all facilities accept it. Assume nothing and ask them.

The amount of info you need is daunting... and the financials can be overwhelming when you are being asked to complete multi-page forms. From doing these I put together a one-page 'cheat sheet' on my FIL that includes everything being asked, from when and where he was born, active dates of service duty, marriage, employment history, banking account balances, life insurance face and cash value, burial plot, etc. It's all there so we can readily see it.

Good luck!

It may not be your decision about placing your mother into long term care, but it sure IS your decision not to have her come live with YOU. Since your home is not an option, her only other choice is to use the insurance policy she's paid handsomely for for years, or find another relative to move in with.

That said, find out if her insurance policy pays for Assisted Living and if so, find a facility with a continuum of care. She can start out now, or soon, in Assisted Living, then move to Skilled Nursing as her needs increase, depending upon how long her policy pays for. My mother has been in AL since 2014 and she has a good time with all the activities and other elders to hobnob with. AL has extended her life....she is 93 in Jan and would have passed away long ago if not for the nurses catching 2 cases of pneumonia immediately. There's lots of good to be said for AL, that's for sure.

Go check out some places and speak with the staff and the residents about their satisfaction level with the facility. I've found that to be most beneficial when looking for a good place for my folks.

Gold luck!

Big, I assumed by “excellent” insurance, your meaning LTC policy, if so a couple of things to think about imho......
she cannot just enter a NH at will &
the LTC policy will have needs restrictions &
some NH do not take LTC policies.
Now if she’s got tons of $$$, she can get into an only private pay type of exclusive facility whatever her needs are & it will be breathtakingly expensive. But otherwise, she will need a referral from her MD & a needs assessment done by the facility. This is all about ensuring her care needs are what facility can do. Sometimes NH will actually decline admission as the elder needs locked ward MC or does not actually need skilled level of nursing care or has medication management that the facility is not set up to do.

Regarding facility not taking LTC insurance, my moms NH did not. It was MediCARE, Medicaid or private pay only. In chatting with billing, I was told was that LTC policies were flat too much of a bother. That there tended to be myriad of items / paperwork needed to get paid & foot dragging about something or other. NH could easily fill their beds without LTC insurance residents. I have no idea if this is common, but I was surprised. I’d try to clearly find out what’s what for facilities in her area. Also ask if the NH puts an extra fee on for administrative costs associated with LTC insurance policies.

Please carefully review policy as to the terms. Like if has inflation rider. Also what gap is for start of policy. Most have set period of time for start day of of eligibility - perhaps 60, 90 or 120 days from her entry for LTC with documented need for skilled nursing care that is private pay. She needs to have cash to pay for the gap as MediCARE or secondary health insurance is not going to pay her room & board. Also look as to daily amount paid once LTC policy is activated & if it’s enough AND if there are restrictions as to who must provide care.

If she is still in payable premium mode, look to see if an increase is looming. Lots of folks encounter. If this is a last millennium policy, several insurers do not write new policies and service on LTC specifics is spotty. Really read the fine print now so minimal surprises later.

Have you discussed it with her and do you have Durable POA and Healthcare POA for her? Does she have an advanced medical directive? I might discuss plans with her to let her know her options now, so it is clear that you will not be able to provide her daily care. Is she realistic about how much she can do? I know that some seniors who have extremely limited mobility seem to have magical thinking that they can continue to live alone, prepare meals, manage hygiene, etc. when they are not able to even walk unassisted. I'm presently trying to get my parents downsized into a more practical living arrangement, but, that is easier said than done.