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Our grandmother Ruth, a woman who was once a wife, an educator and traveler found herself in a nursing home after having a couple of strokes. Grandad had passed away some years ago, so she was now alone in the home they had built together. She lived at home alone for some time until her health began to fail her. Grandma wasn’t able to get around like she once had. My sister moved in with her for a while, we all thought that would help but it only complicated my sister’s already busy life. We searched around for a nursing home that we all would feel comfortable with her being in. Luckily there was one that was nearby and had great reviews.
After placing her there we would visit her as often but we couldn’t spend as much time there with her as we wished we could. We’d bring her meals and play board games with her. She always seemed to enjoy the activities and our company. We’d leave with her smiling and waving bye every time. Our family later had the idea to get her more help in the nursing home, someone that was somewhat like an extension of our family, so we got her a home care service nurse that would come to the nursing home and see to her specifically. This made us all happy, we didn’t wonder about her being alone when we couldn’t get there to be with her.
At the turn of the major holidays, about a week ago we went to visit her taking along her favorite meal and her favorite board game, Monopoly. The common area of her nursing home was nicely decorated with festive holiday ornaments. The members of the staff were all smiling and wearing Santa Claus’ hats, reindeer ears or ugly sweaters. There was music playing in the background. The dinner menu for the day was turkey, dressing and other festive dishes. The atmosphere was so cheerful. For some reason, our grandmother did not seem to be too much in the holiday spirit. We ate with her and talked, we even played a few rounds of Monopoly but she wasn’t her cheerful self.
The holidays can make people nostalgic for the past and invoke memories of a spouse, family or friends who are no longer alive. Ken Druck, a healthy aging expert and author of the new book, Raising an Aging Parent, explains, “In addition to missing loved ones who have died, older adults may also experience ‘living loss’ around the holidays. They may be grieving for children that grew up, friends that moved away, family estrangements or other situations that have caused them to feel left out this time of year.”
I was bothered by her behavior, I wondered if she was going through depression. I had to ask her what was wrong. What she told me was a surprise to us al! Our grandmother believed she couldn’t leave the nursing home to spend a couple of days with us for the holidays and that made her sad. She expressed that she missed being able to wake up with the kids early on Christmas morning to see them open their gifts with joy in their eyes. Grandma said that all of the decorations around the facility only made her feel worse by making her miss us even more. She admitted that the nurses at the skilled nursing facility along with the staff were all very kind to her but she missed her family. She was told by another resident that they would lose their Medicare coverage if they were to leave the facility for extended periods of time and they would have to pay and wait to get back in.
I had never heard of such a thing, so I did my research. I asked a few people and got mixed information. After a short web search, I ran across the Medicare Benefit Policy Manual online.
I found that residents can leave their skilled nursing facility for short periods, such as a day or two, to enjoy gatherings with their families and friends without losing Medicare coverage. However, skilled nursing facilities are allowed to bill residents to reserve their beds so long as they advised residents in advance of the charges to hold the bed and the residents have agreed, in advance, to make the payments.
I couldn’t wait to tell my grandmother what I had found out. When I told her the news she cried. She joked that she was going to spread the word to the other residents who had believed the same thing as she had. We all agreed to pitch in on whatever the cost would be for her to be with us. We arranged a two-day visit for grandma at our home for Christmas. All of the family was there for both of the days. Grandma got to see the kids open their gifts on Christmas day, she even helped prepare Christmas dinner. Her face was glowing the whole while.
Late November begins a time for gatherings with family and friends. Thanksgiving, soon followed by the December holidays. Nursing home residents often want to participate in these gatherings but may worry that they will lose Medicare coverage if they leave the facility to do so. My grandmother and my family and friends can put our minds at ease. According to Medicare law, nursing home residents may leave their facility for family events without losing their Medicare coverage. However, depending on the length of their absence, beneficiaries may be charged a “bed hold” fee by their skilled nursing facility (SNF).
Sharon Newman, owner of Right Choice Home Care says, “If families have the opportunity to get their loved one out of the nursing homes during the holidays it would help with depression and isolation. No one should be left alone for the holidays”