Pre-planning for a patient or family member’s move from a hospital into a skilled nursing facility (nursing home) will make the transition easier for everyone involved.

Helping the patient with worrisome financial arrangements will ease the family’s mind and placate the patient.

You may need to learn or get assistance with Medicare guidelines. For example, a patient must be admitted to a hospital and treated as an inpatient for at least three days before being transferred to a nursing home. Otherwise their initial nursing facility care will not be covered under Medicare.

Medicaid qualifications may vary state to state, but there are general guidelines to know. Eligibility for Medicaid is based on the financial income and assets of the patient. But, people who are not qualified based on their finances may be eligible for Medicaid assistance if they have high medical expenses that “spend down” their income levels. Also, if the patient has a spouse, it’s important to understand spousal protection rules.

With finances secure, you can help a patient have a safe and healthy move by providing all necessary information to the nursing home. It’s unfortunate, but depending upon the facilities involved, you may need to assist with communications between the hospital and nursing home. The most critical information to verify is that the hospital provides accurate and complete medical history and treatment records. If the proper prescriptions are not included with the patient’s transfer, they may not have immediate access to important medications. The continuity of care also includes any ongoing medical treatments that are essential to the patient’s health and comfort, such as dialysis, physical therapy, and pain management.

There is information other than medical records that is vital for a smooth transition. Confirm that the nursing home is aware of cultural needs that will affect the patient’s well-being. Medical transfer records may not include essentials such as language(s) spoken, diet restrictions, and religious practices.

Finally, decorate the patient’s new room with items from home. Family pictures, knick-knacks, and a quilt or linens will make the new surroundings comfortable and familiar.

Many agree that there is a great deal of room for improvement in the patient transition process. It certainly can be overwhelming for family caregivers to handle. If you feel unsure about the process, ask a professional. ‘

Find out more about how Senior Planning Services can help. We provide the assistance needed for a well-planned and stress-free transition for both the patient and their family.

Sundowning is the term for daily symptomatic personality changes that dementia patients experience. Sundowning occurs around the same time every day; usually at dusk. You may notice your patient or loved one experiencing some or all of these symptoms in the evening.

• Intensified confusion
• Agitation
• Pacing and wandering
• Restlessness
• Sleeplessness
• Combative behavior

Since our clocks shifted ahead an hour and the days are getting longer, your family member or patient may experience sundowning symptoms a bit later in the day, which could require a change to their caregiver’s schedule or adjustments to the patient’s evening routine.

The most important thing is that you understand that Sundowning is real, and you should treat it as you do other dementia symptoms. It’s helpful to know that there are things you can do to help minimize the patient’s symptoms.

Some theories state that mental and physical fatigue brings on sundowning symptoms. However, if a fatigued patient is treated with a familiar evening routine in peaceful and calm surroundings, they will wind down with minimum stress and be prepared for a good night sleep. To reduce sleep disturbances, encourage daytime activity and exercise, and discourage excessive daytime napping.

The right eating habits can also help reduce sundowning symptoms. Be sure to limit late day caffeine and sugar.You may even shift your patient’s eating habits by serving a larger meal earlier in the day, and prepare a lighter fare for dinner. This will make them more feel more comfortable and will help provide a more restful sleep.

As the day comes to an end, the darkness itself can cause problems for dementia patients. Increased shadows can make them unsure of what they see. This could cause agitation and fear. Be sure to turn on indoor lights as soon as daylight begins to fade. Keep a nightlight on when your patient goes to bed. If they awake during the night, they will not feel as frightened or confused if there is light in the room.

For more information on sundowning and sleep disturbances, visit the Alzheimer’s’ Association website.