Homes and Alternatives: What New York Families Need to Know
by Jean Murphy and Amy Carroll
is a smoothly written invaluable resource for both crisis
management and basic eldercare planning. Its primary lesson
is simple: Rich or poor, advocacy is an essential ingredient.
Effective advocacy requires knowledge, and this book imparts
that knowledge quickly and accurately.
Published by Friends and Relatives of Institutionalized
Aged (FRIA) (www.fria.org), $30
Reviewed by Jay G. Sanders
reader will soon realize that this book could have evolved
only through firsthand experience with the system. Friends
and Relatives of Institutionalized Aged (FRIA) has been
through this drill thousands of times during its 28-year
history. Each year its helpline assists thousands of New
Yorkers navigating the long-term care quagmire. Every suggestion
the book offers comes with how-to lists, phone numbers,
form numbers, and other relevant information that the reader
will need to take immediate action.
book is organized to help those in an emergency get where
they need to go quickly. For those in a preparatory mode,
it ushers them through a complete analysis of the relevant
issues surrounding long-term care in New York State.
1, “Staying Home: Home and Community-Based Health
Care,” and Chapter 2, “Adult Homes, Assisted
Living and Other Options,” give advice on home care,
adult homes, assisted living, and other independent-living
options before one requires a nursing home. They discuss
different types of home-care services, how to arrange for
them, and how to finance them. It also guides the reader
on how to get home care through Medicaid. It also discusses
adult homes (from resident rights through complaints), assisted
living in New York State (an evolving and often-misunderstood
option), the New York State Assisted Living Program, and
other options and resources.
3, “Hard Choices: When a Nursing Home Is Necessary,”
alerts the reader to the realities of nursing home admittance.
It gives a chilling insider’s look at the scoring
systems that nursing homes use to decide whether to admit
someone. It also describes the time-critical nature of the
hospital discharge process. In most cases, the advocate
needs to select a nursing home as soon as the relative or
friend is admitted to the hospital. If the advocate doesn’t
heed the discharge timetable, the hospital will choose the
4, “Coping with Costs: Paying for Long-Term Nursing
Home Care,” gives an excellent overview of the financing
choices available to pay for eldercare. It walks the reader
through the basics of Medicare, Medicaid, asset transfer,
private pay, and long-term care insurance.
5, “Informed Choices: How to Select a Nursing Home,”
provides the tools needed to evaluate nursing homes. It
defines the types of homes in New York State and how to
evaluate them, and it highlights key placement decisions
that need to be considered.
6, “Expectations: Regulations, Right and Required
Services,” describes the care one can reasonably expect
to receive, the comprehensive care plan, and the way nursing
homes are organized and regulated. The reader will also
find detailed analyses of admissions agreements, patient
rights, a typical nursing home’s organizational structure
(both administrative and medical), and grievance procedures.
7, “Solving Problems: Becoming an Advocate for Your
Relative,” instructs the reader on effective advocacy.
It discusses how to solve problems in a nursing home environment,
explains what nursing home family and resident councils
do, and describes what can be expected in terms of support.
Finally, it describes how to lodge effective complaints.
8, “When My Relative Cannot Act for Himself: Legal
Arrangements,” deals with the basic legal tools for
incapacity planning, such as powers of attorney and health-care
proxies. It also explains how to handle problems when there
has been no advance planning.
book can be read cover to cover in two to four hours, a
real benefit when one is in crisis mode. It’s comforting
to know that resources like FRIA and Nursing Homes and
Alternatives exist to help. This
book is a must-read for any practitioner who has clients
50 or older. Families not in crisis, or those outside of
New York State, should read this book for the fundamental
tried-and-tested advice that is relevant anywhere.
G. Sanders, CPA, CFP, CSA, is a member of the NYSSCPA’s
Estate Planning and Personal Financial Planning committees.