• Elderly patients may require or desire professional caregiving either in their own homes or in nursing homes.grand p?¡§re image by Emmanuel MARZIN from Fotolia.com
  
  Elderly and nursing home care is a medical specialty. Elderly patients often suffer from medical conditions that require them to have ready and continual health care assistance in their homes or in facilities that specialize in seniors. There are several important legal issues that health care providers and seniors and their families must consider when deciding on care options. These include the patient's right to make her own health care decisions and to choose her home care provider, the offense of "elder abuse" committed either by caregivers or the elder's own family members, legal rights of nursing home residents, and the financial concerns involved in paying for in-home or nursing home care.
  
  

Patients' Right to Make Health Care Decisions

• Every competent adult has the legal right to make decisions concerning his own health care. Elderly patients, however, frequently suffer from conditions like dementia that render them unable to make or enforce their own informed decisions. The law recognizes the right of elderly patients to still have their choices respected despite any present incapacity. For example, many states provide the right to make advance health care directives instructing medical providers and families as to chosen methods of care in the event of incapacity. Accordingly, in making decisions concerning an elderly patient's care, providers and family are legally obligated to respect his pertinent directives; these might include his chosen health agency, the types of treatment he would accept or reject, and whether he would want professional home or nursing home care at all.
  
  

Patients' Right to Choose the Home Health Care Provider

• Once an elderly patient (or someone properly appointed to make decisions on his behalf) decides to get home health care, she has the right to decide which health care service provider to have in her home; it also requires medical professionals to inform the patient both of this right and of the specific available in-home options. However, physicians affiliated with hospitals often ignore this duty to inform; rather, they may refer a patient to their hospital's home care agencies to the exclusion of other options. This practice violates the patient's federal rights. There are, in fact, many competent home care providers from which a patient may choose. The objective is to make the informed decision to which the patient is legally entitled.
  
  

Legal Considerations in Choosing the Right Health Service Provider

• There are several legal considerations that elderly patients and their families must take into account in choosing the most qualified home health care service provider for the patient's particular needs. These include but are not limited to:
  
  1. Is the agency licensed by the state's Department of Health? Most states require agencies to be licensed and reviewed regularly.
  
  2. Is the agency a member of a national home health organization such as the Home Care Association of America of the National Association for Home Care?
  
  3. Are the caregivers licensed in their particular fields and insured for general and professional liability?
  
  4. Will the agency provide a Patient's Bill of Rights, i.e., a list of rights and responsibilities of all parties involved?
  
  Take advantage of the consumer legal protections that currently exist to measure and promote high quality care, including consumer ratings and clinical performance measures.
  
  

Elder Abuse at Home and Nursing Homes

• Elder care law protects seniors from abuse at the hands of mal-intentioned family members or hired caregivers.serious old man image by NiDerLander from Fotolia.com
  
  Elder abuse is a legally recognized harm under elder care law. As seniors become physically and mentally frail, they can become susceptible to abuse and neglect, both by family members and health care employees. Elder abuse usually occurs in the senior's home or nursing home; most often, the abusers are the senior's adult children, spouses or caregivers. The several types of elder abuse include: misuse of medication; physical neglect, medical, and emotional neglect; and health care fraud. All 50 states have laws that address the problem of elder abuse and punish offenders. Most states have laws requiring anyone with suspicion or knowledge of occurring elder abuse to report it to law enforcers.
  
  

Legal Rights of Nursing Home Residents and Duties of Nursing Homes

• Federal guidelines specifically guarantee the right of each nursing home resident to receive verbal and written notice from her nursing home facility of the rights and services to which she is entitled during her stay. The facility must provide this notice prior to admission and periodically during the resident's stay, in language that the resident comprehends. Finally, the facility is required to have the resident expressly acknowledge her receipt of this notice in a signed written agreement.
  
  Important federal and state legal rights of nursing home residents include the right to see family members, outside physicians, and government representatives; receive federal medical benefits and not be asked to leave a facility; keep their records confidential; keep and use personal possessions absent a showing of endangerment to safety; and participate in social and religious activities absent a showing of interference with other residents' rights. If a nursing home resident thinks that a facility is not in compliance with any of these requirements, she has many resources to contact for assistance, including her state's department of health and community legal assistance programs.
  
  

Paying for In-Home and Nursing Home Care

• Seniors and their families must determine how to pay for care.Bills 1 image by Big R from Fotolia.com
  
  Finally, there is the critical issue of how to pay for elder health care services. Some services may be covered by private medical and disability insurance policies, but care provided on a long-term basis may have to be financed through some combination of personal funds, federal medical assistance programs, and/or long-term care insurance plans. Medicare programs may cover care but only subsequent to a patient's hospitalization and only for a limited time. Medicaid may cover both nursing and home care services but only subject to stringent eligibility requirements, including an often prohibitive income and asset limit. Long-term care insurance for the elderly is a viable option both for nursing home and home care expense coverage. Seniors should ask providers what their financial procedures are and request statements disclosing all costs and payment plans associated with the relevant care services.