How do I Know it is Time for Nursing Home Care?

It is not easy to watch a loved one experience the physical and mental decline accompanying aging. It is even more difficult to decide when it is time for nursing home care. The decision is different for every person and every family but what it all comes down to is quality of life.


This blog is for educational purposes only and should not be considered legal advice. The use of the Paths Law Firm website does not constitute a client-lawyer relationship.

Signs it is Time for Nursing Home Care

You can define the quality of life based on the quality of health, happiness, and comfort a person enjoys. Quality of life affects both the person in need of care and the caregiver. Suppose the quality of life of either is negatively affected. In that case, it may be time to consider the following factors in deciding whether or not a nursing home is the best solution.

Physical Health Conditions

If a loved one suffers from a medical health condition preventing them from performing basic daily tasks, they need care. When the health condition reaches a stage where at-home care becomes difficult, it may be time to consider care in a nursing home.

A caregiver can look for the following signs when caring for a physical health condition having  become unmanageable:

  • The need for medical equipmentor specialized care and treatments the caregiver is unable to administer.
  • Administering medications by the caregiver is no longer possible.
  • You have suffered an injury as a result of delivering care. For example, a back injury from lifting a physically challenged loved one.
  • Your health is at risk.
  • You are physically tired and drained from the effort you are putting into caring for a loved one.
  • The health of the person requiring care is at risk by remaining at home.

Whether your loved one will receive better medical care for a physical health condition than you can provide for them at home is the question. It is important to remember your loved one’s physical health will continue to deteriorate as they age, and the illness, disease, or other health condition is going to keep taking its toll on you and your loved one. If you feel caring for your loved one’s physical health needs has become a challenge, it may be time to start looking at nursing home options.

nursing home care

Mental Health Conditions

Dementia,Alzheimer’s Disease,Parkinson’s disease, and cognitive deterioration are mental health conditions most effecting the elderly. While at-home care is possible and recommended mainly in the early stages of these conditions, there comes a time when nursing home care will become necessary. 

Mental Health Deterioration of The Care Recipient

Noticing the following signs may be an indication your loved one’s mental health is deteriorating to the extent a nursing home may be better suited to their needs. Some indications:

  • Forgetting medication schedule.
  • Reporting they are eating, however, there is no sign of meal preparation, and there is spoiled food in the refrigerator.
  • Wandering off and increased periods of disorientation and confusion.
  • Difficulty managing their hygiene, including bathing, changing clothes, and using the toilet.
  • Difficulty remembering or recognizing loved ones and friends.
  • Disorientation as to their surroundings.
  • Confusion as to date or time.
  • Increasing signs of agitation and aggression.

Few caregivers are aware agitation and increased aggression are symptoms of cognitive decline. A formerly placid person can become quite aggressive and even physically assault another person. Aggression from individuals with mental health issues is partially due to cognitive regression and frustration that comes with difficulty recognizing people and their surroundings. It is essential to keep in mind the above signs put your loved one at risk and you and your family.

forgetting medications

Mental Health Impacts on the Caregiver 

Signs your mental health may be affected by caring for an aging loved one include:

  • Chronic fatigue and difficulty focusing and concentrating.
  • Irritable and experiencing mood swings.
  • Failing to meet your own physical and emotional needs and those of your loved one and other family members.
  • Work is suffering.
  • Increased anger toward the person you are caring for or other family members.
  • Symptoms of anxiety and or depression.
  • Decreased interest in social interactions and activities.
  • Trouble sleeping.

It is common for caregivers of loved ones to be in denial regarding thecognitive declinethey are witnessing in a loved one. This denial, combined with guilt, may prevent the caregiver from seeing their loved one (and the caregiver) may be better off receiving professional nursing care for their mental health disorder in a nursing home environment. It is critical to realize, the state of one’s mental and emotional wellbeing can significantly affect their ability to provide the care a loved one needs.

It is also important to realize a loved one may resist going to a nursing home, especially if they suffer from cognitive decline. We need to remember; cognitive decline means their ability to make decisions is impaired. It is the caregiver’s responsibility to do what is best for them when their mental health deteriorates to the stage where caring at home is no longer the best option.

caregiver anxiety depression

Accidents and Injuries

As we age, we become less physically capable. Muscles and bone health deteriorate, and combined with physical or mental illness, the risk of accidents, falls, and injuries become more likely. The severity of injuries from an accident or fall in seniors is also greater. For example, a fall is more likely to result in broken bones than usual.

Be aware of the following signs and symptoms that your aged loved one is at greater risk of a fall or accident in the home:

  • Difficulty sitting or standing from a sitting position
  • Shuffling feet or difficulty walking
  • Difficulty grasping or holding objects
  • Problems with balance and gross motor coordination
  • Hiding accidents and injuries

If your loved one has fallen in the past, they are at a greater risk of falling again.  Even if you are around 24 hours a day, there is only so much you can do to prevent a fall or accident from occurring. Nursing home care provides a safer environment for the elderly who are at a greater risk of a fall. The staff understand the increased risk and provide the necessary care to prevent falls and accidents. 

elderly man falling

Planning Ahead for Nursing Home Care

Sometimes, life throws us a curveball, and a sudden event or illness can leave us in a position where we need to provide care for a loved one. However, in most cases, simpleagingis the primary cause of requiring care in later life. If possible, it is vital to plan for when nursing home care may become a necessity.

We should have discussions with parents or other loved ones in advance regarding the need for ongoing care.  These discussions may be based on certain life events or stages of physical or mental illness. Decide at which point physical deterioration or cognitive decline will progress far enough for your loved one to require care in a nursing home.  Planning will relieve you of the burden of responsibility and guilt you may feel towards caring for your loved one.

Keep in mind there is rarely a specific timeline attached to these decisions. Diseases, illnesses, and aging progress at varying rates and affect people differently. Planning is not about deciding to send a loved one to a nursing home six months, a year, or five years down the line. Instead, it is about determining when the challenge of caring will become significant for both the caregiver and the person in need of care.

care in nursing home

In Closing

Visiting nursing homes as early as possible and deciding the best facility for future needs allows the care recipient to choose their future arrangements. It is essential to consider any special needs and personal preferences whenchoosing a nursing home. Also, ensure the facility is close to family and friends to make visits easier.

You can start planning for nursing home care at any time. However, if a loved one has been diagnosed with a severe illness or a degenerative cognitive disorder, planning should become a priority. It is preferable to make decisions about future care before a disease has progressed or mental health deteriorates to the extent your loved ones can no longer make decisions for themselves.

AtPaths Elder Law, we are dedicated to serving seniors and their families through legal representation and support.  Our dedicated and caring staff will listen to your unique story and assist you in planning for the future.  Whether this includes assistance with planning for nursing home care, estate planning, asset protection, or any other elder care issues you may experience, we are here to help.  If you or a loved one need assistance,contact Paths Elder Lawto schedule a consultation.  Peace of mind is only a phone call away. 

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We are legal experts focusing on wills, trusts, medicaid, guardianships, and asset protection for seniors and veterans in Missouri.

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Paralegal

Jennifer Scott

jennifer scott

Jennifer serves as an Estate Planning Paralegal, providing comprehensive support to the firm’s attorneys and clients. She assists in the preparation of wills, trusts, powers of attorney, and other estate planning documents, ensuring accuracy, clarity, and alignment with each client’s objectives.

Before transitioning into estate planning, Jennifer gained extensive experience as a Family Law Paralegal, this background enables her to navigate sensitive client circumstances with professionalism, discretion, and a strong understanding of family dynamics.

Jennifer is recognized for her attention to detail, strong organizational skills, and commitment to delivering a thoughtful and reassuring client experience. She approaches each matter with integrity and a focus on ensuring clients feel informed and supported throughout the process.

Outside of the office, Jennifer enjoys practicing yoga, watching sunsets, and spending time in nature—activities that provide balance and inspiration in her personal life.

Assistant to Russell Fracassa

Peyton Osborne

Peyton Osborne

Peyton serves as the Assistant to Russell Fracassa, bringing dedication, reliability, and compassion to her role at Paths Law Firm.

With prior experience supporting small businesses in administrative and operational capacities, she has developed strong organizational skills and a sharp attention to detail that help ensure both attorneys and clients are well supported.

She is currently studying at the University of Missouri–Kansas City as an Honors Student, demonstrating a strong commitment to excellence in both her academic and professional pursuits. Peyton’s work ethic and drive are reflected in the care she brings to each task and interaction.

Outside of the office, Peyton enjoys spending time with her family, reading, and exploring new places.

Probate Paralegal

Shaye Kotze

Shaye Kotze

Shaye entered the field of civil law in 2022 and has quickly developed a strong foundation in client service and legal support.

Her academic background includes an Associate of Science degree in Healthcare Services and Informatics Administration and a Bachelor of Science in Interdisciplinary Studies, with an emphasis in Health and Human Services, Social Sciences, and Humanities.

This unique blend of legal experience and healthcare-focused education allows Shaye to approach her work with both analytical precision and genuine empathy — especially when supporting families navigating complex and sensitive situations.

Outside of the office, Shaye enjoys spending time with her husband and their one-year-old daughter. Whether she’s baking sourdough, working on arts and crafts, or enjoying time outdoors, she values creating meaningful moments with her family.

Receptionist

Malia Blosser

Malia Blosser

Malia serves as the first point of contact for many of our clients, helping create a welcoming and supportive experience from the very first phone call. As our receptionist, she assists with scheduling, communication, and ensuring that each interaction reflects the care and professionalism our firm values.

She understands that many families who contact our office may be navigating stressful or uncertain situations, and she strives to make every conversation feel comfortable and reassuring.

Outside of work, Malia enjoys spending time with her husband and their two children. She loves reading, watching movies, and baking with her kids — creating meaningful memories both at home and at work.

Of Counsel

Janeece L. Dent-Bennett

Janeece L. Dent-Bennett

Janeece Dent-Bennett was born in Lexington, Missouri, in 1960 and graduated from Lexington High School in 1979.  She graduated with a Bachelor of Science in Business Administration with a major in Accounting from University of Central Missouri in Warrensburg, MO in 1982. 

In 1985, Janeece graduated with distinction from the University of Missouri-Kansas City School of Law.

Upon graduation from law school, Janeece joined the former Shughart Thomson & Kilroy, P.C. law firm (now Polsinelli) in Kansas City, Missouri, with a primary practice in corporate and business law. 

She started her own law practice in 1989 and has since practiced law in Lee’s Summit, Missouri, serving clients throughout the state of Missouri with a primary emphasis in Wills, Trusts, Estate Planning, Probate, and Business Transactions.

Janeece is married and has 3 children.  Jillian Dent is an attorney in Kansas City, Missouri.  Nathan Dent is a Certified Public Accountant in Denver, Colorado.  Andrew Bennett is an Electrical Engineer in North Kansas City, Missouri.  Her husband Mark Bennett is an IT specialist contractor for the USDA.

Recently, Janeece closed her former solo law practice of 36 years and joined Paths Law Firm in Lee’s Summit, MO as Of Counsel.

Legal Assistant

Reese M. Lehr

Reese Lehr

With a strong background in customer service and a passion for helping others, Reese brings dedication and a positive attitude to her role as a Legal Assistant at Paths Law Firm. She supports the team by managing client correspondence, organizing policies, and stepping in wherever needed to ensure clients receive the highest level of care. Known for her strong work ethic and adaptability, Reese is always ready to tackle new challenges and contribute to the firm’s mission.

Reese is currently enrolled in the Honors Program at the University of Missouri–Kansas City, where she continues to pursue academic excellence. Outside of work and school, she enjoys spending time outdoors and cherishing meaningful moments with her family and friends. Her enthusiasm, reliability, and drive make her a valuable part of the Paths Law Firm team.

Office Assistant

Christine G. Yates

Christine G. Yates
Christine serves as the Office Assistant at Paths Law Firm, where she supports day-to-day operations with a strong work ethic and a positive attitude. A student at Faith Christian Academy, Christine is passionate about pursuing a future career in both business and law, with a goal of serving her community and making a meaningful impact.
 
Outside of the office, Christine is a multi-talented individual who enjoys spending time with family and friends, playing musical instruments, practicing martial arts, cooking, exploring the outdoors, and constantly learning new skills. Her energy, curiosity, and dedication make her a valued member of the Paths team.

Legal Assistant

Bailey E. Harrison

Bailey
Bailey is a skilled Legal Assistant with a focus on elder law, providing dedicated support to both clients and attorneys. With a strong background in customer service and a certification from the University of Arkansas’ paralegal program, Bailey brings exceptional organizational skills, attention to detail, and a client-centered approach to their work.
 
Committed to efficiency and professionalism, Bailey assists in navigating complex legal matters with compassion and precision. Outside of work, Bailey maintains a balanced lifestyle by reading, staying active, and spending quality time with their cats.

Community Relations

Jeane M. Fracassa

Jeane M. Fracassa

Jeane Fracassa – a dedicated and accomplished professional who retired with an impressive 38-year service record from the Kansas City Missouri Police Department. Throughout her illustrious career, Jeane served as a Civian Supervisor in the Communications Unit, where she played a pivotal role in ensuring efficient and effective communication within the department.

Even in retirement, Jeane’s commitment to community service remains unwavering. Currently, she serves in various capacities within Community Relations at Paths Law Firm. Actively engaged in the Lee’s Summit and Overland Park communities, she proudly represents the law firm.

In all aspects of her life, Jeane Fracassa exemplifies the values of community, compassion, and family. Her commitment to making a difference and her love for exploration make her a remarkable individual, whose presence brightens the lives of those she encounters. Whether at work, with family, or during her travels, Jeane’s genuine care for others and her zest for life make her a truly remarkable and inspiring person.

Attorney

Kathleen E. Overton

Kathleen E. Overton, Attorney

Kathleen Overton is an attorney and owner at Paths Law Firm. She has more than 17 years of experience advocating for those with special needs and navigating the state and federal agencies formed to help the disabled and elderly. At Paths Law Firm, Kathleen’s practice focuses on helping the elderly qualify for nursing home Medicaid, creating estate plans to protect beneficiaries, as well as a lot of time planning and forming businesses. Kathleen also enjoys helping clients form non-profit organizations and obtain 501(c)(3) tax exempt status.

 

After attending law school at the University of Oklahoma, Kathleen began representing clients before the Social Security Administration. Eventually her practice switched to federal court appeals and Kathleen spent years representing clients before the Eastern and Western District of Missouri, the District of Kansas, and the Eighth Circuit Court of Appeals. Kathleen has since focused her practice on estate planning and elder law after watching clients struggle to find ways to financially care for loved ones with special needs or aging parents.

 

Kathleen lives in the Northland with her husband and four children. She spends her free time attending soccer matches and ballet performances with her children and starting endless home improvement projects with her husband. 

DIRECTOR OF OPERATIONS

Sydney R. Morris

Sydney R. Morris

Sydney serves as the Director of Operations at Paths Law Firm, overseeing the firm’s internal processes, team coordination, and strategic initiatives. Since joining the firm in 2017, she has grown from an experienced paralegal and internal accountant into the central force behind the firm’s operational excellence. 

She graduated with honors from the University of Missouri–Kansas City in 2022 with a Bachelor of Science in Accounting. Sydney is also a proud alumni member of Bloch Launchpad, Phi Theta Kappa, and the National Honor Society.

Outside of the office, Sydney enjoys spending time with her husband, reading, baking, and going on long walks.

FINANCIAL MANAGER

René A. Fracassa

René A. Fracassa

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

In her spare time, René is currently quite active managing multiple generations of her family, including parents and grandkids.  René has had great impact on the lives of many women teaching discipling and teaching and abundance of Bible Studies. Her former career in management and event planning trained her well to juggle all the activity.

MARKETING MANAGER

Hilary R. Tichota

Hilary Tichota

Hilary plays a vital role in managing the Marketing Department at Paths Law Firm.  She is excellent at bringing new ideas and sharing valuable resources with the law firm and our community. Hilary has been with the law firm since the beginning, working in nearly every role which is invaluable in her marketing endeavors as she brings a unique set of skills into the Marketing Department.

Hilary is nearly complete in her Bachelor’s of Arts Degree in Marketing at Park University.  She has earned the honor of being listed in National Honors Society, Phi Theta Kappa, and the Dean’s List. Hilary is always looking for new and innovative ways to share the law firm’s message.

ATTORNEY

Russell A. Fracassa (Rusty)

Attorney Russell A. Fracassa

When asked what he wants to do, his reply was “I just want to sit at the kitchen table and work directly with people.” Rusty enjoys working with clients providing experienced advocacy and supporting them through their unfamiliar and overwhelming situations. Due to all the challenges faced by seniors, it is essential to work with an experienced elder law attorney who has expertise in the law, issues, and concerns affecting seniors and their families.

Rusty brings more than 30 years legal experience and expertise working for seniors and their families as an elder law attorney in Kansas City and surrounding. Prior to law school, Rusty was an accountant and his first couple years practicing law was as a tax attorney. This provides invaluable experience in his current practice of law. Rusty’s focus is helping protect seniors’ assets from taxes and long-term care costs, benefit qualification, and navigating more complex family scenarios in their estate planning.

Rusty has personally experienced the loss every parent fears, caring for a spouse suffering with cancer and the treatment, and working with aging parents through all stages of their lives.  He intimately understands the challenges faced by individuals and their caretakers when capacity or health declines, how to prepare for it, and the legal matters while in the midst of it.  He may not be able to eliminate his client’s grief, but he strives to provide clients with peace of mind.

In 2010, Rusty’s faith and love led him and part of his family to China as Christian missionaries. He and his wife, went permanently, but ended up dedicating 3 years to that ministry. They returned to Missouri to help with grandchildren after a family tragedy and later began anew with Paths Elder Law. The goal is providing compassionate care through legal advocacy.

Rusty has multiple degrees and advanced study spanning his Bachelor’s of Arts in Business Administration – Accounting at Rockhurst College (now Rockhurst University), Masters of Arts in Accounting and in Intercultural Studies, as well as his Juris Doctorate from the University of Missouri at Kansas City School of Law.

When Rusty is not practicing law, he enjoys spending time with his family, grandchildren, and excessive eating at local restaurants.

Practice Areas

  • Wills and Trusts
  • Estate Planning
  • Asset Protection
  • Medicaid Benefits
  • VA Benefits
  • Probate
  • Guardianship and Conservatorships
  • Education

 

BSBA and Master’s in Accounting, Master’s in Inter-Cultural Studies, and Doctorate in Juris Prudence

  • Rockhurst University
  • Liberty University
  • University of Missouri – Kansas City


Admissions to Practice

  • Missouri


Professional Memberships and Affiliations

  • State Bar of Missouri
  • National Academy of Elder Law Attorneys (long-time Member)
  • Elder Counsel (Charter and Ongoing Member)
  • Missouri Association of Trial Attorneys (Past Member)
  • Kansas City Metropolitan Bar Association
  • Missouri State Bar Committees – Elder Law, Estate Planning, Probate