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 equipment or 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 the cognitive decline they 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, simple aging is 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 when choosing 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.

At Paths 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 Law to schedule a consultation.  Peace of mind is only a phone call away. 

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Community Relations

Jeane M. Fracassa

Community Relations

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.

Administrative Assistant

Laura E. Messer

Administrative Assistant

Laura E. Messer

Laura is the Law Firm’s marketing assistant, supporting all marketing tasks, including managing calendars, researching upcoming events, updating marketing software and spreadsheets, and partnering with organizations to maintain relationships that benefit Paths Law Firm’s clients.  Laura is also the law firm’s professional photographer as she provides the professional photographs for the headshots, organizations, events, and networking.

Laura has over 10 years of experience as a professional photographer.  She is also Adobe and Microsoft Certified.  She graduated from Columbia College, Columbia, Missouri with her Bachelor of Arts degree, Magna Cum Laude, in Behavioral Psychology (minors in Social Work and Criminal Justice), and her Photographic Craftsman degree from Professional Photographers of America. She is certified as a Qualified Mental Health Professional, Certified Gentle Teacher, Medicaid Billing Certified, Crisis Intervention Counselor, and a Missouri Notary.

Laura has been married more than 26 years and has a daughter and a son. She has four brothers, a niece, and a nephew. Her four spoiled pets that love her attention. A lot of Laura’s off time is spent taking photos and she is an internationally published photographer. Laura owns a studio on the historic Independence Square. 

Administrative Assistant

Holly D. Bramble

Administrative Assistant

Holly D. Bramble

Holly is our newest member of the administrative team. She is hardworking, has proven organizational skills and excellent communication skills. Holly has transitioned to the Estate Planning field from healthcare administration where she gained valuable knowledge that has contributed to her success here at Paths.

Holly enjoys spending time with loved ones, cheering for the Chiefs, and relaxing on the beach.

Administrative Assistant

Tressa L. Purdy

Administrative Assistant

Tressa L. Purdy

Tressa has the important role of being a client’s initial point of contact as the law firm’s receptionist for all locations.  She also welcomes, assists, and cares for clients at the Lee’s Summit office. Additionally, she provides support in an administrative capacity for the attorneys, staff, and clients.  When you meet Tressa, the first quality many note is her readiness to be of assistance.

 

Tressa is a graduate of Park Hill High School with extensive administrative experience and executive level management. Tressa brings a stability and comfort to the law firm experience having worked in a variety of industries and having lived in six different major metropolitan cities.

 

Tressa has a daughter, two sons, and one grandchild.  In her free time, she enjoys her family and friends, loves being outdoors, gardening, bike riding and bird watching. Indoor hobbies include scrapbooking, painting cookies, and cheering on Chiefs football. She is a Kansas City native but enjoys traveling but is always happy to be back in her hometown.  

Attorney

Kathleen E. Overton

Attorney

Kathleen E. Overton

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. 

Medicaid paralegal

Tena K. Dooley

Medicaid Paralegal

Tena K. Dooley

Tena is a Medicaid Paralegal.  She is very meticulous and organized.  She works closely with the attorneys, clients, and State representatives. 

Tena has an associate in applied science and has over 20 years of office management experience. She has two daughters and one grandson.

Tena enjoys spending time with her family.  She enjoys everything outdoors and her hobbies include fishing and gardening.

PARALEGAL & ACCOUNTANT

Sydney R. Morris

PARALEGAL & ACCOUNTANT

Sydney R. Morris

Sydney is the law firm’s internal accountant and one of their experienced paralegals having been with Paths Law Firm since 2017. She is a primary point of contact for estate planning and business planning.

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

In her free time, Sydney enjoys spending time with her husband, reading, baking and going on long walks. 

SENIOR ADMINISTRATIVE ASSISTANT

Christy L. Phillips

SENIOR ADMINISTRATIVE ASSISTANT

Christy L. Phillips

Christy has three years of experience in elder law working for seniors and their families. She is currently the Senior Administrative Assistant and organizes the day to day functions of the office and makes sure everything runs smoothly. When asked why she loved what she does, Christy said at Paths Law Firm, she gets the opportunity to help clients in more ways than one. Her favorite parts of the job are getting to know the clients and helping them get their questions answered. 

Christy’s experience in the finance industry has been extremely beneficial to her role as the Senior Administrative Assistant. Christy has a special place in her heart for the elderly and attributes this to the relationship she had with her grandparents. 

Christy was raised in Ogden, Utah and moved to Independence, MO, when she was ten years old. She has been with her high school sweetheart for 25 years and they have two beautiful children together. Her daughter works in the medical industry, and her son currently attends High School and plays Baseball. When Christy is not working, she enjoys crafting and spending time with her family and friends.

Christy’s experience in the finance industry has been extremely beneficial to her role as Benefits Coordinator. There have been many influences that went into her decision to select the field of Elder Law. Christy has a special place in her heart for the elderly and attributes this to her relationship with her grandparents.

When asked why she loves what she does, Christy said that at Paths Elder law, she gets the opportunity to help clients in more ways than one. Her favorite part of her job is getting clients approved for Medicaid or VA benefits as it is a huge relief for them and their loved ones.

Christy was raised in Ogden, Utah, and moved to Independence, MO, when she was ten years old. She has two children that keep her busy and fill her life with joy! Christy’s daughter cheers for Avila University, and her son plays competitive baseball for the Bucks and races BMX locally for the Motorcycle Closeout Team.

When Christy is not working, she enjoys crafting and making homemade gifts for her loved ones and raising her kids to be healthy, happy, and positive humans.

 

Practice Areas

  • Medicaid Benefits
  • VA Benefits

 

Professionalc Memberships and Affiliations

  • Missouri Notary

FINANCIAL MANAGER

René A. Fracassa

Rene A. Fracassa, Paths Law

FINANCIAL MANAGER

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.

 

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.

 

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.

 

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

MARKETING MANAGER

Hilary R. 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.

While not working, Hilary spends her time with her family at their rural home. They tend to their chickens and honeybees and enjoy the solitude of country living.

SR. PARALEGAL & OPERATIONS MANAGER

Jennifer A. Bronson

SR. PARALEGAL & OPERATIONS MANAGER

Jennifer

Jennifer is the Sr. Paralegal and Operations Manager at Paths Law Firm.  She oversees the firm’s probate department as well developing, implementing, and managing all the firm’s administrative processes having been with the law firm almost from the beginning.  She enjoys client contact as well as behind-the-scenes operations.

 

Jennifer began her legal career in 1990 as a legal secretary.  She has worked in small and medium sized firms, as well as court operations.  She has her Paralegal Certificate from Boston University, Law Office Management Certificate from University of Central Missouri, and she is a Master Financial Coach. 

 

Jennifer has two daughters, twin sons, and twin grandsons.  She spends as much time as she can with them.  She enjoys reading, listening to podcasts, and tending her yard. 

ATTORNEY

Russell A. Fracassa (Rusty)

ATTORNEY

Russell A. Fracassa (Rusty)

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