Whether you are searching for yourself or you are a family member helping out, finding the best nursing home can be a difficult process. For all involved it’s a new emotional and financial challenge. But the more prepared you are the better decision you’ll make.
What is a Nursing Home?
A nursing home is place for a person who can’t be cared for at home but doesn’t need a hospital. Nursing homes typically have a nursing staff on site 24 hours a day. Some are set up like hospitals with physical, speech and occupational therapy. Some have special units for Alzheimer and dementia patients.
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Nursing home are not only for the elderly; they are for anyone who needs 24-hour care.
Up until recently, nursing homes were rigid and institutionalized. There were rules and a schedule for everything (waking, sleeping, eating, bathing, etc.). Now the culture is changing to one of resident-centered care. They want their residents to feel like they’re at home.
Many nursing homes are households—small groups of residents living under the same roof with the same staff sharing meals and activities. Some homes are on campuses with multiple households. Resident dogs and cats can often be found in the homes. And some homes let residents bring in their own pets.
Initial Searching
Before you do a lot of leg work, ask around.
Ask your doctor, family, friends, neighbors and clergy what experiences they have with nursing homes.Ask a hospital’s discharge planner or social worker for recommendations especially if you’re in the hospital or were recently.Contact a social service agency and talk to case manager about nursing home choices.Contact your local Agency on Aging for recommendations.
Selecting the Right Nursing Home
After you’ve asked around (see above) and have some homes that sound promising, go for a visit. And think about these questions while you’re there. These questions will most likely lead to other questions.
Quality of Life
Is the staff respectful and friendly?
Is the nursing home clean?
Do they offer social, recreational, religious and cultural activities that interest you?
Can you choose your waking, bed time, and bathing time?
Can you get food and drinks anytime? Is the food good? Ask to try it.
Can you have visitors anytime?
Can you have a pet?
Is transportation provided?
How much privacy is there?
Can you decorate your room how you like?
Is the temperature comfortable?
Is there good natural lighting?
Do you have a telephone and TV in the room?
Quality of Care
To be a certified Medicare/Medicaid provider, a nursing home must meet 150 requirements ranging from safe storage of food to protecting residents from physical and mental abuse. The State Survey Agency performs an inspection to rate the nursing home on these requirements. Ask to see a copy of this inspection report. You can also compare nursing homes on www.medicare.gov.
Will you get a copy of your care plan? Your care plan is based on your health information and must be assessed in the first 14 days and at least every 90 days thereafter.
Who are your doctors? Can you see your personal doctor?
What improvement goals is the nursing home working on?
Staffing
Federal law states there must be enough staff to care for the residents. What is enough? There must be at least one RN for at least 8 straight hours, 7 days a week. And there must be either an RN or LPN (Licensed Practical Nurse) on duty 24 hours a day.
Does the staff wear nametags?
Does the staff know the residents by name?
Do they knock on residents’ doors before entering?
Is there a licensed doctor on staff daily?
Costs
Costs will vary based on location, the type and amount of care, and who the provider is. Some nursing homes will charge extra for additional services while others will have “all inclusive fees.”
The average across the country as of 2009 was:
$219 per day for a private room$198 per day for a semi-private room.
Seniorliving.org has a complete directory of nursing homes and includes reviews and other features than can be useful when combined with the existing government resources.