Alzheimer's Disease and Nursing Home Care

Medically Reviewed by Christopher Melinosky, MD on September 11, 2022
Written by WebMD Editorial Contributors
4 min read

When people with Alzheimer’s disease need round-the-clock care, a nursing home may be the best way to make sure they’re safe and healthy.

This kind of long-term care offers many services that can meet the physical, social, and emotional needs of people who have long-term illnesses and can’t take care of themselves.

The decision to move your loved one into a nursing home isn’t an easy one. It helps to have all the information you and your family need about this option so you can know if it’s the right choice.

There are two main types:

  • Basic care, such as help with bathing, eating, dressing, and getting around.
  • Skilled care includes the services of health professionals, like a registered nurse, physical therapist, or occupational therapist. They manage health conditions and give medical treatments.

The services that nursing homes offer vary, but they usually include:

  • Room and board
  • Help with medication
  • Personal care like dressing, bathing, and using the toilet
  • 24-hour emergency care
  • Social and recreational activities

It takes time to research nursing homes and decide on the one that’s best for your loved one. So you should start looking long before you’ll need to take the step of moving them. Many facilities often have waiting periods, too. Plan ahead so you can make the transition much easier.

Family and caregivers should talk about what services their loved one needs and how often they need them. Think about what’s important to you before you start calling different nursing homes.

Before you schedule visits to the ones you’re interested in, ask about vacancies, admission requirements, the level of care they provide, and if they accept payment with Medicare, Medicaid, or other government-funded health insurance options.

There are four main choices: Medicare, Medicaid, private insurance, and paying out of your own pocket. Not all facilities accept each type of payment. When you’re researching nursing homes, ask them which options they take. It’s important to know how they’re different, too:

  • Medicare is a federal health insurance program that offers health care benefits to all Americans age 65 and older. It offers insurance protection to cover major hospital care, but it allows only some benefits for nursing home care. Also, the program only pays for skilled care in a nursing facility that has a Medicare license.
  • Medicaid is a joint federal/state health insurance program that provides medical care benefits to low-income Americans who qualify. Nursing home care is covered through Medicaid, but eligibility and covered services vary a lot from state to state.
  • You can buy private long-term care insurance to supplement Medicare coverage. Each policy has its own eligibility requirements, restrictions, costs, and benefits.

Review this checklist before you visit nursing homes, and take it with you to keep track of your questions.

Facility

  • Does the nursing home provide the level of care your loved one needs, such as skilled care?
  • Does the facility meet local and state licensing requirements? Does the administrator have an up-to-date license?
  • What are the visiting hours?
  • What is the policy on insurance and personal property?
  • How does the staff respond to a medical emergency?
  • Does the facility have a Medicare license?

Admission and Assessment

  • Is there a waiting period for admission?
  • What’s required to get in?
  • Is there a written care plan for each resident?
  • How does the staff decide what services a resident needs? How often do they do that?

Fees and Financing

  • Have fees gone up a lot in the past few years?
  • Is the fee structure easy to understand?
  • What are the billing, payment, and credit policies?
  • How much do different levels or types of services cost?
  • Which services are covered in the quoted fee, and what costs extra?
  • Does the facility accept Medicare, Medicaid, Medicare Supplemental Insurance, Supplemental Security Income, and other government financing options?
  • When can the center terminate a contract? What’s the refund policy?

Staff

  • Do the nurses, social workers, and administrators have experience working with older patients?
  • Are staff members available to meet scheduled and unscheduled needs?
  • Do staff members seem to enjoy working with the residents?
  • Do they treat residents like adults? Do they call them by their first names?
  • Are there people to help residents who have problems with memory, confusion, or judgment?

Residents and Atmosphere

  • Do residents seem happy and comfortable? Are they clean and dressed well?
  • What do residents, other visitors, and volunteers say about the nursing home?
  • Are the rights of residents clearly posted?

Facility Design and Features

  • Do you like the look of the building and its surroundings?
  • Do the living spaces feel homey?
  • Is the floor plan easy to follow?
  • Do wheelchairs and walkers fit in doorways, hallways, and rooms?
  • Are there elevators?
  • Are the rooms well-lit?
  • Is the facility clean, odor-free, and at a comfortable temperature?
  • Is there a 24-hour emergency response system in each room?
  • Are bathrooms private? Do wheelchairs and walkers fit?
  • Can residents bring their own furnishings? What may they bring?
  • Do all rooms have a phone?

Medication and Health Care

  • What’s the policy on storing medication and helping residents take it? Can residents take their medicine themselves?
  • How often does a doctor or nurse visit to give medical checkups?
  • Who coordinates visits from physical, occupational, or speech therapists?

Social and Recreational Activities

  • Is there an activities program? Is the schedule clearly posted?
  • Do most of the residents at an activity seem to join in?

Food Service

  • How often does the center provide meals? What’s a typical menu? Are there set meal times?
  • Is the food hot and appetizing?
  • Are snacks available?
  • What if residents need special foods?
  • Is it easy to get drinking water anywhere in the facility?
  • Are there group dining areas, or do residents eat meals in their rooms?