If your loved one needs medical care that you can't give them, but they don't have to be in a hospital, a nursing home may be the right choice. It's a way for them to get regular attention from skilled health professionals.
What Is a Nursing Home?
A nursing home has aides and nurses on-site 24 hours a day. Some have doctors that visit regularly. Others bring residents to their doctors' offices.
People stay for different reasons, like critical injuries, serious illness, or getting care after having surgery. Some nursing homes have units for people with memory problems like dementia.
Many nursing homes are set up like a hospital. Your loved one will either have their own room or share one with another resident. They have a full staff for medical care, physical therapy, speech therapy, and occupational therapy.
Others are set up like shared housing, with a community kitchen that residents can use and home-like décor.
How to Choose the Right Nursing Home
First, get recommendations from people you know and trust. Talk to:
- Your loved one's doctor
- A social worker at a local hospital
- Religious groups or clergy
- Friends and family
Next, call each nursing home. Ask questions like:
- Do you have space available now?
- Is there a waiting list? If so, how long?
- What are the requirements for admission?
- What levels of care do you offer?
- How much does it cost?
- Do you work with government-funded health insurance?
- Are you licensed? By whom?
- What is your Medicare star rating?
- How do you respond to medical emergencies?
- What are your visiting hours?
Then visit the homes you're interested in. Be sure to:
- Meet with the director and nursing director.
- Ask more detailed questions about the policies, costs, and services.
- Find out how long the staff has been working there. Low turnover is a good sign.
- Visit a second time, without calling ahead. Do it at a different time or day of the week.
When you visit, observe things like:
The dining room. Is it clean? Does the food look good?
The staff. Are they attentive to residents?
The smells. Are there strong odors? If so, ask what they're from.
Handicap access. Will it accommodate your loved ones needs?
How to Pay for It
Nursing homes are expensive. Medicare may cover some of the costs, like short-term care or rehab that's needed after a hospital stay. But you can't rely on it for the long term.
"Many people do not realize that Medicare doesn't pay for nursing home care indefinitely," says Chris Herman, MSW, LICSW, an eldercare expert at the National Association of Social Workers.
If Medicare funding and your loved one's own savings start to run out, Medicaid may help. That's a government program that helps provide health coverage if you have a low income.
Most nursing homes accept both Medicare and Medicaid. Before your loved one moves in, check to see that it takes payments from both.
How to Make It Work
You can do things to make sure your loved one is getting the care they need:
Visit often. You should also ask friends and relatives to do the same.
Get to know the staff. Share with them what you know about your loved one, such as what they like and don't like. If they prefer a certain daily routine, ask the staff to help provide it.
Pay attention. Check your loved one's care plan, and make sure everyone is following it. If you see something you don't like, speak up. Ask for a meeting to discuss your concerns.
Get involved. Go to family meetings if they're offered.
Keep up with regulations. Check in with your local ombudsman to make sure the nursing home is following all the latest rules.
Document everything. Note any problems that come up. Include dates, times, and the names of people who were involved. This will be helpful if you decide to file a complaint.
Lose the guilt. Remember that you're giving your loved one the best possible care.
"Moving elderly parents -- out of love and safety -- is not a denial of duty," says Barbara McVicker, an eldercare expert and host of the PBS television special Stuck in the Middle: Caring for Mom and Dad.