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Decision Process |
| Home » Make Healthcare Choices » Decision Process |
Most of us want to care for our loved ones at home, that’s only natural. However, there are times when a loved one could benefit from the skilled nursing care a nursing home can provide. Your loved one’s physician(s) or other qualified healthcare providers can help you determine what type of care is needed so you can carefully evaluate your options.
When considering your options, keep in mind that a nursing home is more than just a residence that provides a room, meals and recreational activities. It is licensed to meet an individual’s ongoing needs for rehabilitation, medical care or supervision, or simply assist with daily living. Equally important, a nursing home is truly a resident's “home,” whether for a few months, a year or longer. Deciding to place your loved one in a nursing home can be difficult, and it’s important for both your loved one’s care and your own peace of mind that you make an informed decision.
Deciding on Nursing Home Care
Nursing homes—also referred to as skilled nursing facilities—can provide skilled nursing care 24 hours a day. This is ideal for people who may require help with daily living activities such as getting out of bed, eating, bathing, dressing and using the bathroom. Additionally, many people who live in nursing homes have chronic illnesses or need rehabilitative care, and can benefit from the services available at a nursing home.
If possible, include your loved one, as well as close family and friends, in discussions regarding nursing home care. And be sure to consult your loved one’s doctor before making a final decision.
Choosing the Right Home
Choosing a nursing home can be difficult. Unfortunately, many times a family has to make this decision when the loved one suddenly becomes ill or suffers an injury.
It is not uncommon for a hospital patient to be admitted directly to a nursing home. When this occurs, the hospital discharge planner can help guide you and your family through the admission process. Consider the following when deciding which nursing home best fits your loved one’s needs. (You can also visit the American Health Care Association’s Web site at www.ahca.org for more information and guidance on selecting a nursing home.)
Reliable referrals. Once the individual's specific needs are determined, your doctor can usually recommend quality nursing homes in your area. Friends and neighbors can also be valuable resources. Contact the local affiliate of the American Health Care Association, as well as health departments and agencies on aging. In addition, each state has a long-term care ombudsman—a patient advocate who can provide information to help you make this important decision.
Convenient location. The closer you are to your home, the more frequently you will be able to visit. Consider proximity to hospitals and the loved one's personal physician as well. Narrow your list to two or three nursing homes, and tour each at least once.
Competent staff. When visiting, notice if the caregiving team treats residents and family members with warmth and respect, and if requests for assistance are answered promptly. Make sure the level of cleanliness meets your personal standards. Ask about the types of individual and group activities offered, and discuss specific dietary needs if necessary. This is also the time to verify the nursing home has access to any additional therapeutic services your loved one may require.
Payment terms. Personal concerns aside, cost is understandably one of your important considerations. Licensed nursing homes are required to inform you of all services and fees in writing. In addition, each state has an Insurance Counseling and Assistance program. Its counselors can help you determine if you qualify for Medicare or Medicaid, if some or all of the cost is covered by a managed care plan or employer benefit package, and how to pay for any care that is not covered.
Personal involvement. If it's possible, including your loved one in the selection process will help ensure a successful transition to the new environment. Keep in mind, too, that you are an important part of your loved one’s caregiving team. Commit to regular visits, and encourage other family members and friends to do the same.
Touring the Home
When you’ve narrowed your list of possible nursing homes, take a tour and, if possible, take your loved one with you. During your tour, keep an eye out for the following important features that make a nursing home safe and comfortable for your loved one:
- There should be handrails in the hallways, grab bars in the bathrooms, hallways wide enough for two wheelchairs, smoke detectors and sprinklers, and other features that may prevent accidents.
- If your loved one has been diagnosed with Alzheimer’s disease, be sure that the home is well equipped to care for him or her. Ask specifically about the program in place.
- There should be space designated for residents to read, do crafts, play games or just socialize. There also should be a lawn or garden area for residents to enjoy fresh air outside.
- Choose a nursing home with a location that suits your loved one and makes it possible for family and friends to make regular visits.
- A “Resident’s Bill of Rights” should clearly identify and respect the resident’s individual rights.
- Residents should have an attractive dining room, food that looks and tastes appetizing, and tables that are convenient for wheelchairs.
- Noticeable odor or clutter is a sign that conditions might not be adequate. The nursing home should feel like a pleasant place to live.
Medicare’s “Nursing Home Checklist”
Medicare's “Steps to Choosing Long-Term Care”
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