I have been helping several friends who have suddenly found themselves in caregiving crisis mode–each with an elderly parent who has had to be placed in a nursing home after a stint in the hospital. Several are there because of terrible falls (one straight down a whole flight of stairs head first...
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Re: How to Find and Check Out Nursing Homes
AFA Social Services Team
Monday, July 09, 2007 at 03:20 PM
Jacqueline makes a very poignant point regarding the importance of choosing the correct nursing facility for a loved one. It can be difficult to know where to turn at such times, and the wonderful links that Jacqueline has provided will surely be of benefit. The AFA Social Services Team often receives calls and emails from caregivers regarding the placement of a loved one in a residential care setting. We would like to share some general definitions and guidelines regarding this important topic in the hope that they too will be of use. Many families choose to investigate residential care settings, such as assisted living facilities and nursing homes, when their loved one develops needs for care and supervision that are difficult to manage in the home. These “long-term-care” residences often have special Alzheimer's disease or dementia care units within the facility. Such a unit is an appropriate setting for someone with the unique needs created by symptoms of dementia. However, the quality of these units can vary greatly and they are not always available in all areas of the country. The additional challenge of affording this care can actually complicate matters further. Assisted Living Facilities are private rental facilities with individual and shared units, where older adults can purchase care services just as they could if they were living at home. They are not health care facilities. However, the supervision is often very good and the setting creates a nice feeling when the family visits. There are good facilities, where the dementia unit is very well run. There are also not-so-good facilities, where the dementia unit is barely adequate. There may be little oversight or regulation by the department of health in certain states. You must be an informed and thorough consumer when shopping for such a facility. Also, the contract you sign can be confusing and difficult to understand. These contracts may allow the administrator to deny or discontinue services and residency to your loved one under certain circumstances, and it is important to understand those restrictions up front. Almost all Assisted Living Facilities are private-pay only. Once in a while you can find one that has a few beds that may be paid for by billing Medicaid (not Medicare). Such arrangements are rare. Also, Alzheimer's disease very often creates a need for skilled nursing care, and these facilities can be insufficient in meeting those needs if they do not include comprehensive on-site nursing services.Nursing homes are another option. These facilities are licensed healthcare centers, and are regulated and inspected. There is a public listing of complaints and inspection results that you should review. Nursing homes can provide a great deal of skilled care. However, they are not always attractive and can invoke negative feelings. Even the words "nursing home" can create strong emotions. However, it is important to understand that these facilities are designed to care for people in need. If it is possible to find a nursing home with an Alzheimer's specialty or a special care unit, the staff will probably have a good deal of training and supervision. There should be frequent specialized programming to stimulate the residents both socially and intellectually, but such facilities vary greatly in the scope and availability of therapeutic activity. Medicaid typically pays for skilled nursing care, and private-pay arrangements can be made. The best way to assess a facility, once the list has been narrowed to a few good options, is to visit the facility in person. Go a few times to each facility on weekdays, evenings, and weekends. It is helpful to see how the facility looks at different levels of staffing. Ask about the programming that is done to keep people happy and stimulated (1 or 2 hours each day is not enough). Ask about the quality and quantity of training for the staff (specifically for dementia care), the security of the unit, and the ratio of residents to workers. Ask the residents if they enjoy living in the facility. Trust your senses—does the unit smell badly or have poor lighting? Does it have a comfortable temperature? Are the nursing assistants chatting to one another at the nursing station while the residents sit in the corridor without any companionship, or are the professional workers engaging the residents and actively trying to improve their quality of life? Remember, the long-term-care facility that is chosen at first does not have to be the facility that is permanently entrusted with the care of your loved one. If the care is disappointing, unsatisfactory or outright neglectful, find another facility that is eager for the opportunity to impress you with the extraordinary quality of care offered within. Please do not hesitate to contact AFA in the future for information, referrals, or support. AFA recognizes the enormity of caregiving, and has an array services to help. These include a toll-free national hotline (866-AFA-8484), a free caregiver magazine (http://www.alzfdn.org/publications); and a national toll-free telephone support network, Care Connection (http://www.alzfdn.org/services/careconnection.shtml or www.askdrjamie.com).
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nursing home
N.C.
Thursday, March 20, 2008 at 11:00 AM
This is very informing. Thank you all very much! It is useful for us to find a home for my father-in-law in the future.
Nina
Many families choose to investigate residential care settings, such as assisted living facilities and nursing homes, when their loved one develops needs for care and supervision that are difficult to manage in the home. These “long-term-care” residences often have special Alzheimer's disease or dementia care units within the facility. Such a unit is an appropriate setting for someone with the unique needs created by symptoms of dementia. However, the quality of these units can vary greatly and they are not always available in all areas of the country. The additional challenge of affording this care can actually complicate matters further.
Assisted Living Facilities are private rental facilities with individual and shared units, where older adults can purchase care services just as they could if they were living at home. They are not health care facilities. However, the supervision is often very good and the setting creates a nice feeling when the family visits. There are good facilities, where the dementia unit is very well run. There are also not-so-good facilities, where the dementia unit is barely adequate. There may be little oversight or regulation by the department of health in certain states. You must be an informed and thorough consumer when shopping for such a facility. Also, the contract you sign can be confusing and difficult to understand. These contracts may allow the administrator to deny or discontinue services and residency to your loved one under certain circumstances, and it is important to understand those restrictions up front. Almost all Assisted Living Facilities are private-pay only. Once in a while you can find one that has a few beds that may be paid for by billing Medicaid (not Medicare). Such arrangements are rare. Also, Alzheimer's disease very often creates a need for skilled nursing care, and these facilities can be insufficient in meeting those needs if they do not include comprehensive on-site nursing services.
Nursing homes are another option. These facilities are licensed healthcare centers, and are regulated and inspected. There is a public listing of complaints and inspection results that you should review. Nursing homes can provide a great deal of skilled care. However, they are not always attractive and can invoke negative feelings. Even the words "nursing home" can create strong emotions. However, it is important to understand that these facilities are designed to care for people in need. If it is possible to find a nursing home with an Alzheimer's specialty or a special care unit, the staff will probably have a good deal of training and supervision. There should be frequent specialized programming to stimulate the residents both socially and intellectually, but such facilities vary greatly in the scope and availability of therapeutic activity. Medicaid typically pays for skilled nursing care, and private-pay arrangements can be made.
The best way to assess a facility, once the list has been narrowed to a few good options, is to visit the facility in person. Go a few times to each facility on weekdays, evenings, and weekends. It is helpful to see how the facility looks at different levels of staffing. Ask about the programming that is done to keep people happy and stimulated (1 or 2 hours each day is not enough). Ask about the quality and quantity of training for the staff (specifically for dementia care), the security of the unit, and the ratio of residents to workers. Ask the residents if they enjoy living in the facility. Trust your senses—does the unit smell badly or have poor lighting? Does it have a comfortable temperature? Are the nursing assistants chatting to one another at the nursing station while the residents sit in the corridor without any companionship, or are the professional workers engaging the residents and actively trying to improve their quality of life?
Remember, the long-term-care facility that is chosen at first does not have to be the facility that is permanently entrusted with the care of your loved one. If the care is disappointing, unsatisfactory or outright neglectful, find another facility that is eager for the opportunity to impress you with the extraordinary quality of care offered within.
Please do not hesitate to contact AFA in the future for information, referrals, or support. AFA recognizes the enormity of caregiving, and has an array services to help. These include a toll-free national hotline (866-AFA-8484), a free caregiver magazine (http://www.alzfdn.org/publications); and a national toll-free telephone support network, Care Connection (http://www.alzfdn.org/services/careconnection.shtml or www.askdrjamie.com).