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8 Factors to Consider When Choosing a Nursing Home

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The decision to place a family member in a nursing home is often very difficult and may be accompanied by feelings of guilt, sadness and anger. In addition, the bad publicity some nursing homes have received for providing inadequate and sometimes dangerous care can add to the anxiety. Try to focus on the fact that many nursing homes do provide excellent care. With thorough research, you should be able to find a suitable facility.

The first step toward finding a good one is to talk to as many people as possible. Helpful information may come from the patientís doctor, from friends and acquaintances who have a family member in a home and from the nursing home ombudsperson (a staff member who is responsible for investigating complaints). In addition, your local chapter of the Alzheimerís Association may have a list of recommended homes or personal references. Visit any nursing homes under consideration several times before making a final decision. Some factors to consider during those visits are outlined below.

Licensing and regulations.†The home and its administrator should have current licenses from the state, and the facility should meet state fire regulations, which include sprinkler systems and fire doors. Consider asking to see the latest state survey and/or monitoring report. (This report, which comes from the state†licensing agency, should be kept in a public place.) Medicare has developed a ranking system that looks at quality of care markers and provides comparative data on all licensed nursing homes.

Care and services.†It is important for the staff to be familiar with common issues arising from dementia. Ask whether the staff is continually trained in dementia care, what kinds of programs are offered to the residents, how individual care plans are developed and how different levels of functioning are supported.†

Staff.†Talk with the staff members who work directly with residents to see if they are competent, friendly and content in their jobs. Does the nursing home conduct background checks on the staff? Observe how residents are treated and whether they receive help when they ask for it. Note whether the person giving you a tour of the home knows the residents by name and is recognized by them. Also, meet with the administrator and directors of nursing and social services. Ask about such things as the number of people each aide takes care of and how the facility is staffed on weekends and in the evenings. Find out if the staff has received any special training in caring for people with Alzheimerís diseasef. Also, ask whether there are licensed nursing staff 24 hours a day, including a Registered Nurse (RN) at least eight hours every day. Do the nurses and Certified Nursing Assistants work with the same residents four to five days per week? Is there a licensed doctor on staff daily who can be reached at all times?

Costs.†Nursing home care is expensive. Be sure all costs are clearly outlined and understood before you make a decision. Address how costs will be met and whether paying for them will create a financial burden for family members. Because the laws regarding payment for nursing home care can be complex and vary from state to state, be sure to contact a reliable source for accurate information. The Alzheimerís Association, insurance companies, attorneys who specialize in financial planning, Medicare representatives and some staff members of in-home care programs may be well informed on payment options. Important questions to ask include: Does the home accept the patientís funding sources (for example, Medicare or Medicaid)? Will the resident receive a refund of advance payments if he or she leaves the facility? How does the home protect cash and assets that are entrusted to it? How are withdrawals noted to keep track of the account? What charges are extra (for example, television, telephone, laundry, personal-care supplies, special nursing procedures)?

Cleanliness and safety.†Be sure the nursing home is clean and safe, especially the kitchen and bathroom. Note unpleasant odors, such as mold, garbage or urine. Odors that persist on return visits may indicate poor patient care or poor housekeeping. Make sure that the bathrooms have handrails and nonskid floors, the furniture is sturdy, the doors to the outside are secure and the facility protects the safety of people who wander. Find out whether there are policies to protect residentsí possessions. Does the home replace items that are lost? Is there an emergency evacuation plan, and are regular fire drills held? Does the home have an arrangement with a hospital for emergencies?

Comfort.†Spend time observing everyday life. Ask residents and visitors their opinions of the facility and its staff. Do the residents look happy, relaxed and involved in activities? Are residents clean, appropriately dressed, and well-groomed? Ask yourself: Is the facility relatively quiet, well lit and pleasant to be in? Is there a well-planned indoor or outdoor wandering path? Are there familiar elements, such as home-like furnishings?

Visiting.Be sure the home is close enough so that family members can visit regularly. Confirm that the home has convenient visiting hours and that the resident can have privacy with visitors. Are there quiet areas where residents can chat with family members and friends?

Meals and activities. Check whether the food is wholesome, appealing, and suitable for older persons. Can residents choose their meals? Are nutritious snacks available? Does the staff assist the residents with eating and drinking if necessary? Also, be sure there are creative social activities in addition to supervised daily exercise. Are there outdoor areas designed for residentsí use? †

Posted in Memory on April 28, 2016


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Health After 50 Disclaimer


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