Nursing Home Care

 

Sometimes the needs of a family member are more comprehensive than the family or caregiver can provide. In-Home Care may be an answer. But if it is not, the caregiver must make decisions about the future living arrangements.

There are two main types of long-term care residential facilities:

• Assisted Living, and
• Nursing Home Care

Nursing homes are primarily designed to meet the needs of persons convalescing from illness or to provide long-term nursing supervision for persons with chronic medical problems. Nursing homes are not hospitals and do not provide acute care. Residents are admitted by a physician’s order.

The discussion of nursing homes below is based on North Carolina law. It may be similar in your state. Check with your Ombudsman Program if you have any questions.

 

 

Types of Nursing Homes

There are three types:

Skilled Nursing Facility
They are required to provide continuous nursing supervision by registered or licensed nurses. Typically, they care for the incapacitated person in need of assistance with many aspects of daily living (walking, bathing, dressing, eating, etc.). At a minimum, they provide medical, nursing, dietary, pharmacy, recreational activities and social services.

Intermediate Care Facility
They are required to provide 8 hours of nursing supervision per day. This type care is less extensive than skilled nursing care and generally serves patients who are ambulatory and need less supervision and care. Licensed nurses are not always immediately available. At a minimum, they provide medical, intermittent nursing, dietary, pharmacy, and activity services.

Alzheimer’s Units
A facility that provides a "protective" and secure (locked) environment for people who have Alzheimer’s disease or other types of dementia that might cause them to be a danger to themselves or others.

Nursing homes are licensed by the NC Division of Facility Services.

 

 

Finding a Nursing Home

If it has become evident that your family member needs more oversight and nursing care than can be provided at home, a nursing home may be the best option. If you are undecided about whether or not making that move is the right decision, contact your local caregiver specialist. He or she can go over your options and can guide you related to what questions to ask of yourself and your family as you make this important decision.

 

Many Area Agencies on Aging maintain lists of long-term care facilities to assist caregivers and older adults as they make these life changing decisions. The Ombudsman (usually part of the Area Agency on Aging) can be very helpful in helping you to ask the right questions as you begin to look at facilities.

 

 

What to Look for When Choosing a Facility

None of us enjoys thinking about the possibility that we may need nursing home care. Often, the selection of a nursing home is made during a family crisis or right after a serious illness. There is little time to explore all the options before making a decision. But, if you have the opportunity, it is important to try to evaluate a facility beforehand.

Keep in mind that you are evaluating the facility for its ability to offer acceptable quality of life and quality of care. Often your five senses provide a good yardstick for quality of life and quality of care. Be aware of what you experience when you visit a facility. This may be your future home or the home of your family member. You want to make the best choice you can.

Remember to visit the potential home several times, at different times of the day and night. Talk to residents, staff, and other visitors. Don’t feel bashful about asking questions.

Check with your Ombudsman Program and/or your state aging agency for information on recent citations and complaints for a facility being considered. In NC, contact the NC Division of Health Services Regulation for this information.

 

The NC Division of Health Services Regulations also posts penalties for the facilities that they monitor (adult care homes, nursing homes, hospice facilities, hospitals, etc.). NC DHSR List of Facility Penalties

 

Use a checklist to help you evaluate each facility.

 

Our checklist is an adaptation of one available in a booklet on choosing a nursing home by the United States Department of Health and Human Services Health Care Financing Administration which may be read online, requested, or downloaded.

The United States Medicare website has a feature called "Nursing Home Compare". This feature allows a review of the state survey reports for a facility. These reports now indicate when updating last occurred which is very important. After reviewing this information, it may still be prudent to check with your Ombudsman and/or appropriate state agency to see what information they have on the facility(s) in which you have interest.

 

Remember that you may choose a home that suits you but the home may not be an option for you. You may be paying for care in a way that is not accepted by the home, they may not have enough beds assigned for the type payment you can provide (i.e. facilities often say that "x" number of beds are for patients who are "private pay", "x" number are for those paid for by Medicaid, etc.), all their beds may be full, or other issues may be involved.

 

Your local Ombudsmen can help you understand what has happened if the home you have chosen is not available to you.

 

Consumer Reports offers information on choosing a nursing home that may be useful. The information is part of a publication by Consumer Reports called "Complete Guide to Health Services for Seniors" that is available for purchase in bookstores and by phone at 1-800-500-9760. They also offer a Nursing Home Watch List which identifies facilities with the most questionable patterns of deficiencies on state inspection surveys.

 

 

Moving to a Nursing Home

When you have selected a home and/or found a home, there are many things to consider to help ease the transition to the home for both you and your family member. Click below for helpful hints to make this transition smooth and as stress-free as it can be.

 

 

What to do if You Have a Problem....

Sometimes, caregivers of family members residing in nursing homes are not satisfied with the care their loved one is receiving, the condition of the facility, or other areas of concern. Your long-term care Ombudsman Program can be a great help.

 

 

 

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