So the time has come to place a loved one in a nursing home. This can be one of the most difficult emotional decisions to make and a huge stressor on families. The recognition to admit to yourself ” I can no longer take care of you” is a troubling one. Perhaps you promised you would never do this, perhaps you feel guilty that you now know you can no longer care for a loved one.
So many are also unprepared financially to keep the loved one at home with privately hired caregivers. Now is not the time to ponder what could have been…did I not save enough? Why didn’t I look into Long Term Health Care Insurance? Why doesn’t Medicare pay for placement? Why is Social Security not enough?
Many times, when a loved one requires this level of care for what is termed custodial care, insurance is not there to cover the costs. Nursing home placement costs several thousands a month. So what do you look for when the decision for placement comes up?
Location of the Nursing Home
Most important is probably the location. You want to be able to place a loved one close by your home or work so visiting does not become a burden. You want to explore costs as nursing home prices vary greatly. You want to do your research in an organized fashion. Get a thorough list. The free publication New Lifestyles or Eldercare directory are good resources and which lists facilities by level of care and by location. They can both be found at your local library or hospital and on the internet. Some specialize in dealing with dementia or Alzheimer’s, some have a hospice component, some specialize in daily activities for the resident both in house and in the community.
Research the Nursing Home
Plan to tour a facility both during the day, night and /or week end. Ask about the staff to patient ratio. How often does an MD visit? Does it offer specialty nursing such as wound care or psychiatric? Or even better, an MD who specializes in preventative measures to avoid bedsores or a Psychiatrist or Psychologist? Ask about any extra fees associated with the care such as a fee for doing laundry, transportation to other appointments. These fees can start adding up.
Use all your “senses”
Ask to sample a meal there, many facilities include a free lunch during the tour. Does it smell bad? If the place is clean, it should have no odor at all. Are the residents hanging out in the hallways looking bored or are they participating in an activity with staff? Ask to see the rehabilitation area, is it crowded or a nice open space where someone can work out and receive daily exercises?
Does it look like a home where you would want to be in or a cold hospital like setting? Do you want a large facility or small, they both have advantages and disadvantages.
Do they allow pets or have a pet therapy program which can be very important to some patients. Does it offer a beauty salon? Something as simple as getting your nails done can make someone feel good about themselves. How does the staff respond to you as a visitor or the residents? Do they look up and say hello or allow you to walk by without acknowledgment?
Imagine being treated like that everyday in the nursing home?
Do they take the time at answer your questions or were you hurried away.
Expect the unexpected and going above and beyond, there are plenty of choices out there and do not be afraid to ask any questions, after all, this is for a loved one. Once you tour, rate the facility on a scale you come up with and if needed,go back a second or third time. Ask if it is o.k. to take pictures of the facility to help you recall room sizes, colors, patio areas, etc.
Many rely on personal recommendations however, what may be important to you may not be important to others. And do not rely solely on ratings on the Internet, they are not always truth worthy! Do check if they have been sited or fined recently for lack of care, or worse. Medicare has a web site for this. And if you do not have the time to look, seek help. There are professionals who place clients in all levels of care facilities from board and care, to assisted living to nursing homes and sub acute care.
In closing, keep in mind, even if you are not ready for placement, now is the time to do your research while you are not under pressure. Place your loved one on a wait list at three choices, if a bed becomes available and you are not ready, they will keep the name at the top and call again next time. Your name does not drop to the bottom and you will have the comfort of mind that you are prepared.