A Guide to Nursing Homes
Is a nursing home right for you or a loved one? This guide can help you choose a skilled nursing facility or convalescent home that fits your needs.
What is a nursing home or skilled nursing facility?
A nursing home is normally the highest level of care for older adults outside of a hospital. Nursing homes provide what is called custodial care, providing help getting in and out of bed, and assistance with feeding, bathing, and dressing. However, nursing homes differ from other senior housing facilities in that they also provide a high level of medical care. A licensed physician supervises each patient’s care and a nurse or other medical professional is almost always on the premises. Skilled nursing care is available on site, usually 24 hours a day. Other medical professionals, such as occupational or physical therapists, are also available. This allows the delivery of medical procedures and therapies on site that would not be possible in other housing.
As our population ages, more of us are faced with the prospect of moving either ourselves or an older family member into a nursing or convalescent home. It may be a decision that arrives suddenly following hospitalization, or gradually as needs become more difficult to meet in other types of housing. Deciding to move can be stressful, but by learning all you can about nursing homes, you can ease your fears and make a decision that’s right for you or an older family member.
Myths and facts about nursing homes
While nursing homes provide medical practices and therapies not available in other senior housing options, the label “nursing home” can have negative connotations for some people, so it’s important to separate nursing home myths from facts.
|Myths about nursing homes|
|Myth: If I can’t take care of myself at home, a nursing home is the only option.|
Fact: Today, there are many options to help older adults stay in their homes, ranging from help with shopping and laundry to caregiving and visiting home health services. If home care options are no longer possible, other options, such as assisted living, may be a better fit if the primary need is custodial care rather than skilled medical care. Even if you’re considering hospice care, that can often be done at home.
|Myth: Nursing homes are for people whose families don’t care about them.|
Fact: Many cultures have strong beliefs that it is a family’s duty to care for elders. However, in today’s world of smaller families living farther apart and people living longer with more chronic illness, it simply may not be possible. Considering a nursing home for an elderly family member doesn’t mean you don’t care about them. If you cannot provide the necessary care, it is the responsible decision to find a place where your loved one’s needs will be met.
|Myth: Nursing homes are poorly run and provide awful care.|
Fact: While it is key to research homes thoroughly and visit your family member frequently, it is not true that all nursing homes provide poor care. There are more and more safeguards in place, and a facility’s staffing information and any previous violations are available to the public, which can aid your decision-making.
|Myth: Once I’m in a nursing home, I’ll never leave.|
Fact: Sometimes an illness or injury progresses to the point where you’ll need both ongoing medical and custodial care through to the end of your life. However, many people encounter a nursing home for the first time after a sudden hospitalization, such as from a fall or stroke. After rehabilitative care, you may be able to either return home or choose a more appropriate housing option.
When should you consider a nursing home?
Whether you and your family are facing a quick decision about a nursing home due to a recent event, or have been coping with a worsening progressive disease such as Alzheimer’s or Parkinson’s, considering a nursing home is not an easy decision. Emotions such as guilt, sadness, frustration, and anger are normal. But by working through your housing, financial, and medical options, you and your family make can make an informed decision.
Whether you’re looking for yourself or an older family member, here are some questions to ask when considering a nursing home:
Have you had a recent medical assessment? If you’re considering a nursing home as the next step after hospitalization, this has likely been done. However, if you’re considering a move from your home or another facility, a more formal assessment by a medical team can help clarify your needs and see if other housing options may be a possibility.
Can your needs be met safely in a different housing situation? If you need 24-hour supervision, or are in danger of wandering off or forgetting about a hot stove, for example, a skilled nursing facility may be the best option. If your needs are solely custodial, though, an assisted living facility may be a better fit.
Can your primary caregiver meet your needs? Caregivers are often juggling the needs of work, their own family responsibilities, and their own health. It’s not possible for one person to be awake and responsive 24 hours a day. Sometimes other family members can help fill in the gap, or day programs, home care services, and respite care can provide the necessary caregiver support. However, there may come a point where medical needs become too great and home care services are insufficient or become too expensive.
Would the need for a nursing home be temporary or permanent? Sometimes, a temporary situation may be covered through home care, or family members might be able to rotate care on a short-term basis. However, if the level of care is expected to be permanent, this may be too expensive or coverage might not be enough.
Nursing home vs. other types of senior housing
Nursing homes provide some of the highest levels of care, both medical and custodial. If you’re not sure that you or your loved one needs that level of care for the long term, learn more about other types of senior housing, including home care, to see what will best fit your needs.
Handling the emotions of moving to a nursing home
Moving can be a stressful experience, even at the best of times. Moving to a nursing home can bring with it a whole host of additional, difficult emotions.
If you’re the one moving
You’re leaving behind a familiar place with lots of memories. If the nursing home move was due to a hospitalization, the transition may have been abrupt and you may not have had time to even process what has happened. Add to that your increased medical needs and decreased mobility, and moving to a nursing home can become a very stressful time. You may even feel angry and abandoned by your family members, even if you realize they can no longer provide the level of care you need. These are perfectly normal emotions.
Accept your feelings. Everyone needs time to adjust and come to terms with their own their feelings. Trying to sweep anger and grief under the rug—or refusing to acknowledge the difficulties of the transition—will only intensify these feelings.
Remember that you’re not alone in this. Many of us over the age of 65 will require some type of long-term care services. And there’s nothing to be ashamed about in admitting you need more help than you used to.