Top Takeaways

 

• Nursing Homes provide a high level of physical support for people with physical or cognitive challenges. 
• Nursing homes can provide medical care- including but not limited to; insulin support, catheters, and ventilators. 
• Nursing homes are regulated by the state and must follow state guidelines. 
• Nursing homes can be paid for by Medicaid, when an individual is eligible. 
• Finding the right nursing home can be difficult, but help is available. 

 

Whether you foresee a transition to residential care in the future, or you intend to support someone at home, understanding what your care options are, and what each one provides is important in planning for a loved one’s future. 

 

What Can a Nursing Home Help With? 

 

Nursing homes, or skilled nursing facilities, can provide a high level of physical support for older adults, or anyone who may be experiencing physical or cognitive challenges. Nursing homes are staffed 24/7 by medical professionals- certified nurses assistants, nurses, therapists and more. 

 

Upon admission:

• The nursing home staff will create a care plan designed to embody all the physical care needs of the new resident.
• They will work with the family to understand the new resident’s social history and get to know their likes and dislikes.

 

What Care is Provided:

Nursing homes provide high levels of skilled nursing care.

• Therapies such as physical, occupational, and speech therapy on site as needed by the resident.
• Medical Services including:
• Wound Dressing
• IV medications
• Tracking Vital Signs
• Transfers- including those requiring multiple aides or Hoyer lifts.
• Palliative and Hospice care on site, for end of life residents.

 

The ability to provide nursing care is the primary difference between assisted living facilities, another form of senior living, and receiving home health care, which may be limited in capabilities.

 

Engagement and Activities

 

Additionally, nursing homes provide a range of activities to benefit the residents. Residents are encouraged to participate in group activities. One of the benefits of this type of living is the way it can provide structure and routine for the residents. Well-rounded daily activities as well as structure, can improve quality of life and mental health. Activities include a holistic approach and cover different pillars:

• Physical Activities
• Cognitive Stimulation
• Socialization
• Emotional Care
• Spiritual Programming

 

Additional Care: Memory Care Neighborhoods

 

Some facilities may have special memory care units within their building. These units have programs designed specifically for individuals living with Alzheimer’s disease or other types of dementia.

• Staff are trained in the best approaches for working with this population. They are taught to understand that an individual may be able to complete personal care tasks, but need cueing, rather than hands-on help.
• Activities are designed specifically to benefit those with cognitive impairments
• A secured entrance to reduce the risk of wandering and becoming lost.

 

The goal would be to help the person with Alzheimer’s or another form of dementia to embrace their strengths with the support and safety they need.

 

Making the Transition

 

Moving into a nursing home can be a complicated process. Below are a few tips to be prepared for a transition.

• Explore in advance if the nursing home has a waitlists. Check out a variety of local options to know which can offer, and which feels like the right fit.
• Involve your loved one’s physician as they will need to share the medical history to the residence.
• Work with an Elder Law Attorney to ensure that all legal and financial documentation is up to date. This includes a will, power of attorney and health care proxy.
• It can often be easier to make the transition from the hospital, rather than a home setting. If a hospitalization occurs, this is where your research of options will come in handy.

 

Some families find it difficult to communicate an upcoming move to their loved one. This occurs especially if they have a cognitive issue, which may impact their ability to know if something is wrong with them. Consider ways that you might present the move to your loved one to make it more tolerable to them. These are referred to as “fiblets”- white lies to support your loved one with a memory impairment. Below are a few examples:

• Say that it is for rehab
• Say repairs are needed on their home
• Frame it as a vague, temporary transition
• Be empathetic to your loved one that they want to return home. Place “blame” on doctors if needed in order to stay on your loved one’s team.

 

Regulation of Care Facilities

 

Nursing homes must follow specific guidelines to ensure quality care for their residents. These guidelines are established by the Centers for Medicare and Medicaid Services. Regulations include building requirements such as safety plans and structural requirements- specifically when a memory care unit is present. Additional requirements include specific staff to resident ratios, up to date immunizations, robust programming calendars, and accurate, up to date documentation. More recently, as part of the coronavirus pandemic, nursing homes have included vaccination for COVID-19 as one of their regulations for staff. This was implemented by CDC guidelines.

 

Nursing home residents must also have access to a Patient Advocate, often referred to as an Ombudsman. If the resident has any concerns about their care, this individual can liaise between the resident and appropriate staff at the facility. 

 

How Do You Pay for a Nursing Home?

 

Senior care in general is expensive! Unfortunately, while private insurance and Medicare cover short term care, or rehab, they do not cover the cost of long term care ins a skilled nursing facility. This can leave many families feeling stuck and overwhelmed. 

Forms of payment for senior care, but most specifically nursing home care include the options below.

• Veteran’s Services
• Long Term Care Insurance
• Hybrid Life Insurance Policies
• Medicaid

 

Important Definitions: 

Medicare is a government insurance provided to individuals over the age of 65. Medicaid is a government insurance offered to low-income individuals. 

Medicaid can be complicated to navigate. Some nursing homes will be able to provide guidance to their residents in applying for Medicaid if they enter as a private pay resident. Alternatively, your local Area Agency on Aging can provide resources for navigating a Medicaid application. The Area Agency on Aging is a nationwide network of elder resources. 

If you’re able to do advanced planning, or if your loved one has a complicated financial situation, an Elder Law Attorney can be the most helpful in navigating the world of Medicaid. They are experts in helping you understand disclaimers and conditions of Medicaid.

 

How Do You Find the Right Fit? 

 

It can be overwhelming to find the right residence for a family member! One of the best ways to find a place you can trust is through word of mouth. Talk to your personal network about personal experiences. You may be surprised by the number of people who have gone through a similar situation. Connect with your loved one’s health care providers for referrals or suggestions. Lastly, there are some professionals who may be available in your community. They might be referred to as Senior Living Advisors or Geriatric Care Managers. 

There are also guides available online to provide you with the best questions to ask when you’re touring a nursing home. 

---

Transitioning to a nursing home can be overwhelming and emotional for a caregiver. Some caregivers may experience grief as they shift away from providing hands on care. Keep in mind that while your role may shift, you will still be the one to advocate for and spend quality time with your loved one.