How to Place the Elderly in Nursing Homes
Placing an elderly person in a nursing home is a tough decision. For many who are elderly, nursing home placement means an end of independence. Further, some nursing homes have poor reputations, with allegations of patient abuse and neglect. But there are many reputable nursing homes. With research and preparation, an elderly loved one can enjoy many more years of quality living in a nursing home.
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Instructions
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Determine the patient's needs. Why does he need to be in a nursing home? Is he lonely and simply needs companionship? Is he confused and/or prone to wandering? Is he at risk of falling or burning himself? Is he combative? Does he need physical or occupational therapy? Does he need special medical treatments, such as dialysis or oxygen tanks?
Some of these services are available through home-care and social-service agencies. The patient may not need to be placed in a nursing home. -
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Gather the patient's financial and medical information. You may need to designate a power of attorney if the patient is unable to handle his affairs. Does he have long-term care insurance? Does he qualify for Medicare or Medicaid? Compile a list of savings accounts and other assets.
Medical information should include all diagnoses, medications and medical procedures. -
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Compile a list of nursing homes in your area, using the computer and/or the telephone. Contact each one to determine which offer the services the patient needs and to find out their rates.
Nursing homes are similar to group homes, assisted-living centers and retirement centers. Investigate each of these possibilities to find the facility that best meets the patient's needs. -
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Consult the U.S. Department of Health and Human Services' Nursing Home Compare Tool at medicare.gov to determine how the facilities compare with each other.
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Contact your local long-term care ombudsman to find out whether any complaints have been filed against facilities you are considering and how they were resolved.
The long-term care ombudsman handles issues related to nursing homes and assisted-living facilities. The ombudsman program is part of the U.S. Administration on Aging, which sponsors local Agencies on Aging. Agencies and ombudsmen are found throughout the United States.
You can find your local ombudsman and agency on aging at eldercare.gov, or consult your local phone book for Agency on Aging. -
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Visit each facility. You will likely be given a guided tour and information about rates and services. Ask to see the specific unit where your loved one will be assigned. (Otherwise, you may just be shown the shiny new addition and not the older parts of the facility.) Ask about staffing levels and turnover rates. A high turnover may signal that employees are overworked and underpaid. Observe whether the patients and staff seem content. Are there many patients in restraints? (Restraints should only be used when the patient is at risk of harming himself or others, not for the staff's convenience.) Do patient rooms seem crowded? Is there a strong smell of urine or feces? If possible talk to residents and their relatives to find out if they are satisfied.
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Work with the facility's social work and admissions representative to handle the financial aspects. Admissions procedures will vary, depending on several issues, including savings and insurance coverage. Also find out what possessions the patient may bring and what supplies the family must provide.
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Set a date and time for admitting the patient. Depending on the patient's physical, mental and emotional condition, you may need to help him pack and to emotionally prepare for the move. If he is able, let him have some say into the selection process. Be a comforting and reassuring presence during the move, as it can be bewildering.
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Admit the patient, bringing all allowed possessions. During the admissions process, the patient and his family will be asked about personal preferences. If the patient has difficulty communicating, family members will be asked to provide the information.
Show the patient where his belongings are. Walk with him around the facility to show him various features, such as the activities room, the dining room and chapel. Answer any questions he may have and address all of his concerns in a reassuring manner. Be patient, especially if he is upset about the move. -
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Visit the patient frequently, especially in the first days after admission. The patient may be confused, angry or depressed at first but should adjust. If the patient instead becomes increasingly confused, angry or depressed or noticeably changes in health, investigate and consult the area long-term care ombudsman. Keep records of all concerns.
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Once the move is complete, it may be necessary to consider other issues, such as selling the patient's house, car and other possessions.
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Tips & Warnings
If possible, visit several facilities at several times of the day. While facilities tend to put their best foot forward during a tour, conditions may vary greatly among shifts.
If possible, check local news media about any allegations against a facility.
Staff turnover is usually high at nursing homes, largely because of low pay and demanding working conditions. Determine whether the staff seems compassionate and professional. Do they seem available at all times? Do they have a large patient load? An overworked staff member may not be able to give proper care to your loved one.
