The following questions are often asked about nursing home life. In the past decade, nursing homes, like all areas of health care, have changed dramatically in terms of staffing, policies, procedures, and general approach. Our goals as long term care professionals are to provide both quality care and a quality way of life for our residents.
Many people fear moving to a nursing home. They don't know what to expect and worry about losing control over their lives. Long term care providers understand these concerns, and we want residents and their families to know the truth about life in a nursing home.
Is a nursing home like a hospital?
A nursing home is not a hospital. Many people enter a nursing home after a hospital stay and tend to think of the nursing home as an extension of hospital care. A nursing home is different, however. Medical and nursing care are provided as needed by qualified personnel. Yet at the same time, nursing homes try to be homes -- where people can feel comfortable, find familiar faces, and build a quality of life.
Nursing homes do not have restrictive visiting hours like hospitals. Whenever possible, residents eat in dining rooms rather than in their rooms. Various activities are offered each day to stimulate residents both mentally and physically.
Are all nursing home residents confused?
No, they are not. But most people slow down physically as they age. For some, this may be true of their mental processes as well. In fact, many people enter a nursing home, in part, because poor memory makes caring for themselves difficult or impossible. Often, memory problems can be reversed with adequate nutrition, exercise, social stimulation, and properly controlled medication.
It is true that a large portion of nursing home residents suffer from Alzheimer's disease, an irreversible neurologic disorder which causes severe and progressive mental difficulties. In many cases, Alzheimer's patients live together in special wings where they can receive the specialized care they require.
Can I have privacy in a nursing home?
Nursing homes must strike a difficult balance between the provision of adequate supervision and much needed privacy. Common areas in nursing homes tend to be open, while resident rooms are considered private. Staff members respect patient privacy by being courteous and by knocking before entering a patient room.
If I enter a nursing home, will I ever go home?
The primary goal of the nursing home is to rehabilitate residents so that they can return to the community. In fact, nearly 30 percent of all residents are discharged to homelike living arrangements. Those who cannot return to their homes permanently can make short visits, health permitting. In most states, Medicaid-certified nursing homes will hold beds for residents while they make what are termed "therapeutic home visits."
Don't nursing homes have an unpleasant odor?
Today's nursing homes should have no pervasive unpleasant odors. In fact, with the effective cleaning products available, a properly cleaned nursing home should smell pleasant. However, because many elderly people are incontinent, an occasional odor may be noticeable. If incontinent resident's are changed and cleaned promptly, there should be no lingering smell.
Do nursing home residents receive adequate care?
Stories about inadequate care in nursing homes make news precisely because they are not typical. More common are aggressive internal quality assurance programs which constantly monitor the delivery of high quality care.
Keep in mind that inspections are made frequently by each state to ensure high quality care. Problems are cited and plans for correcting them are put into action immediately.
Family and friends can serve as an important safety net. If you feel that proper attention or care is not being given to a specific problem, ask questions. Speak with the director of nursing and/or the administrator. If you are not satisfied with their responses, it may be time to explore other options with the area ombudsman (Resident/Facility advocate) being one of them.
Do husbands and wives live apart from one another in a nursing home?
Many married couples enter nursing homes together and may share rooms. In fact, the patient's bill of right mandates that this be permitted in facilities certified to receive Medicare and Medicaid funding. Furthermore, staff members respect the privacy of couples living in nursing homes.
Are nursing home residents visited regularly by family and friends?
When an elderly person needs more physical care than his family can give, professionally trained staff take over a portion of the care. However, hard as they try, the staff can never offer the same sort of social and psychological support friends and family bring to a resident. Staff members recognize this and try to encourage visits and make visitors feel as welcome as possible.
Isn't the food terrible in nursing homes?
What a person considers good food is a matter of individual taste. Everyone is accustomed to certain dishes and styles of preparation that no one else can duplicate. It's the "no one cooks like mom" feeling. In the nursing home, some residents are placed on restrictive diets that may limit salt, fat, cholesterol, or sugar. The dietary staff makes every effort to ensure that these diets are varied and appealing.
Because proper nutrition is so important to the health of the residents, dietary managers should be available to discuss problems concerning food. Try a meal on your next visit.
Will I be given medications that will cause me to lose control of my thoughts and actions?
Every person has the right to know what medication he or she is taking and has the right to refuse any or all treatment. Tranquilizers, pain relieving medications, sleeping pills, and mood changers are all powerful drugs and do have a profound effect on how alert an individual remains. Properly prescribed, these medications help rather than harm individuals. Staff, residents, and family all have a responsibility to review prescription medications, especially if it is felt they are being used improperly or are having a negative impact on the patient.
Will I be physically restrained in the nursing home?
Restraints are sometimes used only for resident's safety and only under a physician's orders. Restraints may be used for people who suffer from stroke-related paralysis or have difficulty sitting up in a chair. They may also be used on persons with severe handicaps who need to maintain a particular position. There are many different reasons, however most facilities review all restraints on a routine basis to audit the appropriateness of the restraint.
People in restraints are checked often to be sure they are comfortable. In fact, the restraint is repositioned and the patient is moved every two hours. Much like prescribed medications, if you feel restraints are being used improperly, speak with a doctor, nurse, or administrator.
Will nursing home care drain my savings?
Nursing home care is costly, not because the per day charge is high, but because many nursing home residents remain in the facility for lengthy periods of time. Surprisingly, a day's stay in a nursing home costs only less than many hotel stays and includes a complete set of services under one roof. In fact, nursing home care averages one-tenth the cost of hospital care.
Still a lengthy stay in a nursing home can be a substantial expense. Consumers should be aware, however, that the government provides little financial assistance for nursing home care unless a patient is impoverished and qualifies for Medicaid. Medicare, the health insurance program for the elderly, covers the first 20 days of care in a skilled nursing facility. For the 21st through the 100th day, the beneficiary must share the cost of care by paying a nationally set rate of $95 a day. Medicare does not cover stays in an intermediate care facility. As a result, personal and family resources pay 51 percent of costs. Long term care insurance pays only 1 percent of nursing home costs at the present time.
Financing nursing home care should be approached with as much thought and preparation as any major investment. Obtain in writing what your basic charge will be and understand clearly all financial arrangements before signing a contract.
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