Considering a nursing home is a hard decision for anyone to make. By working through housing, financial, and medical options, you and your family can make an informed and confident decision.
Henson Fuerst Nursing Home Guide
In this guide, we provide information on when to consider a nursing home, the different types of facilities available, resources to help cover care costs, and tips for selecting the best facility for your loved one. View our 2024 Nursing Home Guide for more information.
When Should You Consider a Nursing Home?
There are unexpected circumstances when it becomes clear that the time has come to move to a short or a long-term care facility. Such instances include when a person is suffering from a severe illness or injury, hospitalization, the caregiver’s death, or dementia.
However, beyond situations that require immediate long-term care and attention, how do you know when it’s time to make a move to a nursing home? Below are some examples of situations that might indicate a nursing home is the best choice for both the aging person and for their loved ones:
- Safety at Home Becomes a Concern. Living alone can pose serious risks to a person after they reach a certain age. At a nursing home, staff members remain available 24/7 to address any issues a resident may be facing.
- Mobility Changes. Living in a nursing home puts less strain on the body, and you can worry less about a slip and fall going unnoticed.
- Irregularity in Taking Medication. Nursing home staff are informed of residents’ medication requirements and ensure the proper medications are taken.
- Conditions Have Gotten Worse. If you or your loved one’s health has gotten worse, it’s better to be where doctors and nurses are easily accessible.
- It’s Stressful for the Family. Even if you all have the best intentions of helping your loved one, the best place for them might be a nursing home. This way, they’ll have the attention and support they need 24/7.
If one or more of these situations sounds familiar, it might be time to move forward with researching and touring a care facility. There’s no definite answer to when it is time to put a loved one in a nursing home, as aging impacts everyone differently. Be sure to talk with other family members and those around you that are familiar with facilities in your area. They may be able to offer recommendations of which facilities you should look into.
Types of Nursing Home Facilities
According to the U.S. Department of Health and Human Services, about 70 percent of people older than age 65 will require some long-term care services during their lifetime.
There are a variety of living facility options for the elderly, and the process of placing or relocating your loved one can be overwhelming. It’s important to know what options are available for your family member. Each type of facility offers different benefits and levels of care, and the quality of individual facilities can vary. The most common categories of healthcare facilities include:
Adult Day Care
Adult day care is an alternative to live-in care for adults who are functionally impaired. These programs run during the day—much like child day care—and provide various health, wellness, social, and other support-related services.
Alzheimer’s Care (Memory Care)
Alzheimer’s care or memory care provides specialized services to meet the needs of individuals with dementia, brain injury, or Alzheimer’s disease. The services offered at these facilities may also be provided at an assisted living, skilled nursing, or residential community.
Assisted Living Facilities
Assisted living facilities promote independence in a private residential setting. These facilities are designed for people who are generally well but may need some help with everyday tasks.
Residents typically have individual rooms with locks for privacy—unless shared by choice—and private bathrooms. Personal care services are available 24/7 and residents are offered assistance with meals, bathing, dressing, or medication if needed. Also, transportation and social activities may be available. Not all facilities provide these services, however, so ask for a list of services in writing.
Continuing Care Retirement Communities (CCRCs)
CCRCs offer multiple levels of care, including independent living, assisted living, and skilled nursing care—all housed in different areas of the same campus. As the personal and medical needs of residents change, residents have the opportunity to move to another care facility while remaining in the same community. This way, social connections can stay in place, and your loved one doesn’t have to be uprooted. CCRCs may provide residential services, including:
- Health care
- Housekeeping
- Laundry services
- Meals
- Nursing care
- Personal care
- Social and recreational services
Hospice Care
Hospice care assists terminally ill individuals and includes health services, volunteer support, grief counseling, and pain management. These services can be provided in a person’s home, a hospital, or a long-term care facility.
Independent Living Communities
Independent living communities typically provide housekeeping, transportation, meals in a restaurant setting, and various social activities. While there may be wellness programs, care services may or may not be available for additional charges. These communities are often part of a CCRC.
Long-Term Care
Long-term care describes any service designed to help those with chronic illness, disability, dementia, or other conditions that require continuous care. Long-term care services can be provided in an individual’s home or a residential facility.
Nursing Homes
A nursing home is a facility licensed by the state to offer 24-hour, skilled nursing care and personal assistance for those who require constant supervision. These homes provide nursing care, personal care, room and board, supervision, medication, therapies, and rehabilitation. Rooms are often shared, and communal dining is standard. Some nursing homes have special care units for people with Alzheimer’s disease or other severe memory disorders.
Rest Homes
These residential facilities offer 24-hour supervision and supportive services to residents who don’t need on-going medical or nursing care. Rest homes provide housing, meals, activities, and medication administration.
Skilled Nursing Facilities
Skilled nursing facilities are Medicare-certified nursing homes that provide 24-hour nursing care and rehabilitation services, in addition to other services. Many of these communities offer short-term, comprehensive rehabilitation programs on an inpatient and outpatient basis.
Finding A Nursing Home
When you’ve decided to move a loved one to a nursing home, it’s essential to use every resource available to find the best fit for your family member. The North Carolina nursing home abuse lawyers at Henson Fuerst recommend doing the following.
- Personal research. Reach out to friends and family members who have loved ones in nursing home facilities. Ask questions and research nursing home facilities online to figure out what quality long-term care facilities are available in your area.
- Consult your local ombudsman. Ombudsmen are liaisons between the state government and long-term care facilities who investigate complaints and serve as advocates for long-term care residents. While they do not have any formal powers over nursing facilities, they serve as excellent information resources.
- Contact your local Department of Social Services. The Department of Social Services is in charge of inspecting nursing home facilities quarterly. These investigations often provide insight into the quality of a facility and expose facilities that have been cited for deficiencies.
Factors to Consider in Choosing a Nursing Home
Selecting a nursing home for yourself or a loved one can be one of the most challenging processes anyone has to go through. At the beginning of your search, you should consider the following to help choose the best facility for your needs:
- Facility Certifications
- Admission Requirements
- Cost of Care
- Specialty Care Options
- Location of the Facility
- Quality of Nurses and Physicians on Staff
- Room Sharing, Layouts, and Furnishings
- Quality and Frequency of Meals
- Transportation Services
Comparing Your Nursing Home Options
How do you know if you’re choosing a good nursing home facility for yourself or a loved one? One resource that can help inform your decision is ProPublica’s Nursing Home Inspect tool. This tool allows you to compare nursing homes based on the deficiencies cited by regulators and the penalties imposed in the past three years.
Another tool available to the public is the Medicare Nursing Home Compare tool which provides information such as:
- Whether the nursing home participates in Medicare or Medicaid
- If the nursing home is in a hospital
- Nursing home inspection results
- Per-resident staffing ratios
- Data regarding the quality of resident care for short-term and long-term residents
- Medication management
- How the facility protects residents from mental and physical abuse
- Fire safety inspections
Visiting a Facility
Once you’ve completed your research, your next step should be to visit all of the facilities you are considering. While touring a nursing home or assisted living facility, ask yourself questions, such as:
- Does it smell clean?
- Does it feel like a quiet and relaxing environment?
- Does the food taste good and seem nutritious?
- Do you see residents engaged in activities, or are they all confined to their rooms?
- How do the caregivers sound when they are talking with the residents—compassionate or harsh?
- Is it a place you would choose for yourself if you could no longer live on your own?
Ask about the staff. Find out if the facility has any registered nurses (RNs) on staff. While it’s not required by law, our North Carolina nursing home abuse attorneys from Henson Fuerst recommend that facilities have at least one RN on staff at all times. RNs can assess a patient’s medical status, which can be crucial if a resident develops a dangerous medical condition that requires more advanced care.
Ask about Elder Abuse Prevention. Research shows that approximately 1 in 10 Americans over 60 years old have faced some form of elder abuse. Unfortunately, there is no foolproof way of preventing elder abuse. Despite this, nursing homes may help prevent elder abuse by:
- Creating concrete patient care policies and procedures
- Offering regular visits from social workers and volunteers
- Installing quality security systems and cameras
- Training employees regularly on elder abuse and how to prevent neglect
Take a Tour With Your Senses. Are you seeing staff interact with residents? Are call lights being answered promptly? Does it smell like urine? Are the residents well kept? Is their hair combed? You want to look for those things.
Speak with a Current Resident. To get an insider’s perspective, you may talk to a resident or the resident’s family about their experience with the facility and whether they’re happy with the level of care provided. Don’t go into a resident’s room or care area of the nursing home without asking the resident or staff first, however.
Before you leave, ask whom to call if you have more questions and write down their name and phone number. After your visit, write down any questions or concerns you still have about the nursing home and how it will meet you or your loved one’s needs. This way, you can compare notes after other tours.
Paying for a Nursing Home or Long Term Care Facility
Putting yourself or a loved one in an assisted living or nursing home facility can be very expensive. There are a few ways to pay for nursing home care without paying everything out of pocket, which includes:
Medicare
Although Medicare does not cover long-term stays in a nursing home, it will cover hospital care, physician services, and medical supplies while you’re in a nursing home. Additionally, Medicare Part A (Hospital Insurance) covers any skilled care provided in a skilled nursing facility under certain circumstances for a period of time. Medicare will also cover certain daily skilled care services on a short-term basis, usually up to 100 days in a benefit period.
Medicaid
As a joint federal and state program, most health care costs are covered if you qualify for both Medicare and Medicaid. Many nursing homes accept Medicaid payment even if you pay out-of-pocket or with long-term care insurance. Medicaid varies from state-to-state, and you may qualify for Medicaid nursing home coverage even if you haven’t qualified for Medicaid services prior.
Long-term care insurance
Long-term care insurance policies vary. Some may cover only nursing home care, while others may include coverage for a whole range of services, like medical equipment, adult day care, assisted living, or informal home care. If you or your loved one already carry long-term care insurance, check the policy or call the insurance company to determine if the care needed is covered. If you’re shopping for long-term care insurance, find out which types of services and facilities the policies cover, and also if coverage could be limited because of a pre-existing condition.
Nursing Home Risk Factors
Nursing homes or long-term care facilities can present a unique set of risk factors to the adults in their care. A nursing home may be at higher risk for elder abuse if the facility has:
- Careless hiring practices, like not performing thorough background checks
- Understaffing issues
- High employee turnover rate
- Dismissive administrative staff
- Stressful working environment
- Untrained or hostile staff members
Why are Nursing Home Residents Vulnerable to Abuse?
Nursing home residents with physical or cognitive disabilities are more vulnerable to abuse and overmedication, and improper distribution of medication. Loved ones should always look for nursing homes with policies that reduce the risk of elder abuse. Although elder abuse cannot be prevented altogether, loved ones can make an informed decision by:
- Thoroughly researching a nursing home and checking for red flags
- Looking out for the signs and types of elder abuse
- Calling their family member or friend regularly
- Bringing concerns immediately about an elder’s care to staff or higher authorities
- Visiting regularly
When It’s Time To Consider a Nursing Home, Contact the Attorneys at Henson Fuerst
At Henson Fuerst, we’re here to answer your questions and protect the rights of nursing home residents and their families. When you have Henson Fuerst on your side, you’ll be treated with respect and compassion.
If you have any questions about choosing a nursing home facility for your loved one, call the experienced North Carolina nursing home abuse and neglect attorneys at Henson Fuerst anytime by calling (919) 781-1107. We will speak with you for free and help you make the best decision to protect your elderly family member’s safety and dignity.
