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Choosing a Nursing
In a perfect world, your parent would never
have to go to a nursing home. In a near-perfect world, both of you
would have already explored nursing-home options and made decisions
before the need arises. In the real world, you may be doing the
investigating and choosing alone as Mom or Dad is about to be
discharged from the hospital.
Here are some suggestions for making that
choice less difficult when visiting nursing homes:
● Do your research first. Viewing
on-line is not as good as in person. Donít rely on that information only. Find a few
facilities to visit.
● Take a sibling or friend along to
help more clearly evaluate the home. The more eyes the better.
● Don't be shy when asking about costs.
A nursing home admissions director may quote a figure, but you need to
find out what is included, what costs extra, and what that additional
cost will be.
Ask what's covered by Medicare, Medicaid,
insurance and private pay. Ask if your parent's bed will be held if he
or she has to be temporarily hospitalized.
● Find out how a patient's care plan is
written. Is it personalized or does a general plan apply to almost
everyone? Find out who monitors the care plan. Ask what happens to
that plan if your parent's health improves or gets worse. Can you be
involved in the planning? How often is it reviewed and evaluated?
● Ask if one doctor is assigned to the
nursing home, if there are several doctors, or if a patient continues
to use his or her own physician.
● Verify the certification and licenses
for the facility. Request a copy of the most recent audits by your
state Department of Health. Be sure any "deficiencies" have
● Walk through the facility. Look
around inside and out. Is it clean and well maintained? Are the halls
stacked with various kinds of equipment because there isn't enough
storage space? Are there any unpleasant smells?
Look at the patients. Do they appear well
taken care of? Are they clean, appropriately dressed and groomed?
Look at the rehabilitation unit. Most nursing
homes have a room for physical and occupational therapy. Is the
equipment falling apart? Is it being used at all?
A good plan is to walk through, talk to the
admissions director and then walk through again, about an hour later.
You should be able to tell if there has been some activity. Does it
seem all the patients are in the same spot they were in sixty minutes
ago? No patient should be in a
hallway "waiting for lunch" for an hour.
Many places will be happy to let you have a
meal at the home. Ask to be served whatever the residents are being
served. Is it nutritious? Does it look and taste appetizing?
● Ask about security. Not just
protecting the patients from someone wandering in from the outside,
but also problems of theft by fellow patients and staff. Find out who
is responsible for monitoring this, to whom one reports a problem and
what the procedure is when something is missing.
● Ask how room assignments are made.
Obviously rooms will be all-male or all-female, but are matches done
according to compatibility or is it just the next person through the
door gets the next vacant bed? What's the procedure if problems arise
● Find out if there's a continuum of
service. If your parent's health gets better or worse, will he or she
need to move?
● Ask who helps with the transition
when Mom or Dad first moves in. Depression is typical and certainly
understandable. Is there a social worker available to help?
● Get a copy of the nursing home's
"bill of rights" for its clients.
● Don't sign a contract during that
first visit. Go home and think about it. Take notes during your visits
to several homes so you can remember what you saw and where you saw
● If your parent is in a nursing home,
get to know the staff and make sure they know you. The more contact
you have with them, the better care your parent will receive.
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