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Is A Nursing Home Really Necessary For My Loved One?

slide-grandpaAccording to the U.S. Census Bureau, there are more than 65 million baby boomers, people born between 1946 and 1964. Of the 65 million, approximately 1.3 million are in nursing homes. As the baby boomer generation continues to age, the question of whether or not a family member will need a nursing home (or long-term care, if you want to be politically correct) becomes a much bigger issue than before.

Placing a family member in a nursing home is not an easy decision, nor is it one to rush into. No one wants to go to a nursing home. The plan all along has been for Mom and Dad or Grandma and Grandpa to live out their days in the comfort of their own home. But along the way, insinuating factors come into play: Dad is a fall-risk, or Grandma has been diagnosed with Alzheimer’s. You’re too busy to take care of them (but try and run yourself ragged in the process), and your two siblings live in other states and are automatically ruled out. And then a nursing home may be the only solution.

Before you sign the paperwork for Shady Acres Nursing Home, you need to thoroughly examine all of the facts because, truth be told, your family member may be better suited for something different – an assisted living community, a visiting nurse coming to his or her home – than a nursing home.

So where do you start? It starts with a thorough geriatric assessment to evaluate your loved one’s physical and mental status. Just because you think Mom and/or Dad needs to be in a nursing home isn’t reason enough. There needs to be legitimate cause for your loved one to be placed into a long-term care facility. It needs to be documented. A primary care physician can do the assessment, or if you want a specialist, a geriatrician or doctor or nurse practitioner with geriatric training can be consulted. There are geriatric nursing agencies that can be consulted. They, too, look at a person’s physical health but also look at the home environment, to see if there are fall hazards (rugs, stairs, etc…) as well as other issues that you and the family may not have considered.

When doing the assessment, the professional will concentrate on the patient’s ability to conduct the five activities of daily living, or ADLs: feeding, toileting, bathing, dressing and walking/transferring. Assessing a senior’s functional abilities helps the family and medical professionals determine that person’s current senior care needs. Other factors will be checked, too. Balance will be checked to assess the risk of falls. Memory deficits, signs of depression or anxiety, or indications of dementia and Alzheimer’s will be evaluated.

Once all of this information is gathered, it will be presented to the family and a recommendation will be made, which will help narrow the choices that have to be made.

You have this report. Now what? The next step will depend on the report’s final answer. It could be something as simple as getting a nutritious meal delivered to your parent every day via the local Meals on Wheels program. Your family member may not need a nursing home, but instead some supervised care. If that’s the case, there are agencies available where a nurse, certified nursing attendant or other caregiver can visit the home daily or multiple times a week to see that your loved one’s needs are being met or give another family member a break. These services are great, especially if the adult children live out-of-state. The professionals doing the assessment can provide a list of community resources.

If time is on your side, use it to the fullest advantage and take the time to do your homework. Selecting the right nursing home isn’t a rush judgment. It’s a little like car or house shopping: you do your homework until you find the right fit. Tour multiple facilities, talk to the staff, other residents and their families to see if the facility’s services fit your family member’s needs the best. Your loved one’s safety and health trump all issues.

There are factors to consider, such as distance. Is the facility close to home, so family members and neighbors can go regularly visit? The best prescription for fending off depression and feelings of isolation in nursing home residents is to make sure they frequently see significant people in their lives.(And frequent visits also demonstrates to the staff that you’re involved and genuinely interested in your family member’s care.)

Cost may also be a factor. The average nursing home cost is $200 a day, or approximately $6,000 a month. If more specialized care is needed, such as staying in a memory-care unit, the daily cost increases. You don’t want to economize in ways that compromise your loved one’s quality of life. It’s recommended to meet with an elder law attorney or certified estate planners to see what options are available, i.e., qualifying for Medicaid. Remember the 1.3 million Americans already in the nursing home? Seventy percent of them are on Medicaid.

There are instances where you don’t have the luxury of shopping around for the best nursing home: your relative broke his hip and isn’t capable of going home. The hospital staff (discharge nurses, care coordination, patient management) and social workers will find an available bed for your loved one. If that facility doesn’t meet your criteria (too far to drive, too expensive) at least you have time to look for another one while your family member’s needs are being met.

Remember to ask questions! Ask about the quality of the food, and when mealtime is. Ask if the residents are free to make decisions on their own, such as when to sleep, when to watch TV, when to participate in group activities. Can they arrange and decorate their rooms with personal items? These questions might sound mundane to you, but they are important for your family member and will help toward their overall mental well-being.