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How to Select a Nursing Home

Updated on August 30, 2012

My experience in finding a nursing home

My mother wanted to keep my father at home. She cried when I convinced her to let him go to a nursing home. Over the past year, he went from being almost comatose to being very happy. I love to hear him greet me with "Hello, my darling!". I never thought I would hear his voice again.

"Hello, my darling!"

Why a nursing home?

I never thought a nursing home would be better than being at home

My father had Alzheimer's disease. My mother was his sole caregiver. My sister and I live 3000 miles away from my parents, so we can't help out much. His needs were becoming overwhelming for her to manage him well. He slept most of the day and seemed like he was comatose to me, even when he was awake. He eventually fell and had to go to the hospital. My father had developed some infections and had become very weak. A day before he was discharged, a social worker asked me to give her the names of three nursing homes that were possibilities. I asked her for a list. I didn't have time to visit them so I decided on one that was in a neighborhood that was close and had certain qualities that seemed good. It was going to be a short-term stay. The social worker at the hospital also suggested I apply for Medicaid (as a supplement for Medicare) for my father. As soon as the application was submitted, he would be covered under "Medicaid pending". The application had to be completed within a certain amount of time to keep him covered.

The nursing home was okay. The staff was great, but the facility was too small in that it was difficult for someone in a wheel chair to get around. This is not something that I would have noticed if I were to have visited the site. It felt closed in, claustrophobic and dark. There was no place for visitors to visit except to sit on his bed. Recreational activities were limited. He wasn't able to walk or feed himself before entering the nursing home. My mother fed him at home and didn't feel that it was important enough for him to be able to feed himself. He also needed help dressing, going to the bathroom and bathing. In the nursing home, my father became more alert, got physical therapy and was able to walk again with a walker. He did not improve any other daily activities. The social worker was difficult to find and didn't seem to have my father's best interest in mind. Even though he was covered by insurance, she knew that Medicare only covered the first 21 days 100% and then only 80% was covered. My father was discharged from the nursing home on the 20th day.

After a day at home, my father relapsed into the coma-like state and couldn't get out of bed. A visiting nurse came to the house and helped me assess the situation. I finally felt he had to go back to the hospital. This time I sent him to a different hospital. By the time he was going to be discharged, I had convinced my mother that my father couldn't go home again. He would need to stay at a long-term facility. This time, I asked people I knew and trusted. It had to be close enough so that my mother could see my father every day and family and friends would be close enough to visit. My childhood friend and a close friend of my parents both worked on a campus that included a nursing home. They couldn't give me information about the facility, but they could be supportive of my mother. My mother had driven past this nursing home often and could easily get there. I visited the facility. I was impressed when I first walked in. The building was clean, brightly lit, and spacious. I visited the area where he would be. Many people were in wheelchairs and getting around was not a problem. There were plenty of places where you could visit privately with patients. There seemed to be many activities going on all day. I had a really good feeling about this nursing home.

There were a few other recommendations from friends that seemed promising, but I didn't have time to visit them. I gave the social worker my list of three. We got our first choice. When he first got there, he was not able to open his eyes, feed himself or communicate. He arrived during a blizzard. My friend lives and works minutes from the nursing home and went there to see him when he arrived. She said she was bombarded with questions about him - what is he like, what does he (or did he) enjoy doing, what is his current condition, etc. Their mission was to make his time at the nursing home as optimal as possible. There are support groups for family members, which my mother joined. She made close friends there and was able to find comfort in this difficult situation. My father has been there for a year. It is the best place for him. His physical condition has improved so much. He doesn't walk anymore, is incontinent, and doesn't dress himself probably because of the Alzheimer's disease. However, he can feed himself and is very social. He is stimulated and participates in activities such as arts and crafts and loves listening to music.

My mother developed a stroke not long after my father went to the nursing home. She went to the first hospital that my father had gone to earlier in the year. When it was time for her to be discharged to a nursing facility, I gave the social worker only one choice. My parent's friend worked at the Alzheimer's Daycare facility spoke with the administrator at the nursing home where my father was staying. I spoke with my father's social worker. Between the two of them, my mother was accepted to the same nursing home my father was in, but on a different floor. When she first arrived there, everyone she knew - friends and staff - went to visit her. I made sure that my parents saw each other every day. Unfortunately, my mother passed away. Thankfully, my father's disease prevents him from understanding that she isn't around anymore. When I visit him now, I feel that I made a great decision in placing him where he is. The staff is great and he seems to be getting great care. I have met and grown attached to the people there, both staff and family members of other patients. But most important, my father seems to be very happy.

The Most Improtant Thing You Should Know About Nursing Homes

They are not all the same. You need to find one that meets the needs of the patient. Don't let insurance or social workers guide your choice.

When does one need to go to a nursing home?

Hard decisions

An individual needs a nursing home when it is too difficult for family members to take care of loved ones who require constant care or who are functionally disabled. Homes are always furnished with special equipment that one might need such as wheel chairs, special beds, oxygen, or other medical supplies. There are usually doctors associated with the nursing home that monitors your loved one's health. It can be difficult to maintain a restricted diet at home. Nursing homes have dieticians to regulate what foods patients can eat and how they are prepared.

After a hospital stay, doctors might recommend that a patient go to a nursing home to continue their recuperation. They might not need the high level of medical care that is available in a hospital but they still need assistance with their personal care, daily living tasks and convalescence. There might be medical needs that the family can't manage such as Alzheimer's , dementia, stroke, or cancer. Many people in this situation require special services such as nursing care to manage or therapy. There are different levels of nursing care ranging from supervised care to round-the clock care. Therapies that are offered include:

  • Physical therapy - help people move or walk
  • Occupational therapy - help people perform tasks such as dressing or eating
  • Speech therapy - help people with speech, voice and language disorders
  • Recreational therapy - help people become active through sports, arts, crafts, games and music.
  • Psychological therapy - help people deal with their medical condition or disability. Social workers can also be supportive.

How do I find a nursing home?

Good question

If the patient is in the hospital, there is probably a social worker can assist you with suggestions. Since there isn't always a bed available at your first choice, you should pick a few that meet your needs. It is best to visit the each nursing that you are considering. Some things to consider are:

  • Location - is the nursing home close enough so I can visit my loved one as often as possible?
  • Services - as noted above, make sure the services (therapies, equipment, medical, etc.) that the nursing home is what your loved one needs.
  • Ask people you know if they can recommend a nursing home
  • Listen to your instincts and judgment. Online reports aren't always current.
  • Search online for nursing homes in your area and visit them. Some sites that might help are:

My father a few months before he died.

The photo on top was taken in February 2007. This picture was taken November 2011. My father actually improved in the nursing home, probably due to the care and stimulation he received.

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    • dlobel profile image
      Author

      Debra Lobel 5 years ago from Oakland, CA

      @anonymous: I hope that your Uncle gets to see his wife often and enjoy his time with her without having to take constant care of her.

    • profile image

      anonymous 5 years ago

      Very well done. One of my Aunties has been placed in a nursing home recently, its been so hard for Uncle to have to do that,

    • Lady Lorelei profile image

      Lorelei Cohen 6 years ago from Canada

      You write very well to express the deep emotions which this topic covers.

    • profile image

      ppt5551 7 years ago

      It is a hard to find the perfect nursing home for your loved one. I work at a nursing home and we strive to treat all our residents well. We get our Nursing Home Activities from LifeBio.com and the residents love the activites.