Marlene Heller, director of marketing and communications for the Jewish Home and Care Center Foundation in Milwaukee, doesn't like the term "nursing home." Too often, it conjures up images of sterile, cold environments where seniors live out their last days alone. It's a stereotype Heller says is all wrong. "Don't look at it as a place where someone is going to go to die," she says. "It's where they're going to live."
To find a nursing home where your parents can live with dignity, Heller and other experts in the field say following these 10 steps can help you locate the perfect place.
Step 1: Take a "just in case" tour. Erin Cornell, director of health services at Rose Villa in Portland, Oregon, says many people find themselves scrambling to locate a nursing home after an emergency situation or hospitalization. "They are usually given a list of nursing homes from a discharge nurse," Cornell says.
That scenario can lead to rushed decisions and poor choices. A better option would be for adult children to take "just in case" tours of local facilities when they have the time. Then, they'll have a nursing home already selected in the event they need to move in a parent on short notice.
Step 2: Sit in on a meal service. As part of the tour, ask to join a meal or at least observe one. Sharon Belovarac, administrator of ForestView Health Care Center at Springhill in Erie, Pennsylvania, says each facility may structure its meal service differently depending on the type of care provided. For example, those receiving memory care at ForestView eat with staff. "They make it more of a family style setting," Belovarac says. Other homes may have designated meal times or allow residents to eat when and what they want, within reason. Watching how meals are structured is an important component in understanding if a facility is right for your parent.
Step 3: Listen to how the staff talks to and about residents. During tours, pay close attention to staff interactions with residents. "Spend time focusing on how they talk to and about residents," Cornell says. "Are they talking about them with respect?"
Step 4: Observe how residents pass the time. While older seniors may have limited abilities, that doesn't mean they shouldn't have choices. A good facility will offer plenty of activities and recreational opportunities for its residents. Heller says people should look for how current residents are spending their time. "Are they propped up in front of the television?" Heller says. "If so, cross that one off your list."
Step 5: Ask about resident choices. Good facilities respect their residents' wishes about how they spend their days. "They are adults, and they make their own choices," Heller says. Ask whether residents are allowed to wake on their own and if accommodations can be made to allow them to eat on their own schedule. Don't forget to find out if residents can personalize their room. "See what type of leniency there is for residents to furnish their space," says Patricia Leuschen, marketing director at Springhill.
Step 6: Learn who's in charge. Talking to the staff who work directly with residents is important, but don't neglect to check who runs the facility as well. High turnover in management or administrative positions can be an indication of trouble. "Look for the stability of the people running the center," Belovarac says. Also find out if there is a medical director on staff and on-site. If a trained medical professional is not provided, ask how residents receive needed care.
Step 7: Check references and ratings. Before moving an aging parent into a long-term care facility, ask family and friends for their recommendations and personal experiences with area homes. You can also check ratings on Medicare's Nursing Home Compare website. But these ratings don't always tell the whole story. "Use them as a starting point," Heller says. "Don't use it as a finishing point because these are imperfect ratings."
If a home you otherwise love has a less than stellar rating, ask an administrator if corrective action has been taken. Some poor ratings may be a sign of ongoing problems at a facility while others may reflect a one-time gaffe, such as leaving a syringe on a counter.
Step 8: Consider specialty care options. Not all nursing facilities operate the same way. Some places cater specifically to those undergoing rehabilitation, which may be a good choice for parents who need short-term care after a hospitalization. If your parent has dementia or Alzheimer's disease, look for memory care units, which are typically more secure to prevent residents from wandering. They may also offer specialized services to support brain health.
Step 9: Find out what happens when more care is needed. At some point, your parent may need agreater level of care. Learn, in advance, how a nursing home handles this type of situation. Some homes may be able to meet advanced needs without moving a resident while others may need to transfer a person to a different wing or floor. The worst case scenario is a facility that can no longer care for your parent and requires you to find a new home.
Step 10: Talk about payment options. The last step to picking a nursing home for mom and dad is to discuss payment. Private health insurance and Medicare may cover short-term stays in nursing homes, when medically necessary. However, families will need to find another way to cover the cost of ongoing long-term care.
Long-term care insurance is one option, but relatively few seniors have these policies. Medicaid will cover nursing home care, but families will first need to spend down income and assets in order to become eligible. Veterans and their families may have access to Aid and Attendance benefits and some facilities, such as the Jewish Home and Care Center, have foundations to cover the costs of some patients.
"People are living longer, but they are not living well longer," Heller says. Choosing the right nursing home for your parents is a critical step toward ensuring their needs are met in a positive way.