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Choosing
a Nursing Facility
Copyright 1999 IlluminAge,
206-625-9128. Reprinted from the Resident and Family Guide to Long
Term Care. Provided exclusively for individual use by long term
care residents and their families. All other use, reproduction,
distribution or adaptation is prohibited.
- An Informed
Decision
- Level of Care
- Paying for Care
- Things to Look For
- More Questions to Ask
- Helpful Resources
An Informed Decision
If you are
considering a move to a long-term care facility for yourself, or for
your spouse, parent, other family member or friend, you will feel more
confident in your choice if you know about your options and what you and
your family can expect after the move.
Whether you are
considering just one long term care facility, or are trying to choose
from among several facilities, your decision should be an informed one.
This means understanding what level of care is needed in your particular
situation and making sure the facility you are considering is a good
fit. Being informed includes becoming acquainted with the facility
itself, its typical resident rooms, dining room, and spaces used for
social activities and aspects of care, such as physical therapy. It also
means getting a good feel for its residents and staff.
Taking the time
to visit, observe, and ask questions not only lets you make the best
selection, but also prepares you and your family to take full advantage
of everything the care facility you select has to offer.
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Level of Care
The level or
levels of care a facility offers is the first thing to ask about. A
person about to be discharged from a hospital and admitted to a nursing
facility for a short period of recovery before returning home has one
set of medical, therapy, and social needs. A frail or chronically ill
person who requires ongoing, around the clock nursing and personal care
has another set of needs. Someone with severe dementia has yet another.
These days,
terms like "nursing home," "extended care facility," and "convalescent
center" refer to facilities that provide a wider range of health care
services than ever before. The facility you are looking at may offer or
specialize in certain types of care. In fact, it may operate programs or
units (groups of rooms on the same floor or wing) for particular
categories of residents, such as a special unit for Medicare (short
stay) residents, or one for residents with Alzheimer’s disease or other
forms of dementia.
Ask whether the
facility you’re looking into offers the right level of care for your
situation . . . and whether it does so in any special way that might
affect your decision.
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Paying for Care
Another thing
to check on is cost and who will pay. The rates facilities charge their
residents vary, and it may be important for you to know which services
are covered in a basic daily or monthly rate, and which ones have to be
paid for as extras.
Not all
facilities participate in Medicare and Medicaid, so if one of these
programs covers you or the person you are helping, it is important to
verify that the facility you have in mind is certified to receive that
type of payment. Medicare is the federal government program for persons
age 65 and over that pays for a limited period of time in a nursing
facility after certain types of hospital stays. Medicaid, a program
funded jointly by the state and federal governments and administered by
the state, pays for extended care for persons who meet eligibility
requirements tied to income and assets.
Similarly, a
growing number of managed care plans, like HMOs, have payment contracts
with particular long term care facilities. It is worth asking about
this, as well.
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Things to Look For
Visiting the
facility you are considering is always a good idea. While you’re there,
these are some of the important things to look for:
Residents
Do the residents appear comfortable and well cared for?
Are they appropriately dressed and well groomed?
Staff
Do the facility’s employees seem knowledgeable and well
organized in the tasks they are performing? Are they courteous and
attentive to the residents (for example, knowing and using a
resident’s name, and knocking before entering a resident’s room)? Are
they wearing name tags to let residents and visitors know who they
are? Are they groomed appropriately? Do they seem happy and engaged in
what they are doing?
Resident Rooms
Are the residents' rooms clean and comfortable? Do
lighting, ventilation, and space seem adequate? Are the bathrooms
equipped with non-skid surfaces and grab bars? If rooms are shared by
two or more people, is privacy respected as much as possible?
Meals
What is the dining room like as a meal is being served?
Do things seem calm and organized? Is the food appealing? Is it served
hot?
Social Activities
Does the facility offer a variety of activities and
outings? Does it keep residents informed and personally active as much
as possible? Are calendars, posters, and photographs displayed?
Building and Grounds
Is the facility well maintained? Are there walkways or a
courtyard for outdoor visits in good weather? Do stairways and
hallways have safety rails?
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More
Questions to Ask
Many important
characteristics of a facility are not visible on the surface. So you
shouldn’t be reluctant about asking more questions. For example, you
might ask about:
Choice of Doctor
Does your regular doctor see patients at this facility?
If not, which doctors do?
Admission Agreement
What sort of written contract does the facility ask new
residents to sign? Ask to see a copy.
Family Involvement
What are the opportunities for family involvement? Find
out about visits, availability of support groups, and participation in
care conferences and care planning.
Survey Results
All long-term care facilities are regularly inspected
("surveyed") as part of their license renewal or in conjunction with
their certification as a participant in Medicare or Medicaid. The
results of the state’s most recent survey are always available for you
to look over. Were there any major problems?
Facility Policies and
Procedures
What does the facility ask of each resident . . . what
are its "rules and regulations"? What is the policy on smoking? On
loud noise? On protection of resident belongings?
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Helpful Resources
An excellent additional resource is the "Resident and Family
Guide to Long Term Care", from which this information piece was taken.
To order, call
800-448-5213. Or order online at
www.IlluminAge.com.
Additional
information about selecting a long-term care facility is usually
available from:
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Hospital
discharge planning staff |
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Physicians
and their physician assistants or nurses |
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Senior
Information and Assistance |
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Long-Term
Care Ombudsman |
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Local,
County, or State Office on Aging. |
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