Most people start to look for a nursing home in the midst of an emergency situation, which is not the time to make an important decision. Make an appointment to visit a nursing home or two to see if you or a loved one enjoy the facility. This will give you the opportunity to ask any questions, including detailed questions about cost, insurance, and payment.
Your visit will also serve to calm any doubt or nerves that may exist around living in a nursing home. As with most things in life, it is the unknown that is more frightening than reality. Most people tour a nursing home and find that its comforts are not too different than those at home, and that the environment can provide much needed socializing.
The first thing to consider when selecting nursing home candidates for short-term or long-term care is which specialty care options you or your loved one may require. Some nursing homes specialize in Alzheimer’s and dementia care, others may cater specifically to residents who are going through rehabilitation, and others may not have a concentration at all.
During your visit, ask to stay for lunch or dinner. Dining during a meal service is the best way to see (and taste) the food that will make up all or most of your meals for an extended period of time. Staying for a meal also helps you see how meal service works (time, frequency, etc.) at the home, as it may vary from facility to facility. Some nursing home allow residents to eat any time, within reason, while others serve meals at set times. Some people do well on a set schedule and benefit from that routine; however, others prefer to exercise choice at any given time and want the option of dining at any time.
Pay attention to the other residents and how they pass their time. A nursing home should have some recreational activities for residents, depending on the intensity of care being provided. If you will potentially have an extended stay and require long-term care and require a familiar environment, ask if residents are allowed to personalize the bedroom with personal effects.
Before making any final decisions, get information straight from the source. Ask residents who you meet on your tour what they think of the home; what are the pros and cons? What do they love and what do they want to see changed? When you get home, search reviews to see what different people are saying about their experience with the home.
In 2008, Oregon Senator Ron Wyden started an initiative to have Medicare
set nursing home
rating because there was not a lot of information available to people that were turning over their lives, or the lives of their loved ones
, to nursing home facilities
. The rating system is kept simple with grades ranging from one to five stars (five stars being the best). The rating is calculated based on three categories:
1. Health inspection ratings
Health inspection ratings make up the key component of the rating. Health inspection ratings are based on comprehensive inspections that use federal inspectors and state inspectors to evaluate a nursing home on 180 different factors.
2. Quality measures
Quality measures are based on the data about the health and care of the nursing facilities’ residents. This number tracks things like the percent of residents who have contracted UTIs, who have pressure ulcers, and who are prescribed antipsychotic medication. Overall, there are 18 quality measures for long-term skilled nursing facilities.
3. Staffing ratio
This is the number of residents for each staff member. This number is two-fold. It includes the number of residents per staff member, and also the number of residents per trained nurse.
However, this rating system still left many concerns that lawmakers addressed in October 2014 with the Improving Medicare Post Acute Care Transformation Act of 2014, and more updates to the act have just been released. New changes include:
- Higher standards for several quality measures
- Changes to the algorithm that calculates staffing ratio
- Confirmation of staffing ratio data via nursing homes’ payroll data
- New quality measures (for example, the inclusion of antipsychotic medication prevalence)
- Expanded federal oversight of state inspectors
- Increased frequency of quality and federal inspections
These changes are sure to raise the bar of the care provided to nursing home residents and will help families choose the best home for their loved ones.
Although nursing homes
are a prominent living option
for elderly people
, the idea of moving into a nursing home
still makes many people nervous. This is largely because people do not know what to expect or have a misunderstanding of life in a nursing community
. However, the numbers show that Americans are happily making the transition to nursing home care
, although they could probably stand to start the conversation sooner. Below are five statistics that illustrate the state of U.S. nursing homes and their residents
7 out of 10 Americans 65-year-old and older will need long-term care. The greatest fear people of that age have regarding long-term care is being a burden on family, on average five times more than the concern of dying.
90 percent of surveyed people said that they have not discussed long-term care options and plans with their loved ones.
87 percent of rooms, on average, are occupied in nursing home facilities across the U.S. This number has risen the past few years partially due to an aging population, and also the warming opinions of long-term care communities.
70 percent more adventurers aged 85 and older hit the international travel scene last year than in 2004. It is crucial that elderly people continue to stay active at any age, and it’s never too late to start.
2009 The year an Independent Living report announced research that revealed most people in nursing homes wish that they had made the decision to make the move sooner. The research also shows that people in nursing homes are more likely to make new friends and lead more active and healthy lives.
A big factor in the elderly choosing whether or not to remain in their homes as they age, versus moving to a nursing home, is the location in which they live. Few people may consciously consider the livability of their neighborhood and how conducive it will be to aging. The AARP recently developed a new online tool that reports Livability Index grades – for free.
The index is on a scale from zero to 100 and is meant to tell people where it is best to retire based on many factors that range from the superficial (like tax rates and sunshine) to the vital (like affordability, health care, and public safety).
This tool is revolutionary because you can input your zip code to pinpoint specific neighborhoods and drill down into the details to get expanded information. So far, the highest ranking big city is San Francisco with a score of 66 and La Crosse, Wisconsin has the highest score (70) of all small towns in the U.S. The low score of the top-ranked cities and towns is telling to the AARP.
The scores indicate that most places across the United States are not designed to take care of the elderly. It is important for people to start paying attention to the low scores now because households held by someone 70 years old or older is expected to skyrocket by 42 percent over the next decade.
Aging in place, or the ability to live independently and comfortably in your home as you age, is highly desired by many people. The reality of the situation is that a home can end up being a financial burden with mortgage, insurance, maintenance, and repair costs, and it take a lot of work to keep up. Most people as they age lose the ability to maintain proper upkeep of a home or are not healthy enough to perform daily lifestyle and medical tasks.
Now the AARP is finding that even if these factors are not present, aging in place may be much more difficult for many elderly people than living in a nursing home due to poor livability conditions in their areas.
As times have changed, so has the traditional relationship structure. Many couples, particularly older ones, are increasingly opting to forgo traditional marriage in lieu of other partnerships. These nontraditional relationships, however, are vulnerable to circumstances but marriage is often a protection, so there are some factors to keep in mind when growing older and life needs change.
A will is crucial for people that are a part of an unmarried couple, particularly if the home is in only one person’s name. If life circumstances were to change and the owner of the home were to become ill, incapacitated, or suffer death, the other member of the partnership can end up without a home or proceeds from the sale. In that case, the home and the decisions regarding it will fall to the homeowner’s family to do as they wish – unless there is an estate plan or some other type of will in place.
This paperwork does not mean that the homeowner’s children cannot inherit the home. Your lawyer can put in place a document that provides for the partner in the home for the duration of their life, and then it can go to your children.
Speaking from a strictly financial standpoint, it may be a good idea for elderly couples to consider marriage if a partner stands to inherit money or property from the other because that is currently the only way to avoid paying taxes on that money. The American tax structure also favors marriage with inherited IRAs. A spouse can roll an inherited IRA into their own and benefit from other perks.
The conversation of what will happen to us and our belongings in case of difficulty can be an uncomfortable one to have. No one wants to think of those situations, but a lack of planning only exacerbates stress and issues later. Older unmarried couples should take a moment to commit to estate and life planning in case of medical emergency, or just a change in lifestyle, like one partner going to live in a nursing home. Foresight is better than sorry.
One of the most difficult conversations a child can have with a parent is one about the future of their care. When parents start aging past the point of being able to sufficiently care for themselves and maintain their health and safety, the responsibility often falls on the children to identify that the time has come to find a solution. Even more stress is put on the situation, however, when parent and child live far apart. In our younger years, we fling ourselves across the country to find ourselves and establish our new lives. After many years, though, the family in your hometown may need your help.
When a parent crosses a threshold and needs to move to a nursing home, children (or other family members in the absence of children) that live far away may choose to move the parent closer. Moving your parent to your city allows you to keep a better eye on their care and the development of their health, even though they may not live in your home. Most parents (around 90 percent in a survey) do not want to burden their children, or bring problems to them that are construed as burdens. When asked about health issues or other concerns, they falsely claim that everything is fine, which only exacerbates the problem. The arrangement of moving a parent closer gives people peace of mind, knowing that they are nearby in case of emergency.
This is an overwhelming time for the person moving, of course. The transition from independent living to a nursing home is a big enough change, add the move to another city and you can understand the condition the person may be in. Remember to have patience and to express that. It is expected that the parent may be stressed out and cranky, but find resolve knowing that this decision is what is best for your loved ones and soon it will be apparent.
If you have siblings, get them involved in the process. Not only will you need help physically packing the parents’ home, but you likely also need assistance getting your loved one in the spirit for this undertaking. The transition will be much smoother the sooner you start to talk about this with your parents, so that there are no surprises or rash decisions made in emergency situations.
When dealing with yourself, it is vital that you do not carry any guilt, as there is no need. As long as you are acting in the best interest of your family and parent, then the decision will be correct. It is normal for many people to feel uneasy about uprooting a parent and moving them to live in a nursing facility, but that goes away quickly once they see their parents’ new comfortable and stimulating environment.
Modern medicine and healthcare practices help many people live longer than the average lifespan of even the past of few years. However, in societies where living well into the 80s and 90s is common, the fears of dementia and nursing homes grow. Of course, the prospect of having dementia is frightening on many personal levels, it also seems that many people are uncomfortable with the idea of living in a nursing home.
Although there have been cases in the news of nursing home abuse, the reality is that nursing home communities are safe, comfortable places that support the changing needs of a quickly aging population. Across the country, nursing home communities have made great strides in developing a strong culture, creating a homelike environment, and adopting other resident-centric practices. The goal is to provide individualized care effectively and consistently.
There are more than 15,000 nursing homes in the U.S., which can accommodate around 1.7 million residents. Although nursing home residents can have varying health conditions, nearly 70 percent of all Americans with advanced dementia live in nursing homes. In the coming years, nursing home use is expected to increase dramatically.
Placing a loved one in a nursing home can also be a difficult time for family and friends. Family members often try to hold off visiting a nursing home because they feel guilty and think they should be able to take care of their loved ones. In reality, dementia and other issues that come with advanced age are conditions best cared for by trained professionals who can be always present. When you start to look at nursing home living as a necessary and even pleasant experience, then you can start to make the most out of this care.
Family and friends will always play a big role in their loved one’s care. Resident and family preferences often drive the care received and medical decisions made. People with dementia are not usually able to make big decisions alone, especially regarding their care. Make sure to be their biggest advocate and communicate their needs. If your loved one can still make these decisions, have the difficult conversation of their wishes. What type of care do they want? Do they want a feeding tube if they can no longer swallow? Do they want medical treatment administered at a hospital or in the nursing home, if possible? Do they want extraordinary measures taken in prolonging life? Together, the nursing home and family can ensure the best care for a resident with dementia.
Winter has the reputation for being the dangerous season for falls and the elderly are warned to be careful on slick walkways. However, spring also poses its own falling risks that many overlook. State aging departments across the United States recommend that seniors try to be active to prevent falls, especially if they are undergoing rehabilitation. They offer the following tips to prevent serious falls:
- Keep exercise simple and not too strenuous, like walking and stretching. Make sure to get at least 15 minutes per day.
- Ask your doctor or nursing home physician to provide an assessment of your risk of falling.
- Review your medications with your doctor and discuss side effects like dizziness.
- Get your vision and hearing checked and discuss fall risk with the specialist.
- Eat regularly to prevent low blood sugar-related dizziness and lightheadedness, and try to maintain a diet rich in calcium to strengthen your bones.
- Drink a lot of water to prevent dehydration.
Ultimately these are all tips for adults and seniors to develop healthy habits overall, and they have the added benefit of preventing traumatic falls. A big part in minimizing fall risk is knowing what to watch out for. Smoothe out loose rugs, clear obstacles from walkways and stairs, keep your space well lit, and check for medical/pharmaceutical culprits behind balance issues.
Spring’s additional hazards stem from the changing weather patterns and left over winter precipitation. Thawing snow and spring showers can make the earth very muddy and slippery, especially when bringing the slick shoes inside. Severe weather such as storms can lead to power outages, in which case you should try to stay put and keep a flashlight handy. Older adults that find it difficult to transition with the seasons and are susceptible to the dangers of living alone may find that now is the time to consider a nursing home. No matter how you decide to spend spring, just remember that safety comes first!
This year, Passover and Easter coincide, with Passover beginning on Friday at sundown and Easter coming the following Sunday. This is a great time in nursing home communities, where residents celebrate the season together. Nursing home host holiday festivities for those that choose to join, with delicious food, cultural traditions, and games. The best part is that families are welcome.
There is a lot of research supporting the benefits of visiting loved ones that are living in nursing homes during holidays, and although the conversation is usually about Christmas, it is equally important during the spring holidays. It is not difficult to bring a family holiday to the nursing home, although this is a great opportunity to take your loved one out and about to enjoy festivities around town, if they are able. Otherwise, take the Easter egg hunt on the road to the grandparents.
Passover is equally an important family time, and honors the elderly. In many Jewish families, the eldest person reads the Passover story. With Passover lasting until the April 11th, this gives more reform families extra time to fit a holiday visit into a busy schedule.
These holiday visits are the perfect opportunities to reconnect with your loved ones. Listen to stories of their day-to-day lives in the nursing home communities. Do they need anything? Are they receiving adequate care? It is important that people feel cared for and important, needed even. Feeling unneeded is one of the greatest difficulties of aging so make sure that your elderly loved one feels their role in your family, even if they live in a nursing facility.
Written by BRIA’s very own, Evan Lafer, learn about the growing demographic of those who have diabetes. Turn to page 23 in this month’s issue of “Healthy Cells Magazine” to learn more.
For a look at the rest of the issue, visit Healthy Cells website.