The term “nursing home” has become generic over
the years, and it is used to define all facilities from a rest home to an
acute care hospital. The
truth is that this muddled meaning can be confusing to those caregivers
trying to decide on a facility for their loved one.
The main goal of a nursing home is to care for those who are
recovering from an illness (short term) or to provide supervision for
those with chronic medical problems (long term).
Nursing homes can be broken down into three
categories. They are intermediate care facilities, skilled nursing
facilities, and skilled nursing facilities for special disabilities.
An intermediate care facility(ICF) must provide at least eight
hours of nursing supervision per day.
It generally caters to patients who are mobile and need less care.
At the least, an ICF provides medical, pharmacy, and dietary
The skilled nursing facility(SNF) must provide
24-hour nursing supervision. This
is most likely what people mean when they say “nursing home.”
Normally those who are incapacitated, and need long- or short-term
care, stay in one of these facilities.
In addition to the services that would be provided by an ICF, the
SNF will also assist in daily living activities such as eating, bathing,
dressing, and walking.
All nursing home facilities are required to be
licensed by their state. If
you come across one that isn’t, avoid it.
A state inspector visits each home at least once a year to make
sure that it is complying with state standards for care and services.
This passing grade is a requirement in order for these places to be
reimbursed by Medicare and Medicaid.
Many nursing homes are run as businesses for a profit
by individuals or corporations, and may even be a part of a chain of
nursing homes. Others are run
as non-profit companies and are sponsored by religious or charitable
groups or by government agencies.
One requirement for all patients in a nursing home is
that they be under the care of a physician.
The reason is that only a doctor can evaluate and prescribe a
program of medical care for a patient’s well being.
That is beyond the scope of a nurse’s responsibility.
In fact, a nursing home cannot authorize any restraints,
medication, medical treatment , change in diet or therapy without a
physician’s okay. A complete physical exam before entering a nursing home may
help in evaluating what treatments are needed, the duration of a loved
one’s stay, and the potential for rehabilitation.
When choosing a nursing home for your loved one, you
should compile a list of several that would be appropriate.
It is essential that you visit each one in person. Things to look for are:
Location-Close to a hospital for emergencies
-Convenient for you, friends, relatives, and the loved one’s
Visiting Hours-Are the hours convenient?
-Ideally, you should be able to visit anytime
Size of Facility-Small home=more personal
-Large home=more activities
-Consider the quality of activities and services
Room Selection-Is attention paid to room and/or roommate selection?
-If loved one dislikes roommate, can he or she change?
-Can we bring some of our own furniture?
Holding a Bed-If transferred to hospital, is a bed reserved?
Valuables-How are these
volunteers used—the more volunteers a home has, the greater the amount
of patient services provided
Morale-How do the patients
-Is there respect and privacy?
-Is there access to TV and radio?
Food-Does it taste good?
-Ask other patients
it clean, attractive, nice atmosphere?
-Is the food the
-Can special diet
needs be met?
-Is food available
at any other time than at regular meal times?
Grievance procedure-Is there
a procedure in place?
-If there is one,
ask other patients if it works.
-Is there a
-Are patient’s involved in the decision-making process?
services Medicaid or Medicare covers.
-Any extra costs above the room rate?
That should get you beginning to consider what things are most important
to you and your loved one when selecting a nursing home facility.
The transition to one of these homes may be difficult at first so
be there on moving day, and bring items that are familiar to furnish the
new room with. Family photos
are ideal to make it seem you’re your family is “there” even when
you’re not. Always remember
to visit often to show your loved one that someone out there still cares.
On special occasions you could even go out. The bottom line is whatever is best for your loved one.
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