At what point should someone live in a nursing home?

Your loved one's disability has progressed to the point of jeopardizing their safety. Your loved one has wandered and been lost more than once. Other important responsibilities are neglected to the point of creating problems for you or your family. Our counselors help 300,000 families each year find the right care for seniors for their loved ones.

Nursing homes are places to live where care is available for people of all ages who need 24-hour nursing care and supervision outside of a hospital. While all nursing homes must provide certain basic services, some provide specialized care. For example, some nursing homes provide services to people with neurobehavioral disorders, some to those who rely on the ventilator, and others to people with AIDS. Some nursing homes specialize in caring for children.

Talk to the nursing home administrator, admissions director, or social work director what services are standard and what additional services might be needed and how much they cost. If you receive care at a hospital, your doctor and hospital discharge planning staff will help you organize your placement, hopefully in the nursing home of your choice. New York State regulations require that a hospitalized patient who is receiving Medicaid and who no longer needs hospital care, but requires nursing home care, be placed in the first available bed within a 50-mile radius of the patient's home. If you leave the nursing home or die, any amount paid to the nursing home that exceeds the cost of services already provided must be reimbursed.

Not all (and not many) older adults will be voluntarily admitted to a nursing home without some being convinced that it is the best solution for them. If your parents are going to a rehabilitation center in a nursing home, I recommend that you visit the center first before they are admitted. I often saw elderly people admitted to nursing homes not because they didn't have families, but because family members were at war with each other and simply couldn't work together to care for the elderly person. Some families who have a family member diagnosed with Alzheimer's think they're going to need a nursing home right away.

The moral or religious philosophy of some nursing homes may conflict with their wishes about advance directives. Not everyone who is older or older will need the support and care offered by living in a nursing home. Being in a nursing home will mean that there is a team around you that will be available at all times to check that you are taking medications. It's important to make the decision that a nursing home is the right place for you and look for different homes to identify the ones that best suit your needs, from the services they offer to your cultural environment.

Nursing home staff are experienced in caring for older adults with mobility problems, and facilities are designed to minimize safety risks. However, people with Alzheimer's who also have other serious and difficult to control health complications, such as uncontrolled diabetes or heart and lung problems that require supportive devices, may benefit from nursing home care. While many older people live in a skilled nursing facility for a long time, they can also go to a nursing home temporarily to recover from a major health problem. Anyone who needs care in a nursing home should be able to enter any nursing home and receive appropriate care, be treated with courtesy, and enjoy ongoing civil and legal rights.

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