Skilled Nursing Facility

caregivinghope.org expert advice on caregiving

When asked to consider life's most difficult events, most people would rank choosing a nursing home as one the most dreaded decisions. Despite our reluctance, as the aging of America becomes increasingly real, many of us will be faced with the difficult task of choosing a home for an elderly parent, partner, sibling, friend or ourselves. The United States Department of Health and Human Services estimates that 40 to 45 percent of all individuals over the age of 65 will require the services of a nursing home at least once during their lifetime. More than 105 million individuals currently reside in nursing homes; a number that is expected to double by the year 2020 when an estimated 18 percent of the population will be age 65 or older.

Choosing a Nursing Home
Choosing a nursing home doesn't have to be an unpleasant experience. Knowing who to talk to and what to look for can ease the stress many people experience when selecting a long term residence for their loved one. Here are some helpful tips:
  • The first step in selecting a nursing home is determining the level of care the individual requires. No matter what their age, a person wants to be able to maintain their independence. Look for the least restrictive setting possible so, the individual can remain as independent as possible and still have their needs met.  
For example, individuals with multiple health problems such as heart disease, respiratory problems, stroke or generalized weakness may need the intensive treatment offered at a skilled nursing facility which provides daily services by licensed professionals. Other individuals with fewer health-related problems may fare better at an intermediate care facility. Individuals with Alzheimer's disease or other forms of dementia also have special needs to consider. Family members may call upon hospital social workers and nursing home admissions coordinators to help decide which facility is appropriate.
  • Once the level of care has been determined, it is important to visit the nursing home to determine if it is a good match. Use your eyes, ears and nose to evaluate the home. Is the home clean? Does it have an odor? Do the residents look happy and well-taken care of? Is the staff attentive and affectionate? Though it may be difficult, physically visit every home you can, so you can make educated comparisons.
  • When you have narrowed your list, visit homes under consideration several more times, and at different times of the day. You're apt to learn a bit more about a home with each visit.
  • While it is not always possible, having the prospective resident visit the nursing home before admission is a good idea. Make arrangements to have a meal there to taste the food. Take time to check out the activities offered, evaluate if there are programs your loved one may enjoy.
  • Another important factor to consider in selecting a nursing home is the staff-to-resident ratio. Look for a ratio of 1 staff person for every 10 residents for intermediate care facilities, and a 1-to-7 ratio in skilled care settings.
  • Equally important is continuity of care, especially in an Alzheimer's unit. Frequently the residents are unable to remember names of staff or other individuals, but they will remember the same faces.
  • Take time to talk with the staff. The staff needs to meet the needs of both the residents and you, the family. You should feel comfortable going to the staff with cares and concerns, no matter how small they may seem.
  • Nursing homes are highly regulated, more so than most any other industry in the United States. The state inspects each nursing home at least once each year, more often, if necessary. Ask to see the latest state survey report. Verify that any deficiencies found by inspectors have been, or are being corrected. Don't be afraid to ask to see the survey, it can help you make an educated decision.


HOW TO SELECT
A NURSING HOME
A Helpful Checklist for Families

 

Levels of Care
There are many types of care to consider: