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  • Administration on Aging

    By Susan Archibald, PhD
    Kaplan University, School of Health Sciences   

    If the time comes when a family needs to choose a facility for the long-term care of a loved one, how should that choice be made? Location? Cost? Survey ratings? Activities available? All of the above? 

    Choosing the right place can be a difficult decision, but there are some things that you can do to make an informed one.

    First of all, you need to know just what kind of care your loved one needs. That can be determined with the help of the physician and others who are familiar with the person. For instance, a person may need some help with taking medicines and making meals, or may thrive in a lower level of care, like an assisted living facility.

    If it is decided that a nursing home is the correct placement, then you need to find the place that best meets the needs of the individual and his or her family. Start by making a list of the facilities that are in the immediate area. Ask the physician, hospital discharge planner (if the patient is in the hospital), friends, and others about their experiences with the available facilities. Ask what they liked and what they didn’t like. Keep in mind that everyone’s experience will be different and focus on different areas of the placement.

    Researching and Visiting a Facility 

    Once you have determined what is available, take a look at the evaluations of the facility. Medicare provides a resource for this that is reliable at Medicare.gov/nursinghomecompare. However, don’t stop there! Visit the facilities that you think may be a good fit. Ask questions of the staff and chat with some of the residents. Keep these questions in mind during your visit:

    • Is the facility clean, bright, and cheerful?
    • Do the residents look content?
    • Are there interesting activities listed on the activity calendar?
    • Are you greeted with a smile from the staff members?

    Keep an open mind—residents are there because they need help, and some may be dealing with complex medical and/or mental issues. What you want to do is get a feel for is the attitude of the facility.

    At this point, you will want to determine the costs involved with each facility. Medicare pays for short-term rehabilitation in some cases. Medicaid helps those who do not have the necessary financial resources. Long-term care insurance may pay for some of the costs. If the person has adequate financial resources, bills can be paid by the individual. For this conversation, you need to speak directly to the person in charge of finances in the nursing home. Ask to see the charges in writing.

    Consider Other Important Questions 

    Don’t neglect to inquire about all the things that make life pleasant!

    • How is the food?
    • Can you share a meal when you visit?
    • Can your loved one get up and go to bed at will, not just when it is convenient for staff?
    • Can the room be decorated? Can you hang pictures or bring furniture?
    • Are pets allowed to visits?
    • Can your loved one go out for an afternoon with family?

    You will also want to know how often the doctor visits, who the doctor will be (if not a regular physician), and what hospital the facility uses. Are medicines covered in the base price? If a question comes to mind, ask it! The facilities should be happy that you are interested enough to ask, and should be willing to completely respond to every question.

    Finally, ask the person showing you the facility to tell you about what a typical day will look like for your loved one. Here are some questions to consider:

    • Will there be regularly scheduled therapies?
    • What time are the meals?
    • Are activities offered throughout the day and on the weekends?
    • Are religious services offered?
    • How will your family member spend free time?

    Remember, you want to be sure the facility is a home, not just a nursing home.

    Many facilities offer specialized care: Alzheimer’s or dementia units, veterans only, rehabilitation units, ventilator units, and others. Make sure the facility you choose has the capability to provide the level of care needed. Ask about care plan meetings (where the patient’s plan for care is determined, then monitored), the frequency of meetings, and if you and your loved one can attend (the answer should be “yes!”). Also find out if anyone else attends the meetings.

    Be a Familiar Face 

    Once you choose the facility that best meets the needs of your loved one, there is still work to be done. Be a familiar face. Get to know the staff, particularly the nurses and nursing assistants who provide the majority of care. Visit as often as possible. Encourage others to visit as appropriate. Get to know the other residents. Attend the Care Plan meetings. Join the Family Council if they have one. 

    Relax into your new role as visitor, the person who comes in to spend quality time with the resident. Let your loved one know that her or she is still a part of the family. All of your hard work will be rewarded when you see your loved one well taken care of and content.

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    If you are interested in pursuing a position in long-term care as an administrator or manager in a nursing home, we invite you to explore our Bachelor of Science in Health Care Administration or Master of Health Care Administration. The programs are designed to offer a solid foundation in the leadership, finance, and organizational skills necessary for success. Upon graduation, those wishing to obtain a position as a nursing home administrator should check their state requirements, as they vary from state to state.

    Susan Archibald, PhD, is a faculty member at Kaplan University. The views expressed in this article are solely those of the author and do not represent the view of Kaplan University. The contents of this article are presented for informational purposes only. Always check with a health care professional with any questions you may have regarding caregiving issues.

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