- Special Needs Alliance - https://www.specialneedsalliance.org -

Choosing the Right Nursing Home

By Martha C. Brown, CELA [1]

When a loved one of any age requires the round-the-clock care of a nursing home, it’s important to select one that fulfills both their medical and social needs. Each facility has its own culture, and since this will be your family member’s home, the environment should be a welcoming fit.

Look for a nursing home as close as possible to relatives and friends, since frequent visitors are important to quality of life. Check reports from certifying agencies and get references. As you whittle down your list, visit the top contenders at various times, noting how well staffed they are on weekends and after 7:00 p.m.

Talk to caregivers and notice how they interact with residents. Does it appear that they’ve developed close bonds? Try to determine how much employee turnover there is, which will affect the ability to maintain relationships. Look for a strong administrator, who won’t let problems fester, and ask how care plans are developed.

Food matters. Is your child a picky eater? Is your mother a vegetarian? Be sure there are choices for each meal and that your loved one’s dietary needs and preferences will be met.

If religion is an important part of your family member’s life, ask about services and who conducts them. And learn about the social calendar. What types of events do they arrange and how often? One of the nursing homes in St. Louis, where I practice, has worked closely with a multiple sclerosis advocacy group to provide age-appropriate activities for a younger population.

Be sure that you understand how charges are determined. Given the high cost of long-term care, many nursing home residents rely upon Medicaid to cover their expenses. It’s a common misperception that the quality of services may be influenced by dependence on government benefits, but the care staff has no knowledge of what takes place in the accounting department. What may be affected is access to a specific facility, since many nursing homes have guidelines concerning the number of “Medicaid beds” they offer. Given that Medicaid is a means-tested benefit, families should consult a special needs attorney [2] to protect assets while establishing eligibility.

Rights of Residents

The Nursing Home Reform Law, which applies to all facilities receiving Medicare or Medicaid funds, protects residents’ rights to self-determination and dignity and requires each state to maintain a long-term care ombudsman program.

Adult residents with appropriate capacity have the right to control their own schedules, receive visitors, choose their activities, and control their medical treatment. Parents, guardians and health care proxies should communicate frequently with nursing home staff to ensure that their instructions concerning treatments and lifestyle are followed.

Other important rights include:

When You Disagree

Disputes can arise from a wide range of circumstances— an inconsiderate roommate, dissatisfaction with food or the quality of health care. In St. Louis, volunteer ombudsmen, who are onsite several days a week, are the logical first place to turn. Involving them as soon as possible often prevents a problem from worsening.

But if the ombudsman is offsite, there are other paths to consider before bringing the issue to an outside party.

While most individuals and their families would prefer in-home care, this is not always an option. But with careful research, ongoing communication with staff, and a readiness to advocate, you can ensure that your loved one receives the medical care they need in safe and congenial surroundings.