When a Long Term Care Facility Must Be Selected

Kim Ciccarelli Kantor  |  Naples Daily News  |  December 11, 2013

There could come a time when the selection of a nursing home is necessary. Aside from what is generally a stressful and emotional time for the family, a “special needs” family member requires proper decisions made on their behalf.

Nursing home care can range from skilled to intermediate to custodial care. Nursing homes are for individuals who cannot do things for themselves. It is possible that the family is forced to choose a nursing home because a family member is being discharged from a hospital, and needs full-time care. Regardless of the circumstances, the selection of a nursing home can be one of the most expensive and ill-informed decisions a consumer can make. Often, families or caretakers are facing the selection of a nursing home during a time of crisis and have time constraints that hamper a well informed decision. The selections may be limited depending on the geographical area and/or financial capabilities. Families should become aware of the type of facilities available should the need arise, regardless of whether the requirement is an interim stay or a permanent stay.

First, contact the area agency on aging, county departments of social services, or other senior housing referral sources. In our offices, we try to maintain information on retirement communities and full care homes for our clients. Lifetime care is an integral part of a family’s financial and estate plan. There are several choices you could look at:

• Senior retirement housing
• Personal care boarding homes
• Adult foster care
• Homemaker services
• Home health care
• Home and community-based services

The type of setting you choose will be dependent on your special needs, the family member’s physical health, and mental ability; you will want to carefully select just the right setting for your loved one.

Some of the steps you may want to start within your search could include:

1. Visiting the retirement community and meeting personally the administrator and the staff. This should help you determine how they work with the people for whom they are caretakers.
2. Studying the general appearance and cleanliness of the community. Is it a pleasant environment?
3. Inquiring about the size of the staff, the turnover employment rate, their qualifications, and how well they like their work. Determine how many staff per residents, and if round-the clock care is available, and if needed, at what additional fee.
4. Observing the general activity and care of the residents.
5. Visiting the community around meal time to see the quality and palatability of the food served to the residents, noting the dining area’s attractiveness.
6. Consider the visiting hours available to guests and family, accessible outdoor area for residents, availability of telephone, and wheelchair accessibility. Is it a secure facility from the standpoint of security, as well as for the resident’s protection from wandering, etc.?
7. Other questions to ask may be related to the variety of programs and activities available for residents, both with the home and as a field trip.

An important part of caring for a family member who is living at the nursing home is the family’s participation in patient care conferences.

Federal law provides for a nursing home resident’s “Bill of Rights” and a list of these rights, not a summary, should be provided when the individual becomes a resident of the home. These rights are designed to insure the dignity and respect of the resident. The contract with the home should make reference to the resident’s rights. Other considerations should include Medicare acceptance, medical consents, the use of blanket waivers, responsible party(s), the admission agreement, transfer and discharge policies, bed-hold policies, notice time of any changes, and grievance procedures.

Begin doing your homework early on so you as a family may become comfortable with your planning when and if the need arises for nursing home care.