About Nursing Homes

Nursing homes, also called skilled nursing facilities, provide 24-hour care by healthcare professionals to men and women who no longer have the ability to take care of themselves because of mental, physical or emotional reasons. There are two types of nursing homes: skilled medical care or custodial, personal care. Skilled medical care consists of the professional health support needed for a specific period of time due to an injury or illness. This care is provided by such people as a physical therapist, who works with someone in an automobile accident; a speech therapist who helps a person after a stroke or an occupational therapist who assists someone relearn self-care. Custodial or personal care consists of help with daily living activities, such as bathing, dressing and getting in and out of bed. Those who lose their ability to function independently need custodial care for the long term.

History

• The number of people who reside in nursing homes has been decreasing due to the other choices available to seniors and the elderly for healthcare support. Assisted living facilities, for instance, care for individuals who previously may have had to go into a nursing home to receive minimal care with their personal needs. Assisted living facilities provide help with daily living activities, but only very limited or no medical care. Nursing homes have registered nurses onsite continually and physicians on call, and assisted living facilities only offer personal support from someone who has little or no medical training. Another option, continuing care retirement communities, allow for independent living, assisted care and nursing home care at one location. This gives seniors the option of staying in a comfortable environment as they age. Many seniors begin living in this type of community when they are still in good health and active. They know that other care is available if and when it is needed throughout the coming years. In some cases, for example when someone falls, it may be necessary to go to a nursing home for a while and then return to independent or assisted living.

Features

• Every person who goes into a skilled nursing facility has a unique situation. Some people may need short care, because they fell and broke their hip and need physical therapy. They are briefly hospitalized and then receive rehabilitative care for a few months. Others need long-term healthcare, because of an illness such as Alzheimer's, a severe stroke or are frail and wheelchair bound. For example, there may be a concern that the person may wander without supervision. Or, a person needs daily medical care by a registered nurse or supervision by a physician. Or, after being in the hospital for an illness or injury, the doctor recommends a nursing home stay. The facility normally consists of a private or shared bedroom and bathroom. In some cases, married couples can stay together or even bring their pets.

Potential

• Because of the growing number of seniors and elderly, nursing homes are undergoing changes. Rather than just looking at medical care, these nursing home changes are concerned with patient-focused personal care as well. They are becoming more homelike with less clinical architectural design and lighting. Hallways may have carpet instead of tile, central courtyards may offer gardens and reading areas, private event rooms offer privacy for small parties. Even the areas for the nurses on call are being updated to enhance the ability of the RNs and patients to communicate easily and in comfort. In addition, some nursing homes allow diners to choose between several different meals. Also, increasing numbers of nursing homes are only offering private rooms. In many cases, the staff can see positive changes in the residents when this additional personal care is provided.

Considerations

• It is now being recognized that a wide range of social activities is also very important for nursing home residents. Studies find that it is essential for the elderly to regularly participate in activities to keep their minds and bodies active. Today there are over a million people living in 16,000 nursing homes, just in the United States alone. Yet many of these nursing homes, even those that do offer social activities, do not mentally stimulate the residents. Involvement with effective social activities can help people regain their self-confidence and sense of control, which is often lost when institutionalized. The best approach is for the facility to offer different types of activities, since the residents have varying interests. When considering a nursing home, see if they offer a necessary variety of recreational activities to keep the people mentally and physically involved.

Warning

• Medicare will pay some nursing home costs for individuals who require skilled nursing or rehabilitation services. To be covered, the patient needs to go to a nursing home that is Medicare-certified after a qualifying hospital stay. Qualifying means a hospital stay that is at least three days. Patients need to contact a Medicare fiscal intermediary or the state health insurance assistance program in their specific state. Medicaid, a state and federal program, will pay most nursing home costs for individuals having limited income and assets. Medicaid covers only government-certified facilities. The eligibility for Medicaid is based on the state's requirements. For more information about Medicaid payments, call the state's Medicaid office. Approximately half of all residents in skilled nursing facilities pay the costs from their own savings. Once these resources are gone, many people become Medicaid eligible. Another option, a managed care plan, does not cover costs unless the facility is contracted for this plan. Some people have Medicare supplemental insurance, or Medigap, which is a private insurance that covers medical expenses not covered or only partially covered by Medicare. Long-term care insurance is a private insurance that has many different plans to provide additional income for healthcare coverage.