Choosing the Right Nursing Home

One of the most difficult decisions to make, whether for yourself or for others, is what nursing home suits your needs. There are many things to consider, including price, location, staffing, specialties and more. Since a nursing home is a place where you or your loved one may be spending the next four or more years, the process you use to make a decision should be like choosing a college.

In some cases, the student selects the college, and in other cases the college selects the student, but in both cases, the family members are very much involved. The same should hold true when making a nursing home decision.

The decision of what nursing home is right for you is seldom made in advance. Most of us simply dismiss the concept by saying, “I will never go into a nursing home.” Or we say, “ I will never allow my (mother, father, spouse) to go to a home.” This is what I refer to as the Turtle Approach. By putting your head into a shell, you are never ready when reality brushes against you.

On the other hand, I know some people who obsess about this choice, even when they do not need it. They go to home after home for interviews, tours and sometimes even the free tea sandwiches. I call this the Buffet Approach, since they are looking at a smorgasbord of options, which makes the final choice almost impossible due to information overload.

The decision of when to go into a nursing home is usually not made by the patient or the family. It is dictated by the physician, the hospital staff and the health condition of the patient. The doctor knows that the patient cannot stay in the hospital any longer, but also cannot go home. And by the time the patient’s condition and treatment plan is revealed, the staff knows that the patient’s residence does not have the proper facilities or support for the level of care that the patient requires. The decision to put the patient into a nursing home is often made on the fly, seemingly as the patient is wheeled out the door.

But if you know this situation is coming, and barring an emergency, we usually do, there are several resources that can help. One is the Federal Eldercare Locator at 1-800-677-1116, or you can visit www.eldercare.gov on the Internet. There is a lot of useful information available, and these resources can help you generate a list of quality nursing homes near you.

Now comes the interactive phase of this project. You need to physically go to the place, much like your son or daughter did when they visited colleges and bonded with their future alma maters. You should walk through the facility and around the outside of the building and inspect the grounds. Ask yourself these questions:

• How does it look from the outside?

• How well is it landscaped?

• Does it appear that they maintain it well?

• How loud is it in the halls and in the rooms?

• Is it clean inside?

• What types of programs are offered, and do they fit with my loved one’s needs?

• Will my loved one thrive here?

Go to the restroom down the hall and wash your hands. Are there spots on the mirror? Is there water or trash on the floor? Are there towels in the dispenser? This information helps you feel good (or bad) about the place, even before you investigate the staff or the facilities.

Talk with the nursing administrator about your family member. Ask if the facility has staff that are trained to work with the condition from which your loved one suffers. For instance, not every home can and will treat Alzheimer’s patients. And not all have physical therapy departments for rehabilitation, so ask early. Some of this can be resolved by telephone or by your Internet search before you make the trip.

Speak with the top administrator, and get a feel for him or her. Ask for a copy of the state’s inspection form (form 2567), which they should provide to you without a fuss. If that form is not provided to you willingly and promptly, then you should probably walk away.

There is another source online at the U.S. Department of Health and Human Services, which operates a highly informative site at www.cms.gov. It can help you analyze the prospects of paying for the care. Often it will take a mixture of savings, long-term care insurance and government programs to cover all expenses. Many nursing homes are only ‘private pay,’ meaning that they will not accept or keep patients who cannot pay. This might mean that your loved one has to move out after his or her money has been exhausted. Ask this question early, too.

Many of my clients call when their parents are already in the home, or are in the hospital with nursing home costs looming, and they want to ‘plan’ for it. By that time, it’s very late in the process and there are very few things that can be done. The time to plan for this is before you need it, just like so many other things in life.

There are a lot of parallels between sending a child to college and sending a loved one to a nursing home. If the planning and investigation stages are well thought out and executed, the next few years should go smoothly.

Christopher M. Abernethy has been practicing law in Hampton Township since 1976. He focuses on elder law, which includes wills, trusts, powers of attorney, living wills and probate matters. He also is proficient in all aspects of real estate law and business law. He is a member of the National Association of Elder Law Attorneys and the AARP Legal Services Network. He can be reached at (412) 486-6624 or by email at cabernethy@aaylaw.com.