Going to a nursing home is the last thing most people want to do. Studies have shown most people prefer to stay in their own homes, followed by going to live in the home of a relative. Sometimes, however, those choices are no longer practical options. Entering a nursing facility can be a positive experience, but that depends largely on the quality of the facility you choose.
What factors indicate a quality nursing home, and how can you find one? This question is hugely important to both frail elderly loved ones and their families and friends. It makes a difference in the health and happiness of their daily lives. There are several factors that influence quality in a nursing home, the first of which is the staffing.
Nursing homes are staffed with both professional nurses and caregivers, all day, every day. The professional nurses are responsible for medication administration and health assessment and coordination, among other duties. Caregivers, or Certified Nursing Assistants, provide most of the direct care to the residents. Two of the critical staffing issues are the staffing ratio of staff members to residents, and the turnover rate of the staff in the facility.
The staffing ratio means the average number of nursing hours each resident receives. An independent resident advocacy group recommends facility staffing at 4.04 nursing hours. Lower staffing levels result in a decrease in resident care. Many nursing homes staff at much lower levels. Staffing ratios of 3.2 of lower are not uncommon. At this level of staffing, one caregiver would be taking care of eight to twelve residents during her shift. Whether or not this level of staffing is adequate depends on the amount of care each of the assigned residents needs.
Related to staffing levels are the facility turnover rates. Turnover rates indicate how often nursing homes have to replace staff that quit. Many facilities have turnover rates that exceed 100%. The rate that care staff have to be replaced impacts resident care, as the residents must continually get used to different caregivers.
Cleanliness is another important quality to evaluate. This is different from the decor. Is the floor polished and the carpet free of stains? Are there unpleasant odors? The level of cleanliness indicates the pride the facility takes in itself and the respect it has for its residents.
The dietary department has a huge impact on quality of life for the residents. For many people, meals are the highlight of the day. The meals should be appetizing, nutritious, and built around resident preferences.
The activities department helps nursing home residents find stimulation, social interaction, and enjoyment. The activities should be diverse and planned for residents with varying functional ability. Special programs that bring the community into the nursing home and the residents into the community should happen frequently. Family and friends should be encouraged to visit, and visiting times shouldn't be limited.
How can you evaluate a particular nursing home to see if it meets these standards? The best, most objective resource in medicare.gov nursing home compare. This is where survey results are posted on the web. You can compare facilities side to side in such measures as overall quality, staffing, quality indicators, and more.
After narrowing down the choices, visit each nursing home you're considering several times. Visit at different times of the day and different days of the week, especially on weekends. Look at the latest survey report, which must be posted in an easily accessible location. The information on the website can be outdated, but the posted survey will be the most recent one conducted.
Notice how the staff interact with the residents, how many staff members are working, and the emotional atmosphere. Can you see your loved one living there? Culture change is the idea of care being centered around the resident and their preferences. Is the facility an adherent of a resident centered culture, or must the resident fit into the routine of the facility? Many nursing homes still function around a medical model of care. An awareness of the factors that contribute to a quality nursing home will help you make a decision you and your loved one can live with.
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