Nursing Home - How to Choose the Right One

When a loved one gets infirm or older, sometimes the only alternative is to find them a nursing home to live out the rest of their days in relative comfort. Licensed nursing homes provide skilled care primarily to the elderly, and - hopefully - give peace of mind not only to the people living in them, but also to their relatives and friends.

These days, however, nursing home facilities provide homes not only for people who will live there for the rest of their lives, but also short- term accommodation for those recovering from an operation or hospital stay, especially Medicare patients.

If you are looking for a suitable nursing home for an aging parent or elderly aunt, the choice may be daunting - especially if you have never traveled down this road before. Here are a few tips to help you decide which nursing home is the best for you:

Start early. You never know when Auntie Hilda will suddenly take a turn for the worse, or when she suddenly gets fed up with living on her own. She might want help with daily living, or she may simply crave company. You don't want to force her to move into a place that doesn't meet her requirements. Give yourself - and her - time to nose around.

Shop around. Don't settle for the first available facility. It's best to look around and see what is on offer. Many nursing homes have guided tours in which both you and Auntie Hilda can participate. She might also want to spend an afternoon playing mahjong or canasta with the other seniors to see if she likes the feel of the place.

Check - and compare - the quality of the home. Even if Auntie Hilda loves the place, it's important to see how it adds up in comparison to other homes in the area. It's also a good idea to talk to residents and their families to see what they think of the services provided. Don't just rely on the official tour, as it can be misleading.

Have a set budget. Nursing homes vary considerably, and while you might have a top-of-the-line wish list, it's important to know what you can reasonably afford. This means not only looking at available cash and savings, but also seeing what will be covered by your insurance, Medicaid etc. If Aunt Hilda is unable to take care of herself, of course the costs will be greater.

Know Auntie Hilda's medical needs. Speak to her primary care physician to ascertain what is important for her continuing care, and if the nursing home in questions meets her needs. It's no use finding a facility that looks fantastic and has lots of activities, but doesn't provide sufficient medical care for someone like Aunt Hilda.

Prioritize what's important. The quality of care is most important, but other factors play a role as well. Does Auntie Hilda love to play bridge, does she want to be near her old neighborhood, does she like all her meals prepared in a certain way? If you are her only relative, she might want a place that is close to you and your family - or maybe somewhere that is miles away!

Other Options for More Independent Seniors

If a nursing home isn't the right choice for you, there are other options available to seniors who cannot - or do not - want to live entirely on their own, but who don't need the amount of care a nursing facility would provide. The four main ones, in alphabetical order, include:

Assisted Living. The best ones advertize themselves as a "home away from home", as residents have their own private living quarters as well as their own kitchens, bathrooms and sometimes even their own front doors. Residents are monitored regularly to make sure they are okay, and to provide assistance in

Activities of Daily Living (ADL) when needed.

Congregate Care. The best of both worlds. Seniors live in independent private living quarters but they have shared dining facilities and communal areas, along with a host of recreational activities which they can partake in or not, as they wish. Often some type of transport is also available, assisting with trips to supermarkets and the dentist or doctor.

Continuing Care Retirement Communities (CCRC). Housing, health services and skilled nursing are all provided, although the type of unit and level of care will vary with each individual. Seniors sign a contract which will allow them to stay in one place as they grow older and in need of more and more help.

Intermediate Care. This is for elderly people who need some assistance with their day-to-day functioning, but don't require specific nursing help. They might need help dressing, shopping or bathing themselves, but don't need the specific nursing care you would find in a skilled nursing facility hospital.

Care Outside the Home

Keep in mind that a nursing home may not be the right choice for Auntie Hilda at this time. If she chooses to live outside a nursing home, the community may be able to provide her with some of the services she would normally find in a nursing home environment. Examples include:

Meals on Wheels. Several organizations provide meals to seniors, the most well-known of which is Meals on Wheels. They bring hot, well-prepared meals directly to the door.

Community help with basic needs such as shopping and transport. Sometimes they're called Neighbor helping Neighbor programs, other times they're Adopt-a-Grandparent or care for the elderly.

Elderly visitor programs. Not having regular company is stressful and sad, making people feel isolated and alone. These programs match up individuals with volunteers who visit on a regular basis for a chat and perhaps a cup of tea or game of cards.

Senior community groups. Senior clubs and groups cater to a wide variety of interests and needs, from art, dancing or bridge to mountaineering and politics.

Adult day care. These are for people who are not ready for full-time care, or who have caregivers who need time off to work or rest. Seniors are assessed according to their needs and an active program and treatment plan is tailor-made expressly for them.

Legal assistance with everything from drawing up documents to paying the bills. Many volunteer organizations help seniors with simple things like paying their water bill on time to more complex issues such as selling a property.

Finding the right facility for a loved one is not an insurmountable task, but unless you're incredibly lucky, it's also not one that is accomplished overnight. Take your time and investigate as many possibilities until you find the best place you can. In the long run, taking the time to find the right home that provides the right care will make everyone sleep better at night - and feel a lot happier.