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It is our hope to provide you with a starting point for your search for information on the process and steps that you will need to take during these important times in your or your loved ones lives.

Madrid Home Communities offers you a wide range of information. Including step by step information on "How to Start" the journey that's ahead of you.

When should I or a loved one consider a nursing home?

Whether you and your family are facing a quick decision about a nursing home due to a recent event, or have been coping with a worsening progressive disease such as Alzheimer’s or Parkinson’s, considering a nursing home is not an easy decision. Emotions such as guilt, sadness, frustration, and anger are normal. Working through the possibilities of housing, finances, and medical needs can help you and your family make an informed decision.

Here are some questions to ask when considering a nursing home:

  • Has the senior been assessed recently? If a nursing home is being considered as the next step from a hospitalization, this probably has already been done. However, if a senior is considering a move from home or another facility, a more formal assessment by a medical team can help clarify the senior’s needs and see if other housing options may be a possibility.
  • Can the senior’s needs be met safely in other housing situations? The risk of falls may be too great, or the senior’s medical needs may no longer be able to be met at home or in another facility. If the senior needs 24-hour supervision, or is in danger of wandering off or forgetting about a hot stove, for example, a skilled nursing facility may be the best option. If the senior’s needs are solely custodial, though, an assisted living facility may be a better fit.
  • Can the primary caregiver meet the senior’s needs? Caregivers are often juggling the needs of work, other family, and their own health. It’s not possible for one person to be awake and responsive 24 hours a day. Sometimes other family members can help fill in the gap. Day programs, home care services, and respite care, where a senior temporarily stays in a nursing home, may also provide the support a caregiver needs. However, there may come a point where medical needs become too great and home care services are unable to bridge the gap or become too expensive.
  • Would the need for a nursing home be temporary or permanent? Sometimes, a temporary situation may be covered through home care, or family members might be able to rotate care on a short-term basis. However, if the level of care is expected to be permanent, this may be too expensive or coverage might not be enough.

Finding a nursing home

Finding the right nursing home is not easy, and you may be under pressure to move fast due to a recent hospitalization or deterioration in a health condition. The more information you have, the greater your chances of finding the right fit for you or a loved one. Here are some tips on narrowing down your options:

  • Start with referrals. Does your family physician or specialist have any recommendations? Or do you know any friends who have used different homes? Knowing someone with first-hand experience of a nursing home can help you narrow your choices. However, remember your needs may differ: one size does not fit all.
  • Educate yourself. Online resources for nursing homes include ranking sites that utilize existing state data to rate nursing homes. In the U.S., every state has what is called a long term care ombudsman, which can be a valuable resource about the current condition of a nursing home. Advocacy groups can also provide hints on searching for the right facility. See the Resources section below for more information.
  • Consider your medical needs. Different nursing homes may have more expertise in different areas. Are they experienced in handling your condition, such as for Alzheimer’s or a stroke? Or are you looking for more short-term rehabilitation?
  • Factor in distance. In general, the more convenient the home, the easier it is for family and friends to visit.

Planning a visit to a nursing home

Once you've narrowed down your list of homes, it's time to plan a visit. Visiting is key to understanding if a home is right for you. As with other senior housing options, it's the people that make the place, both the residents and staff. In a nursing home, you'll also need to make sure that the medical care is delivered appropriately and promptly.

What to look for in staff at a nursing home:

  • How is the staff turnover? What is the staffing level on weekdays, weekends, and evenings?
  • Do they have time to speak with you or does it feel rushed?
  • How would they manage your health condition? How are medications and procedures arranged?
  • And how do they handle emergencies or accidents such as falls?
  • Do they appear genuinely interested in you, and do you see them interacting warmly with current residents?

What to look for in current residents and their families:

  • Do the residents appear happy, engaged? Or excessively groggy and overmedicated? Do they seem clean and well groomed? Do they seem like people you’d enjoy getting to know? How do they respond to you? Try to observe social gatherings such as meals or other activities. If needed, are residents getting timely help to eat, and with getting to and from the gathering areas?
  • If you see a family visiting, you can ask them about their impressions of the home and how their loved one has been treated. Ask if there is a family council and if you could attend.

What to look for in the nursing home facility:

  • Cleanliness. Does the facility appear clean? Do you smell urine or strong deodorizers that may be covering up the smell of urine?
  • Food. What kinds of meals are normally served? Does it look nutritious and appetizing? How are special diets handled? What kind of help is available with meals, and do they have to be eaten at the same time or in a common area?
  • Arrangement. Traditionally, nursing homes have been run like a medical facility, including a centralized nursing station and set medication and mealtimes. Some nursing homes are now moving to a different model, with smaller communities and communal areas. If this type is available in your area, it may provide a more homely feel.
  • Activities. What quality of life activities are available for residents? Are outside activities also arranged, health permitting?
  • Experience with your condition. If a loved one has Alzheimer’s, for example, is there a special care unit or specialized staff and activities? How does staff handle behavioral problems like agitation or wandering?

Understanding Nursing Home/Skilled Nursing Facility Costs

In the U.S. nursing home costs are a big part of nursing home care and can vary widely depending on the state you live in. Average costs are around $70,000 per year so you need to know how you’re going to pay for nursing home care. It’s important to understand the limitations of insurance in covering costs:

  • Medicare only covers limited stays in nursing homes. Skilled nursing or rehabilitation services are covered for a period of about 100 days after a hospitalization. Medicare does not cover custodial care (such as assistance with feeding, bathing, and dressing) if that is the only care needed.
  • If your income and assets are limited, you may qualify for Medicaid, which does cover most of the costs of nursing home care. However, not all nursing homes accept Medicaid. If you suspect that you may need extended nursing home care in the future, you may want to contact an elder law attorney to learn more about which assets are protected and to what extent. For example, if you have a spouse living at home, your home is normally not considered in eligibility for Medicaid for nursing home purposes, and some of your savings may be partially protected as well.
  • If you have long term care insurance, check the provisions of your plan to see what portion of nursing home coverage is protected.

The Resources section below provides more information on managing and planning for nursing home costs.

Handling the emotions of moving to a nursing home

Moving is a stressful transition, even at the best of times, and moving to a nursing home brings with it a whole host of different emotions.

If you are the one moving, you are leaving behind a familiar place and memories. If the nursing home move was due to a hospitalization, the transition may have been abrupt and you may not have had time to even process what has happened. Add to that increased medical needs and decreased mobility, and it’s no wonder moving to a nursing home can be so stressful. You may even feel angry and abandoned by family members, even if you realize that they can’t provide the level of care you need. Anger and grief are perfectly normal emotions.

If a loved one is moving, you may feel guilty for being unable to provide care, or sad that your loved one has to go through this transition. You may feel relief that your loved one is getting the care they need, tempered with guilt if caregiving has been particularly intense. Family members may have been arguing about whether a nursing home is necessary, where it should be located, and who should be the point of contact.

Easing the transition

Everyone needs time. Both the older adult and his or her loved ones need time to adjust to this transition and come to terms with their own their feelings. Trying to sweep anger and grief under the rug or refusing to acknowledge the difficulties of the transition will only intensify these feelings.

The older adult takes the lead. As much as possible, the older adult should be the one making the decisions about which nursing home is best. Whenever possible he or she should come along on visits when making a nursing home decision, and make the choices about what to take along and how to personalize the room. If the older adult is unable, loved ones should try to think about what his or her wishes might have been. A familiar blanket or favorite music, for example, may provide comfort even if the older adult is unable to verbalize it.

Tips for loved ones

Keep in regular contact. Even if you live far away, frequent calls, letters, and emails make a big difference. Regular visits by family and friends help ease the transition. Keep your loved one in the loop about family events as much as possible.

Stay involved. Regular contact not only reassures your loved one, but allows you to serve as an advocate for your loved one’s needs. Even if you’ve chosen the finest facility, you want to make sure your loved one’s care continues to be of the highest standard, so visit at irregular hours to make spot checks, and get to know the staff. The more engaged they feel you are, the more attentive they are likely to be towards your loved one. If the nursing home has a family council, a group of relatives and friends who meet on a regular basis to discuss concerns and issues, consider joining.

This information came from - HELPGUIDE.ORG

Madrid Home Communities provides guest speakers on different topics for the elderly.
Here Dr. Chuck Jons of Ames gave a talk on understanding the latest Healthcare Act and how it impacts Seniors. Residents and community members attended.

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