Nursing Homes

Written By: Michele Bayno BSW, BA

Sometimes, even with a lot of hired help and some home adaptations, it just becomes too expensive, and too dangerous to live at home. If this becomes the situation, it may be time to explore a change of living environment, such as an assisted living community or nursing home.

Often after being hospitalized for a medical issue, a senior will experience a significant decrease in autonomy and the doctor informs them that going back to their home is no longer safe for them and that they require a relocation. Now what?

There are several types of homes to consider, depending on how much assistance is required after leaving the hospital. The price of nursing homes and assisted living can range anywhere from 1,200$-7,000$ per month.

There are homes that only offer minimal assistance, such as meals and housekeeping services; others offer additional services such as medication supervision and laundry service. A full care nursing home will be necessary for the senior that has become totally dependent for all activities of daily living. These establishments offer 24-hour assistance.

The decision between nursing homes in the private and public sectors will depend on the senior’s financial situation. Some insurance policies cover some of these expenses, so contacting them while assessing the amount that is available for such placement is strongly recommended.

If paying for a private nursing home is not financially possible, the public sector will need to be explored. The expenses are based on your income levels and sliding scales. However, the waiting lists for the public sector can be very long, and the choice of facility rests with the government service. Seniors and/or their families can obtain assistance with this matter from a social worker that works in the hospital.

War Veterans may qualify for subsidized rates if they served overseas. The local Veterans Affairs office will have the necessary information for those who qualify.

Searching for a Nursing Home.

Please note these are general guidelines only. Different rules apply from state to state, and province to province.

• Make a list of nursing homes in your area.  Start by calling your local  community resource center, or search online. Depending on your financial situation, evaluate if you can afford a private nursing home (non-subsidized), or a nursing home that is government subsidized.  You may also want to call your insurance company and see if they cover a portion of Long Term Care expenses.
• Narrow down your search by calling each nursing home on your list and asking basic questions to get a feel for each facility. Find out what the staff per resident ratio is, whether there is a waiting list and if they have successfully passed state or provincial inspections. This will help you narrow down your list so that you can begin visiting.
• Schedule a first visit with the facility’s director so that you get information about and from the person who runs the nursing home. By arriving unannounced the first time, there may not be anyone available to answer all your questions adequately. Therefore, making an appointment will get you the most information. Ask the director if they are readily available to family members and how often they are in attendance. Places where the director is routinely inaccessible should probably be scratched off the list.
• If the director and the nursing home passes this first tour, then you can visit again, unannounced if you wish. This will let you see how the home runs when the staff is not prepared for a formal visit. I would be very hesitant if the facility does not have “an open door policy,” as this may be an indication that the center has issues to hide.
• When visiting:
  • Ask to see an activities calendar. What type of activities are available to the residents? Are they encouraged to participate?
  • Pay close attention to odors and cleanliness.
  • Is the staff to patient interaction respectful and professional.
  • Listen for “call bells” and observe the time it takes for the staff to respond to these calls for assistance.
  • Talk to some of the nursing assistants. They will be the ones providing the majority of personal care. Are they friendly, easy to talk to?
  • If it is at all possible, talk to the residents and their family members. This will give you a good idea of what life in this facility is like. Do the residents seem happy or despondent?
  • Visiting the facility at meal times is a great idea. Ask to see the kitchen. Is it clean? Does the food look appetizing? Many quality homes will offer you a meal so you can taste for yourself.

In the best possible scenario, you are looking for a place with a friendly, homelike atmosphere that provides quality nursing care.

A Note on the Feelings Associated with Nursing Home Placement

For many seniors, being placed in a nursing home represents a loss of independence and freedom. In my experience as a social worker, when I have asked seniors how they feel about such placement, they often tell me that ” it is the last stop before dying.” As this answer shows, it is not a path many want to travel, but they are left with no other choice.

People who have to leave their homes and families to move into a nursing home experience grief and loss. These feelings and emotions are normal and are to be expected. Many of these seniors and their loved-ones have little or no support during this very difficult time, so the feelings of loss and sadness can seem overwhelming to them. This is because few people ever return to a “normal” life after being admitted to a nursing home facility, and find themselves with nowhere to go for comfort, and quite often, with no one to listen to their grief story.

In entering a nursing home, seniors lose control over their daily activities, as these are now done according to a schedule or depending on the availability of staff. For example, eating meals at the time served by the institution, limited freedom to watch TV, and showering when staff is available. Losing independence in favour of dependence on the nursing home staff may lead to feeling that life is about to come to an end, and that their accomplishments were for nothing. Loss of self-esteem and self-worth is often seen with seniors in nursing homes.

As a friend, or family member, the most important thing you can do is to give compassion and show that you care as your elderly loved-one goes through one of the most difficult transitions of life.

Edited by: Stephanie Thurston