A Guide To Nursing Homes

Laurel McLaughlin

More often than not, the transition to a nursing home comes as a surprise and without warning. Understanding nursing homes and the care that they can provide can help you be prepared in the event of an emergency, or if a quick change is needed. 

Simply put, a nursing home is a residence that can provide physical assistance for an individual living with advanced chronic illness or another disability. Transitioning to a nursing home can be an emotional adjustment for both the person making the move as well as their family caregiver.

In this guide, we’ll explore the benefits of nursing homes so you can feel confident in making an informed decision for your loved one. 

What is a Nursing Home? 

A nursing home is one type of residential care for older adults; other types of senior living options include independent living, assisted living, and congregate housing. 

Nursing homes may also be referred to as skilled nursing facilities (SNFs) or long-term care facilities. They provide a “skilled nursing” level of care for older adults and people with disabilities. Skilled nursing care includes:

  • Activities of Daily Living (bathing, dressing, ambulating, and using the bathroom)

  • Medication Management including IV medications and injections

  • Vital sign monitoring

  • Wound care

  • Advanced transfers (such as those using Hoyer Lifts) 

  • Catheter & Ostomy Care

  • Rehabilitative Services including physical therapy and occupational therapy

  • Alzheimer’s & Dementia Care

In contrast, independent and assisted living facilities do not offer medical services such as the ones above, and only limited support with activities of daily living.

A person may move to a nursing home if they need assistance with any one or more of these care services. They may also move if there is a significant safety risk to living independently - specifically for someone living with dementia.

In some situations, an older adult may be able to have home health services, but there are often financial restraints limiting the plausibility of this.

Easing the Transition to a Nursing Home

It’s important to work with the staff at the nursing home to ensure a smooth transition for your loved one. 

Understand that your loved one may be apprehensive about the move. If this is the case, try to understand their greatest concern. The loss of independence? Fear of being left alone by loved ones? The reason can inform your response and direct the way you approach the transition. 

Some ways to ease the transition include: 

  • Make the process as easy as possible by moving anything that is going with them, making calls, and filling out paperwork.

  • Bring familiar items to make the room feel more home-like.

  • Talk to the staff about your loved one ahead of time about things your loved one enjoys, so they can quickly establish a relationship.

  • If your loved one has dementia, you might talk to the nursing home staff about using a “fiblet” to explain why they are at the nursing home (for example it is a temporary stay while repairs are done on the home).

  • Talk with your loved one about your concerns about them living at home, and engage other trusted loved ones or doctors in the conversation as needed, as well. 

How to Pay for a Nursing Home 

Senior care, in general, can be pricey, and a nursing home is no different. Luckily, nursing homes are one of the few care options that fall under Medicaid services, and sometimes even Medicare. 

Medicaid is a state insurance program for people living with disabilities and those with limited incomes.

For those who meet eligibility, Medicaid will pay for the cost of a nursing home. For those who may be on the cusp of financial eligibility, working with an elder law attorney can assist you in the application process. 

Medicare Part A covers short-term stays in long-term care facilities, typically for rehabilitation purposes. In most cases, Medicare will cover 100 days, if it follows at least a three-day hospitalization. 

Additional forms of payment include Veterans' Benefits, some private health insurance companies or long-term care insurance companies, and private pay. Working with an elder law attorney in advance is the best way to financially plan for nursing home care.

Who Regulates Nursing Homes?

The quality of care provided by nursing homes is regulated by the Centers for Medicare and Medicaid Services (CMS). 

Nursing homes have strict requirements regarding staffing, services provided, documentation and care of residents. CMS may visit a nursing home at any time to assess the status of the building and also keeps track of and investigates any complaints filed against the facility. When searching for a nursing home, use CMS’s Care Compare on medicare.gov to see how nursing homes in your area compare with one another. 

Each nursing home has a dedicated Ombudsman, a volunteer advocate for nursing home residents. If any issues should arise, the ombudsman will work with the resident to find a solution and ensure the resident is being treated properly.

What Role Can A Family Caregiver Play When Their Loved One Moves To A Nursing Home?

Caregivers often experience a variety of emotions after their loved one moves to a nursing home. Some common emotions include grief, guilt, sadness, and relief. Any and all emotions are normal during this process. 

Many caregivers go from providing significant hands-on care for their loved ones, to having a limited role in their loved one’s day-to-day life. 

However, a caregiver’s work is not done. No matter how great a nursing home is, the caregiver is the one who knows their loved one best. 

Caregivers can advocate for their loved one’s preferences as well as be emotionally supportive of their needs. They can ensure that their loved one has everything they need and organize visits from friends and family members. 

Having proper support such as a mental health care provider or support group is key for caregivers during this transition time.