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Nursing Homes

Nursing homes are facility based care that provides various care services including personal care and medical services.

Nursing homes vary in terms of cost, appearance and services offered. Some nursing homes are state-funded and others are privately operated.

Increasingly, nursing homes are also providing skilled nursing care and therapy services for short term care following a hospitalization or injury.

Many nursing homes also have memory care facilities specifically to house individuals with Alzheimer’s and other Dementia. Although these units generally house the elderly, memory care facilities are open to individuals of all ages.

Short-term care is offered for patients who recently underwent surgery, are recovering from illness, injury, or who need rehabilitation services before they can return home.

Long-term nursing care is offered for those that live with chronic illnesses, terminal conditions or cognitive disorders such as dementia.

Nursing Home Services

Residents in nursing homes generally require around the clock care and monitoring.

All nursing homes provide assistance with activities of daily living (ADLs), also known as personal care, that some residents are often able to perform without assistance.

Nursing homes are staffed with certified nursing aids and medical care providers to accommodate the needs of its residents.

Nearly all nursing homes provide dental and mental health services, either on-site or off-site.

Nursing homes and skilled nursing centers are not the same. Nursing homes generally provide more basic personal care services, while skilled nursing homes offer more extensive rehabilitation and specialized medical services.

Many nursing homes offer additional services such as restorative care, dementia care, pain management, and palliative care.

Other general services include:

Medication Management: Medication errors are a leading cause that seniors end up in the emergency room. Managing medications can be difficult, especially for seniors who may take many different medications each day at different times.

Life Enrichment: Isolation and loneliness put older adults at greater risk for health problems, such as depression, diabetes and high blood pressure. Nursing homes offer a variety of life enrichment activities designed to meet residents’ physical, emotional and spiritual needs.

Secure Environment: Nursing homes are designed to house elders with handrails, grab bars, emergency call systems, etc.

Well-Balanced Meals: Nursing home residents have three well-balanced meals and nutritious snacks each day.

Many nursing home offer more specialized services including:

24-Hour Medical Care: Many nursing homes provide 24-hour supervision and care to residents.

Physical Therapy: Physical therapy for residents who broke bones, underwent surgery or are recovering from another physical ailment.

Respiratory Therapy: Respiratory therapy for residents with pneumonia, asthma, lung trauma, emphysema, and other lung diagnoses.

Speech Therapy: Speech therapists in skilled nursing homes may concentrate on literacy, articulation, and stuttering. However, speech therapists can shift their focus to swallowing and memory problems if the resident requires those specialized services.

Rehabilitation: Rehabilitation services for residents who need short-term recovery services until they can care for themselves and return home.

Dietitians: Dietitians to create personalized meal plans aimed to minimize nutritional complications in each resident.

Dental Services: Per federal law, residents in all nursing homes should have access to emergency and standard dental care.

Laboratory Services: Some nursing homes have in-house lab services to conduct blood and other tests.

Nursing Home Costs

Nursing homes in Greater Boston average about $10,380 a month and range between $7,050 and $13,200 per month.

Annually, the costs are $84,600 to $158,400 with the mean cost of around $126,290 for Greater Boston, which is higher than the national mean average of $77,380 a year.

Nursing Homes Versus Skilled Nursing Care Center

In a skilled nursing care center, around-the-clock care is provided by licensed and trained nursing professionals. Residents generally have high care needs and more complex medical conditions.

Licensed nurses are onsite 24 hours and a doctor is on call at all times.

Skilled nursing care centers offer services ranging from short-term care for a rehabilitative stay to long-term extended stays.

Rehabilitative services, treatments assisting patients in regaining recently lost abilities, are offered onsite to help individuals recovering from disease, illness, injury or surgery.

The definition of a nursing home versus a skilled nursing care center can get blurred as nursing homes add more specialized medical services.

Nursing Home Versus In-Home Care

An AARP study found that 3 out of 4 people surveyed wish to stay at home and Age In Place versus be moved into another senior care option.

With in-home care, there are no shared rooms with roommates or the divided attention of nursing home staff dealing with the greatest crisis at the moment.

The in-home caregiver focus on only the care needs of one person, your loved one.

By remaining at home there is none of the confusion, stress, and anxiety your loved one feels from relocation to a new setting in a nursing home.

Live-in home care costs are comparable to the cost of nursing homes at around $384 a day for the care needs of one person or $504 per day for two people to receive care.

24 Hour in-home care is about $576 a day for the care needs of one person or $624 a day for two people to receive care.

In-home care is also flexible and hours of care and services can be add or reduced as needed.

This flexibility also reduces costs as you only pay for the care and services needed.

With in-home care your loved one also has less exposure to inflection:

The Centers for Disease Control (CDC), states that over 4 million Americans are admitted to or reside in nursing homes and skilled nursing facilities each year and nearly 1 million persons reside in assisted living facilities. Data on infections in long-term care facilities (LTCFs) is limited, but it is estimated that 1 to 3 million serious infections occur every year in these facilities.

These infections include urinary tract infection, diarrheal diseases, antibiotic-resistant staph infections and many others.

Infections are a major cause of hospitalization and death with as many as 380,000 people die of these infections in LTCFs every year.

Nursing Home Versus Assisted Living

Assisted living communities do not provide 24-hour supervision, medical care, or the more extensive specialized medical care that nursing homes with skilled nurse center services do.

They provide assistance with the activities of daily living (ADLs) such as bathing, grooming, etc.

Similar to nursing homes, assisted living communities offer planned activities, laundry and housekeeping services, meals, transportation, exercise, and wellness programs.

Nursing homes and assisted living communities differ in their appearance. While nursing homes generally look institutional and hospital like because of the type of care provided, an assisted living usually resembles an upscale apartment community.

Assisted living communities provide their services in the patients their living unit.

Nursing Home Versus Residential Care

Residential care homes cater to individuals who live in a residential setting rather than in their own home.

They usually offer more personalized services than assisted living communities.

Similar to assisted living communities, residential care homes focus more on helping residents with activities of daily living (ADLs) such as bathing, grooming, etc. than medical care or rehabilitation services.

Choosing A Nursing Home

The good place to start is asking your doctor for recommendations.

Checked the nursing home’s star ratings on Medicare.gov.

Once you have a list of nursing homes of interest, consider what is most important to you or your loved one:

– Physical Therapy

– Nursing Care

– Meals

– Religious Connection

– Special Care Units for Dementia Patients

– Hospice Care

Identifying your most important needs will help you narrow down your list.

Call each nursing home and asks questions about the number of residents, cost, waitlists, etc.

Plan a visit to each facility and to meet with the director and nursing director.

Look for indicators of quality of care such as handicap access, Medicare and Medicaid certification, warm interaction between staff and residents, and residents who look well-cared for.

Questions To Ask During Your Nursing Home Visit

General Questions:

– Is the nursing home Medicare and Medicaid certified?

– Has your license ever been revoked?

– Is the nursing home currently accepting new patients and is a bed available?

– What is the patient to staff ratio?

– Does the nursing home offer skilled nursing and specialized services, such as a special care unit for a resident with dementia or ventilator care?

– Are there resident policies you must follow and will you get a written copy of these policies?

– Is transportation services available?

– Are there extra charges for other services such as beauty shop services?

– Will you get in writing their services, charges, and fees before the move in?

– Is the nursing home located close enough for friends and family to visit?

– Are there quiet areas where residents can visit with friends and family?

– Is there a person on staff assigned to meet social service needs and can you meet them?

Safety Questions and Observations:

– What safety and security measures does the facility use?

– Does the nursing home do background checks to make sure they don’t hire staff members with a finding or history of abuse, neglect or mistreatment of residents in the state nurse aid registry?

– Does the nursing home have policies and procedures on prohibiting and reporting abuse and neglect?

– Is the nursing home taking action to keep residents safe from abuse, neglect, mistreatment, or exploitation?

– Does the staff knock before entering rooms?

– Are the doors shut while staff members help with dressing and bathing residents?

– Is there information about how to report concerns about the care and safety of residents?

– Is there information about how the facility responds to concerns that are reported?

– Has the nursing home been cited for issues related to abuse in the last year or two?

– Is there a backup generator or alternate source of power in the event of a blackout?

– Is the place well-lit and are the exits clearly marked?

– Does the nursing home have smoke detectors and sprinklers?

– Are there handrails and grab bars in the bathrooms and hallways?

– Are all common areas, resident rooms, and doorways designed for wheelchairs?

– Does the floor plan make sense?

– Can residents still see their personal doctors? If needed, does the facility help arrange
transportation for this purpose?

– Does the nursing home have an arrangement with a nearby hospital?

– Does the nursing home’s inspection report show quality of care problems or other citations? The nursing home should have the report of the most recent state or federal survey of the facility available for you to look at. These reports tell you how well the nursing home meets federal health and safety regulations. Reports can also be found on most state survey agency websites and Medicare.gov.

– Has the nursing home corrected all citations on its last state inspection report?

Quality of Care Questions and Observations:

– Does the nursing home have an arrangement with a nearby hospital?

– Are care plan meetings held with residents and family members at times that are convenient
and flexible whenever possible?

– Is the nursing home free from overwhelming unpleasant odors?

– Does the nursing home appear clean and well kept?

– Is the temperature in the nursing home comfortable for residents?

– Does the nursing home have good lighting?

– Are the noise levels in the dining room and other common areas comfortable?

– Is the furniture sturdy, yet comfortable and attractive?

– Do the residents look clean, well-groomed, and appropriately dressed for the season or
time of day? Are their nails cut and the men shaved?

– Does the relationship between staff and residents appear to be warm, polite, and respectful?

– Does the staff refer to residents by name?

– Do residents seem to participate in the activities?

– Do the residents get the same daily caregivers?

Quality of Life Observations:

– Do residents have a choice of food items at each meal? Do they serve foods you like?

– Can the nursing home provide for special dietary needs such as low-salt or no-sugar-added diets?

– Are nutritious snacks available?

– Does the staff help residents eat and drink at mealtimes if needed?

– Does the facility meet your cultural, religious and language needs?

– Does the nursing home have outdoor areas for resident use?

– Is staff available to help residents go outside?

– Do residents have daily routine choices?

– Can residents, including those who are unable to leave their rooms, choose to take part in a
variety of activities?

– Do residents help plan or choose the activities that are available?

– Are personal items allowed?

– Does each resident have storage space such as closet and drawers in their room?

– Are there policies and procedures to protect residents’ possessions, including lockable cabinets and closets?

– Is there a window in the bedroom?

– Do residents have access to the internet, a computer, a personal phone, and television?

– Do residents have a choice of roommates?

– Does the staff look nice and happy? Do they smile or look miserable like they do not want to be there?

Attend a Resident or Family Group Meeting

While visiting a nursing home ask if you can attend a resident or family group meeting.

These groups are usually organized and managed by the residents or their families to address concerns and improve the quality of care and life for the residents.

If you are able to attend a meeting, ask a group member these questions:

– What improvements were made to the quality of life for residents in the past year?

– What are the plans for future improvements?

– How has the nursing home responded to recommendations for improvements?

– Who does the group report to?

– How does membership in the group work?

– Who sets the agendas for group meetings?

– How are group decisions made, for example, by voting, consensus, or does one person make them?

Visit a second time

It is good to visit the nursing home a second time on a different day of the week and at a different time
than your first visit. As staffing can be different at other times of the day and on weekends.

About Unique HomeCare Services

Unique HomeCare Services provides care for seniors and people who are recuperating from illness, injury, or surgery.

We offer a full range of personal and in-home care services such as personal care, grooming and incontinence care, bathing and dressing, post-hospitalization care, Alzheimer’s and Dementia care, and medication management.

We also provide non-medical support services such as meal planning and preparation, light housekeeping, caring companionship, shopping/errands, accompanying to medical and other appointments, as well as case management services.

UHS can also assist you with VA Aid and Attendance Benefit approval.

Our service area is Boston, Norwood, Dedham, Westwood, Walpole, Canton, Sharon, Stoughton, Avon, Braintree, Easton, Milton, Quincy, Weymouth, and surrounding towns.

To schedule a no cost and no obligation full In-Home Assessment to determine the home care needs of you or your loved one please call us at (800) 296-9962 to speak to a Case Manager or fill out our Free Quote Contact Form.

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