Deciding whether or not your loved one needs to move to a nursing home can feel overwhelming. And if you're their caretaker, it might feel like there's not enough time in the day to do your own research. In this guide, we'll cover nursing home basics, including services offered, levels of care available, signs it's time for a nursing home, and how to find nursing homes near you.
Nursing homes are residential care facilities for seniors or people with disabilities who don't need a hospital but need more help than they can get at home. That help might include medicine dispensing, certain types of medical care, assistance with activities of daily living (ADLs), meal service, and laundry. If you're familiar with other types of senior care, it might help to think of a nursing home as a step above assisted living.
For more details on nursing homes and what they entail, watch the video below from our Editor in Chief, Jeff Hoyt.
The feel of a nursing home varies from place to place. Some nursing homes feel more like a hospital with a nurse's station on each floor.1 Others feature more personal touches that make them feel like a home or mini neighborhood. Traditional nursing homes are distinct from assisted living centers, which are meant for people with more independence. Nursing home residents typically are recovering from illness or injury, or need help managing chronic health issues such as cardiovascular disease, diabetes or dementia. Many of the homes are equipped with oxygen tanks, dialysis machines and other medical equipment that isn’t normally found at assisted living centers.
Regardless of the style and feel, a nursing home cares for all of a senior's needs—medical, food, fitness, and social. Exact offerings vary, but here are some commonly provided services.
All nursing homes offer 24/7 supervision, personal care assistance, and on-site medical care, but some nursing home types provide additional levels of care.
It's common to hear the terms “nursing home” and “skilled nursing facilities” used interchangeably. They aren't quite the same, though. A skilled nursing facility is a nursing home that provides a higher level of medical care and assistance. For example, skilled nursing facility residents might be bed-bound or need dialysis, whereas a nursing home resident just needs medications dispensed.
At a skilled nursing facility, you can expect:
Memory care facilities specialize in monitoring and caring for individuals with Alzheimer's or another type of dementia. Some nursing homes have memory care or Alzheimer's units. They are designed to meet the needs of individuals at any stage of dementia.
At a memory care facility or in a memory care unit within a nursing home, you can expect:
Nursing homes don't often have age restrictions. Anyone who needs supervision, help with daily activities of living, and medical care can stay at a nursing home. That being said, it's more common for older adults to live in a nursing home. Nearly all nursing home residents are ages 65 and up, with almost half being 85 or older.2
Nursing home stays vary significantly, depending on your needs and reason for becoming a resident. For example, a quarter of all nursing home residents only stay for three months or less. These short-stay residents are usually individuals who need hospice care or rehabilitation following a surgery or hospital stay.
Other residents stay longer. About 50 percent of nursing home residents remain for at least one year, and 21 percent stay for about five years. Seniors who need to stay longer might face a long recovery or simply need ongoing supervision and support.
You love your aging senior, but sometimes at-home care isn't enough. When your loved one needs more care than you can provide, it may be time for a nursing home. Caregivers and adult children should carefully evaluate their loved one's health, happiness, and safety as they make decisions about care.
Before you do a lot of leg work, ask around for recommendations.
After you’ve asked around and have some homes that sound promising, go for a visit. Before choosing a nursing home for a loved one, visiting more than once is recommended. For example, one day you could observe afternoon activities. Another day you could visit for dinner and see how the community winds down for the night. Sharing a meal with residents and staff can be an especially valuable way to get insights about the facility. While touring a nursing home, you’ll note generalities such as the cleanliness of the rooms and hallways and how kindly or not-so-kindly people interact with one another. You might also find that one facility is more fitting than another in ways that matter to your loved one — for example, it might have gardens, a therapy dog, or bilingual caregivers. Below are several questions to consider as you tour the facility.
To be a certified Medicare/Medicaid provider, a nursing home must meet 150 requirements ranging from safe storage of food to protecting residents from physical and mental abuse. The State Survey Agency performs an inspection to rate the nursing home on these requirements. Ask to see a copy of this inspection report.
Federal law states there must be enough staff to care for the residents. What is enough? There must be at least one RN for at least eight straight hours, seven days a week. And there must be either an RN or LPN (Licensed Practical Nurse) on duty 24 hours a day.
Here are specific questions to ask directors at nursing homes and similar facilities:
We'll just cut to the chase. Nursing homes are expensive. The exact cost depends on a few factors like room type or location. In the U.S., a semi-private room costs an average of $7,441 per month, while a private room costs an average of $8,365 per month, according to a Genworth Cost of Care There are several ways to pay for nursing home costs, including long-term care insurance, Medicare or Medicaid, and VA benefits. Give our nursing home costs guide a read to see average costs in your state and ways to pay for nursing home care.
When you start looking for nearby nursing homes, you might come across facilities called care homes. It can be confusing to know what each term refers to, especially when they sound so similar.
Care homes differ from nursing homes in a few key ways. They’re usually small facilities with up to 20 residents, and care home staff only assist residents with personal care and meals. You won't usually find medical assistants, nurses, or medical care on-site. So, when you see “care home,” think personal care.
A care home is best for seniors who:
Nursing homes focus more on providing medical care and services, which is why individuals who live in a nursing home usually need temporary or ongoing medical care and supervision. Residents might also receive needed rehabilitation services on-site like speech therapy or occupational therapy. Like at a care home, nursing home residents get help with personal care and three meals per day.
A nursing home is best for seniors who:
As you continue learning about nursing homes and making decisions about your loved one's care, it's helpful to research local facilities. Then you can ask specific questions, learn more about the cost, and find out if it's a good fit for your family member.
Find nursing homes near you by talking to your loved one's doctor or calling your insurance company or the VA. You can also check out our nursing home directory to see a list of nearby facilities.
Scott founded Select Home Care Portland in 2009 and has been helping seniors live their best life at home or in their local senior community ever since. As an advocate for seniors, the primary philosophy has been to listen, educate and provide… Learn More About Scott Witt
Since graduating from Harvard with an honors degree in Statistics, Jeff has been creating content in print, online, and on television. Much of his work has been dedicated to informing seniors on how to live better lives. As Editor-in-Chief of the personal… Learn More About Jeff Hoyt
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