|
FAQs -- PLANNING
for Long-Term Care
What are the FOUR BASIC TYPES OF
SERVICES offered in long-term nursing care?
Four basic types of
services offered by nursing facilities are:
• Medical
Care
Residents in nursing
facilities are under the care of physicians, who visit regularly and
are responsible for the residents’ overall plan of care. Physicians
certify the need for nursing care and may serve as a resource for
information about long-term care facilities in the community. When
individuals enter the facility, physicians write orders for
necessary medication and play a role in the development of the
residents’ care plan, including restorative and rehabilitative
procedures, special diets, and treatments. Every nursing facility
has a physician on staff or on call to handle emergencies.
•
Nursing
and Rehabilitative Care
All nursing facilities
require the professional skills of a registered or licensed
practical nurse. Nursing services include assessment, treatments,
injections, coordination of care, and medication administration.
Rehabilitative services such as post-hospital stroke, heart, or
orthopedic care are available in addition to related services such
as respiratory therapy, physical therapy, occupational therapy, or
speech therapy. Dental services, dietary consultation, laboratory,
x-ray, and pharmaceutical services are also available.
•
Personal
Care
Personal care is
provided to residents who need help with various activities such as
walking, getting in and out of bed, bathing, dressing, and eating.
Certified nurse assistants provide many of these services.
•
Residential Care
Residential care
services include general supervision, provided within a safe and
secure environment, along with a variety of programs and activities
to meet the social and spiritual needs of residents.
What LEVEL OF CARE is needed?
Every situation and
every set of circumstances are different. There is no such thing as
the "typical situation." Everyone, every family, has a unique set of
circumstances that must be weighed. It is unwise to compare and
judge your family’s decisions based on what other people think.
If you believe a
long-term care setting may be needed, it is best to begin planning
in advance. Try to involve the prospective resident in the planning
process as much as you can. If the individual has questions
regarding care that you are not able to answer, be sure to ask the
prospective facility’s staff. Remember – experienced, professional
caregivers understand both the concerns of the resident and those of
the family and are eager to help make the transition as easy and
positive as possible.
When is the RIGHT TIME to consider a senior living
arrangement?
Again, it all depends on
the circumstances of the individual. Knowing how to recognize the
right time comes down to the kind of living arrangement that is
needed. Some seniors choose to stay at home. Others require some
type of specific care. Still others may require some type of
assisted living arrangement or nursing care. Whenever possible, it
is advisable to consider these senior living decisions well in
advance of the actual living change so that adequate preparation can
be done.
How do I FIND A FACILITY?
After you and your
physician discuss the type of services needed, obtain the names of
facilities in your area.
Other resources for
information about nursing facilities include:
-
Discharge planner (hospital)
-
Social workers
-
Geriatric case manager
-
Local medical society
-
State or local Office on Aging
-
State long term care ombudsman program or health
department
-
Minister, priest, rabbi, or other spiritual advisers
in your community
-
Friends or neighbors who have had direct experiences
with local nursing facilities
-
Individual
facilities' Internet sites
By telephoning the
facilities on your list, you will be able to narrow the field to two
or three offering the specific services and location you desire.
Talk with administrative personnel and make an appointment to tour
the facility.
Why should I VISIT THE PROSPECTIVE
FACILITY?
A personal visit to the
prospective facility can provide an abundance of valuable
information. Try to visit each facility at several different times
of the day; this will give you a better sense of the facility. Be
sure to ask questions about what you are seeing, hearing, or feeling
about the facility.
When you visit a nursing
facility, you will see a variety of staff specialists. The number
and specialties of staff members reflect the specific needs of the
facility's residents. Caregivers are available around the clock, and
licensed nurses with the help of certified nursing assistants
provide 24-hour care.
Resident social
activities and programs are provided in all nursing care facilities.
Ask what types of group activities are offered and how individual
residents' needs and preferences are identified. Residents should
have the opportunity to be involved in activities that provide
mental, physical, and social stimulation. Ask to see examples of
some of the activities provided.
Take some time to talk
with the residents. Ask them about their life in the facility. Also,
try to plan a visit to the facility during mealtimes so you can
observe food presentation and interaction in the dining room. Each
facility has a registered dietitian who can talk to you about
special dietary needs.
Other specialists who
may be on staff or available on a consultant basis include physical
therapists, speech pathologists, occupational therapists,
psychiatric personnel, social workers, pharmacists, podiatrists, and
dentists.
The overall management
of the facility is the responsibility of the administrator. Other
administrative personnel include medical records staff, human
resources director, admissions director, and financial staff.
Laundry, maintenance, and housekeeping personnel are also
on staff.
During your visit, talk
to the caregivers; many of these talented professionals are
registered or licensed practical nurses and certified nursing
assistants who have devoted their careers to caring for the elderly
and the disabled. People providing services to people is what long
term care is all about.
How are nursing care facilities REGULATED?
Your state's health
department inspects every facility annually. The survey results are
available at the facility, and you may review the report of the
facility's performance. A staff representative can answer your
questions and provide additional information about this complex
document.
The latest surveys are
also online at
www.medicare.gov. Under the
Search Tools section, click on "Compare Nursing Homes in Your
Area."
In addition, many
nursing facilities participate in voluntary Quality Assurance
programs. One example is the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) Long Term Care Program. This
accreditation program evaluates facilities' operations based on a
monitoring system to measure the facility's performance.
What are some ISSUES / QUESTIONS I need
to think about in making this nursing care decision?
The following questions
/ issues may guide you in evaluating nursing facilities throughout
your selection process. Remember, each resident - young, elderly,
ambulatory, bedridden, or disabled - has different needs,
preferences, and desires that should be taken into account in the
selection of a facility.
Location
Visitors are
important! Is the facility conveniently located for
frequent visits from family and friends?
Ambience / Atmosphere
Is the atmosphere
welcoming and attractive?
Staff
Observe staff
interactions with the residents. Do caregivers show
respect and a positive attitude toward residents and others?
Activities
Look over the
activity calendar for the week or month and ask about the
programs available. Are residents encouraged to
participate?
Religion
Rooms
-
Ask to visit a
typical room. Does the living space suit the needs of the
resident?
-
How are roommates selected?
-
How are private items stored or secured?
-
What is the policy for residents having a private telephone?
-
What is the policy for decorating rooms with personal items?
Dining
-
Observe mealtime
at the facility. How is the menu managed weekly and
monthly? Ask to have the dining procedures explained to
you.
-
What arrangements will be made if residents are unable to eat in
the dining room?
-
What is the practice for special dining or menu requests?
-
Are snacks provided?
-
Are private dining areas available when family and friends are
visiting?
Care
Planning
-
How are residents
and families encouraged to participate in developing their care
plan?
-
Does the facility provide services for terminally ill residents
and their families?
-
What special programs (Alzheimer's, AIDS, sub-acute care) does
the facility offer?
Medical
-
Are other medical
professionals (dentists, podiatrists, optometrists) available?
-
Does the facility have an arrangement with a nearby hospital?
-
Will a bed be available after hospitalization?
-
How are prescription drugs ordered?
-
Are therapy programs provided (physical, occupational, speech
pathologist)?
Costs
-
Are all the
services the resident requires covered in the basic charge?
-
Request a list of specific services not covered in the basic
rate. (Some facilities have schedules covering therapies,
beautician services, barbers, specialty foods, personal laundry,
transport costs, etc.)
Resident Rights/Autonomy
-
What are the
resident's rights and responsibilities?
-
When are restraining devices recommended and why?
-
Does the facility have a Resident Council?
-
Does the facility have Care Plan meetings in which you can
participate?
Licensure and Certification
-
If needed by the
resident, is the facility certified to provide Medicare and/or
Medicaid coverage?
-
Is the latest state survey report available for review?
-
Does the facility have a formal quality assurance program?
Your
Role
If you are helping to
select a long term care facility for a loved one, are you:
-
Involving this person in the process?
-
Prepared to ease the resident's transition to the nursing
facility by being with them on admission day and staying several
hours to get them settled?
-
Ready to visit the resident frequently and encourage friends to
make similar visits?
Contact us | View site map
| 