It is something no family expects or wants to do. It may be one of the most difficult decisions a child has to make, but there is always the possibility that a parent or other loved one will eventually need a skilled nursing home. Moving a parent from home to an assisted living facility may be difficult, but placing them in a nursing home may be far more traumatic. Jonathan Rauch, of Atlantic Magazine, in his article titled “Letting Go of My Father,”described the emotional journey he experienced placing his father in an assisted living facility.

Moving a parent to an assisted living facility, in some ways, may be less traumatic, but is still heart wrenching. Moving a parent to a nursing home, many times the next step in the care cycle, can be an even more difficult decision.

The decision may be forced on a family in a number of ways: the assisted living facility has called to say the person can no longer stay in assisted living; money is running out for care that had been given in the home; the family member who had been devoting time to the care decides he or she can no longer safely provide for the person. Far more likely is that the loved one has been in the hospital, and the hospital is suggesting that the person be discharged to a nursing home for long-term placement.

Plan Ahead and Research Tools

Often, decisions made in the middle of a crisis are not the best. If a family member is ill, or starting to decline, start looking at facilities before you actually need to make the placement decision.How do you choose? What nursing home is going to be the right fit for the person and family? The first step is to research. If geographic location is important so that a spouse or other family can visit regularly, check with friends who may have placed a family member in a nearby community.

Massachusetts Survey of Nursing Home Satisfaction

The Massachusetts Office of Health and Human Services publishes a report on Nursing Home Satisfaction. The surveys were done in 2005, 2007 and 2009. A family member of residents in every facility in Massachusetts were sent questionnaires, and asked to rate the nursing home from the consumer point of view. The questions covered a wide spectrum of facility services, including: the staff, physical environment, activities, personal care services, quality of the food, and residents’ personal rights. Each facility has an overall rating for satisfaction. This Summary of Individual Facility Results report is a wonderful resource and starting point for selecting a facility.

Medicare National Survey

Medicare also does a yearly review of nursing homes throughout the country. For this report, Medicare collects information on over 15,000 nursing homes and publishes the data.Unlike the Massachusetts survey, Medicare looks only three categories: Health Inspections, Staffing, and Quality Measures (e.g. how well the nursing home helps people keep their ability to dress and eat, or how well the nursing home prevents and treats skin ulcers).

Nursing homes are rated from one to five Stars, but only ten percent of nursing homes in each state may be rated Five Stars, so don’t eliminate a facility just because it may rated at Four Stars.

Visit the Facility

Visit the facilities. Then visit again. Nothing is better than a visit to the nursing home – except one or two more visits. Medicare has a Nursing Home Checklistthat you print out and bring with you on your visits.Although never an easy task, placing a parent in a facility in which you have confidence can ease the anxiety.

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