Nursing homes: When they’re right for you

We all hope that our bodies and minds will remain steadfast as time passes, but unfortunately, that’s not always the case. So, how should you approach decisions when you (or your loved one) can no longer live independently—whether because of a physical or cognitive disability or impairment? A Texas A&M Health Science Center public health expert provides an inside look at nursing homes and when a future resident should consider making a nursing home their permanent home.

Homes—not institutions

“In a nursing home setting, we call someone a resident rather than a patient,” said Darcy McMaughan, Ph.D., assistant professor at the Texas A&M School of Public Health and director of the Program on Disability Research and Community Based Care. “It’s important that we move away from the concept that nursing homes are a clinical place, when in reality, they are a setting where people live and receive the care they need.”

Nursing homes are places of residence for individuals who can no longer live autonomously and perform daily tasks because of limited cognitive or physical abilities. “Residents normally cannot function on their own and do things like get out of bed, dress themselves, cook food or go to the bathroom,” McMaughan said. “Nursing homes provide a place where someone can live and receive a more intensive level of care when they need it.”

When should you consider a nursing home?

The decision to become a nursing home resident is an extremely personal one, and it’s often not a decision for one person, alone, to make. It’s probably time to consider different options if you or a family member can no longer function independently.

“In most cases, you should begin to look at a nursing home if you or your loved one has reached a severe level of care need,” McMaughan said. “Most nursing homes won’t accept you unless you meet a specific level of care. Many people also decide to become a resident after an event like falling and going to the hospital with an injury. The hospital will then recommend a nursing home because the patient cannot safely care for themselves at home.”

Signs your loved one may need to make a nursing home their new residence includes assessing their activities of daily living. Can they cook meals, eat without assistance, dress themselves, bathe and use the restroom alone? If the answer to these questions is no, then a nursing home may be your best option.

Choosing wisely

First things first, when evaluating a potential nursing home, you must assess the care needs of the future resident. Are they experiencing cognitive decline like dementia or Alzheimer’s, or is their need based on the physical inability to move around?

“It’s important to match the care needs of the person to the kind the nursing home provides,” McMaughan said. “For example, some nursing homes specialize in caring for people with Alzheimer’s, while others are more generalized.”

Next, McMaughan recommended visiting Nursing Home Compare—a website maintained by Medicare.gov. You can search for a nursing home by zipcode and this site will rate all the nursing homes in your area by overall value, health inspections, staffing, quality measures and distance.

While Nursing Home Compare is an extremely useful tool, no Internet search is as powerful as visiting a potential nursing home in person. McMaughan explained it’s always important to visit different nursing homes, receive a full tour of the facilities and services offered and visit with residents to determine what quality of life would look like.

“In person visits are necessary and crucial to the evaluation process,” she said. “You are the most valuable asset to your loved one and it’s imperative to speak with the residents and the people who run and work in the nursing home.”

 Important to know, every nursing home facility is assigned an ombudsman who speaks and works on behalf of the residents. Their job is to visit nursing homes on a regular basis, get to know the residents and inspect the quality of care and life. “You should also get to know your local ombudsman,” McMaughan said. “The ombudsman and their volunteer team have specific training to advocate on a residents’ behalf. Even if there is conflict between a family member and a resident, the ombudsman is always looking out for the residents’ best interest.”

A new alternative in community based care

Because most people would prefer to live at home, long-term care is trending more toward the community-based care model. Similar to palliative care teams, community based care is more patient-centric—allowing residents to remain in their homes while professional care providers and home health aides assist with the activities of daily living.

“What people may not realize is the vast majority of these services can be provided at home with the right funding mechanisms,” McMaughan said. “Now, there is much more incentive at the federal level for people to live at home and receive care. As more funding becomes available, we are hopeful community care will become more economical and cost-effective.”