Is Skilled Nursing Care needed?

This past year has had skilled nursing care (aka nursing homes) in the wrong spotlight. With the number of deaths and the fear of the future of health and safety, many people have turned away from moving a loved one into a skilled nursing community. I am here to tell you that the pandemic has been an eye opening experience for all in the skilled nursing industry- a lesson learned for all.

So, how do we know when someone we love, or are assisting with, needs skilled nursing? What do you look for when researching and visiting different nursing care communities? Many questions, thoughts, and fears come up quickly, and I hope to ease the anxiety that comes with this decision.

When is it time to move into skilled nursing?

There are so many different reasons why someone may need 24-hour care in a skilled nursing community.

• Needing assistance with most activities of daily living (ADLs)- dressing, bathing, toileting, dental hygiene, and eating
• Medicine assistance and/or distribution
• Requires a two person assist transfer in and out of bed, or wheelchair
• Lives alone and is a fall risk (Home Health may be able to assist with this at home for a short term)
• Advanced Dementia that hinders them from making safe decisions (i.e. remembering to turn off the oven when finished baking, locking the doors at night, wandering their neighborhood and does not know why, etc.)
• Has special medical equipment that needs daily upkeep (colostomy bag, catheter, feeding tube, etc.)

What to look for in a nursing care community.

There are many factors that all should be on the lookout for when researching and visiting skilled nursing. Here are somethings to look for and questions to ask.

• Is this a For-Profit or Non-Profit community?
• How much is the monthly fee and what does it include?
• Do you take Long Term Care Insurance?
• The number of total resident rooms and the ratio of certified nursing assistants (CNAs) to resident.
  • This can be tricky because the workload per CNA is determined by the amount of care each resident needs. The CNA might have six residents under their care, but they might all be able to walk and need assistance with most ADLs. Whereas, another CNA might just have four residents to care for because two of them are wheelchair bound and need extensive assistance with ADLs. So, please keep that in mind when they tell you the staff/resident ratio.
  • What is the ratio during the day versus at night?
• When was the last health inspection done? How did the community do?
• Do you have a disaster plan? (For fires, hurricanes, tornadoes, flooding, pandemics, earthquakes, etc.)
• What is your emergency plan (regarding cardiac arrest, trauma, stroke, etc.)?
• Are the rooms furnished?
  • Are we allowed to bring items to personalize their room?
• Who is my point of contact to keep up with my loved ones health and needs?

What services are offered?

The purpose of moving into a nursing community is not only to receive medical care, but all of the amenities and services you depend on for a happy, good quality of life.

• Is there a Medical Director on staff?
  • How often do they see each resident?
  • Do you have to request to be seen?
• Is there a separate Director of Nursing? Are they also the Executive Director?
• Dining- dietician on staff?
  • Can meals be delivered to rooms?
  • Is there a dining room to socialize?
  • Can family members join them for meals?
  • What about special dietary needs?
• Lifestyle/Activities- is there a Lifestyle director to keep them engaged?
  • Is there a wellness director?
  • Do they go out on excursions?
• How many social workers are on staff?
• Are there different types of religious services offered?
  • Is there a Chaplain on staff?
• Does a Podiatrist come to the residents?
  • A Dentist?
  • A Psychiatrist?
• What type of therapy is available? (Speech, Physical, Occupational, etc.)
• Are there visitation hours, or can family and friends visit at anytime?
• How does laundry work?
• Can the residents receive mail? The newspaper?

What amenities are available?

Not many human beings can be confined to a one room lifestyle, unless they really want to live that way by choice. Being mostly social creatures, who enjoy the company of others in fun or relaxing settings, amenities are something to inquire about.

• Is there an activity/recreation room?
• Is there a communal dining room? A private dining room?
• Is there a library?
• What type of outdoor space is available to the residents?
• Are there computers or tablets available for use?
• Do the residents have access to all spaces in the community?
• Is there a hair salon on site?

Recognizing the need for skilled nursing care is the first step and the hardest.

I personally understand the fears and unknowns. However, you need to not only think about the health of the older adult in need of 24-hour medical care, but you (the caregiver’s) health and wellbeing as well.

Do your due diligence by researching and visiting the different communities and most importantly do not be afraid to ask the hard questions.

-Courtney

(If you have questions I did not answer in this blog post, please feel free to comment below or email me at courtney@generationalsupport.com)