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Eight ways to make the nursing home experience work for you

by Sue Lanza

You've been caring for someone at home and suddenly they need a short rehabilitation stint, or even an extended stay in a nursing home. How do you survive with this new living environment for your loved one and still stay sane?

No one wakes up in the morning and says, 'Today, I'd like to place my family member in a nursing home.' I know from personal experience as an administrator (for over twenty years) that admitting a loved one to a long-term care facility is an incredibly stressful time. Let's consider some ways to make this troubling time easier.

8 nursing home transition tips

  1. Get educated. Often, a long-term care stay is an option that develops quietly after a hospital stay, illness or injury. Most of us are not prepared for this and lack the necessary knowledge to make an informed decision. Some make an impulsive choice just to 'get it done', but a health care decision shouldn't be made without considering the facts, no matter how much pressure you may be getting from hospital staff to get your loved one discharged. One simple way to start this journey is to use the nursing home comparison tool from Medicare.gov. You can get addresses, as well as critical reports on recent surveys concerning the care given. The discharge planners from the hospital may also give you some recommendations of facilities to visit that may fit your loved one's needs.
  2. Establish a point person. Once admitted, you need a person you can talk to at the facility about questions or concerns you may have. This could be the facility's admissions director, often the first person you meet, the social worker or the unit manager/nurse of the area where your family member resides. This should make life easier for you if you have a steady contact. It also works better for the facility to have one person working on an issue for you, rather than multiple people.
  3. Understand how the nursing home works. A long-term care facility is like a hotel with medical services. It is a 24/7 operation with various departments servicing your needs, all coordinated by an administrative team. Some typical departments would include: nursing, dietary, housekeeping, maintenance, laundry, recreation, social services, business office and admissions.
  4. Get involved. I've always recommended that new families integrate into the culture of the facility by attending family meetings, social programs or going on facility trips. Make a point to introduce yourself to department heads that you haven't met already.
  5. Base your visiting schedule on your current relationship with your family member. This question comes up frequently, 'how often should I visit?' First of all, there are no 'shoulds,' just find what works for you. We usually tell family members that visiting could be based on how often you normally see the person. If you visit monthly, you might try visiting a few times during the month. For those who lived together before admission, daily or a couple of times a week for visiting may suffice.
  6. Stay in touch with the doctor. People new to the nursing home experience are surprised to learn that the attending physician does not see the patient every day, as they do in a hospital setting. This can be distressing to learn, but be assured that the nurses monitor symptoms and communicate as much as needed with the physician if problems arise. Long-term care is a less critical level of care than acute care, so the constant physician presence is not needed. Each facility should have a Medical Director who oversees the care that each physician delivers. Your best bet is to reach out to the doctor personally, at their office, if you have any questions or concerns about your loved one's care.
  7. Be realistic. The care that is delivered in any long-term care facility may never duplicate the tender loving care that you provided at home. So many facilities do an excellent job of trying though. You need to advocate for the care your loved one needs, but do it constructively and with the knowledge that things may never be perfect. Know your rights and expect good care, but be levelheaded about your expectations.
  8. Detach and get a life. If you have been a primary caregiver for a long time, allowing others to be the professional to your family members is not easy. I know I just told you to get involved, but balancing your time at the facility with a health outside life just for you will only help you and your loved one get through this.

One more thing to remember: This situation may not be the one you chose for your loved one but it is here, and your acceptance of it is critical for it to work.