People who are involved from the beginning are better prepared when they move into a facility.

"A person's home is their castle," so any move, especially to a nursing facility or even an assisted living facility, is a huge one.

When you have all the information about the facility you are interested in, talk with people who understand your personal and health care needs. This might include your family, friends, doctor, clergy, spiritual advisor, hospital discharge planner, or social worker.

If you find more than one nursing home you like with a bed available, use all the information you get to compare them. Trust your senses.

Caregivers

• Keep the person you are helping involved in making the decision as much as possible. People who are involved from the beginning are better prepared when they move into a facility.
• If the person you are helping isn’t alert or able to communicate well, keep his or her values and preferences in mind.

Before The Move

• Important: If you visit a facility that you don’t like, look at other options if available. Quality care is important.
• If you are in a hospital and moving to a facility, talk to the hospital discharge planner or your doctor. They may be able to help you find a better facility than the standard one people are sent to automatically. They may also help you arrange for other care, like short-term homecare, until a bed is available at another facility you choose. However, you may be responsible for paying the bill for any additional days you stay in the hospital.
• Moving is difficult. However, an extra move may be better for you than choosing to stay at a facility that isn’t right for you. Be sure to explain to your doctor or discharge planner why you aren’t happy with a facility they may be recommending.

Making Arrangements

When you contact the facility's office, it’s helpful to have the following information ready.

• Payment Information
• Insurance Information: Provide information about health care coverage and/or long-term care insurance you have that pays for nursing home and/or health care. This includes the name of the insurance company and the policy number.
• Note: You may have to pay a cash deposit before you are admitted to a nursing home if your care won’t be covered by either Medicare or Medicaid. If nursing home care will be covered by Medicare or Medicaid, the nursing home can’t require you to pay a cash deposit. They may ask that you pay your Medicare coinsurance amounts and other charges you would normally have to pay. It is best to pay these charges when they are billed, not in advance.
• Medical History: Your doctor may give the staff some of this information. This includes a list of any current or past health problems, past surgeries or treatments you’ve had, allergies you have to food or medicine, and shots you’ve had.
• Current Health Status: Your doctor may give the staff some of this information. This includes a list of your current health problems, recent diagnostic test results, and information about any activities of daily living that might be difficult for you to do by yourself.
• List of Current Medicines: Include the dose, how often you take it, and why you take it.
• List of All Your Health Care Providers: Include names, addresses, and telephone numbers.
• List of Family Members to Call in Case of an Emergency: Include names, addresses, and telephone numbers.
• Personal Needs Account: In a facility, you have the right to manage your own money or to choose someone you trust to do this for you. Therefore, you may want to open an account managed by the facility. You can deposit money into the account for personal use. Check with the nursing home to see how they manage these accounts. You may only have access to the account at certain times.
• Health Care Advance Directives: You may be asked if you have a health care advance directive. A health care advance directive is a written document that says how you want medical decisions to be made if you can’t make decisions for yourself.

There are two common types of health care advance directives:

• Living Will—A written legal document that shows what type of treatments you want or don’t want in case you can’t speak for yourself. Usually, this document only comes into effect if you’re terminally ill (usually if you have 6 months or less to live) or permanently unconscious and can’t speak for yourself. A Living Will tells others what medical care or treatment you want, such as whether you want life support, like a respirator.
• Durable Power of Attorney for Health Care—A legal document that names someone else to make health care decisions for you if you become unable to make your own decisions. If you don’t have a health care advance directive and need help preparing one, or need more information, talk to a social worker, discharge planner, your doctor, or the nursing home staff. You can call your local Area Agency on Aging to find out if your state has any legal services that help with preparing these forms. AAAs assist adults age 50 and older and their caregivers. To find the AAA in your area, call The Eldercare Locator at 1-800-677-1116 weekdays from 9:00 a.m. to 8:00 p.m. (EST), or visit www.eldercare.gov.

Services and Fees: You must be informed in writing
about all facility services (those that are charged and not charged to
you) and fees before you move into the nursing home. The nursing
home can’t require a minimum entrance fee as a condition of admission
if your care is paid for by Medicare or Medicaid. Also, you must be
informed when any services and fees change.

A good facility should function like a good community, and help you stay involved.

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Source:

Centers for Medicare & Medicaid Services: Guide to Choosing a Nursing Home

Reviewed by
Dr. Boaz Ancselovic, MD, Geriatrician, Alzheimer's Weekly.
Edited by Peter Berger, Alzheimer's Weekly.
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