For many years, Elizabeth Barfield used the tape ministry of First Baptist Church, Springville, in St. Clair Baptist Association to minister to residents of local nursing homes. As a result of her ministry, she knew which nursing home would be her choice if she ever needed that kind of care.
“She played the piano for the residents (at that nursing home) and was in and out at various times,” said Betty Derrick, daughter of the late Barfield. “She saw that the staff was friendly and cared for its patients, and she already had friends there.”
So when Barfield’s health made nursing home care necessary, the decision was easy, Derrick said.
Nursing home care is necessary to the health of more than 1.5 million Americans each year. Planning helps make the often difficult decisions surrounding nursing home care easier, according to the “Guide to Choosing a Nursing Home” — a publication of the Centers for Medicare and Medicaid Services.
The guide encourages those looking for a nursing home to compare and visit several different homes and to plan financially for such care. Doing so can ensure patients receive the quality of care they want.
Virginia Moore-Bell, state long-term care ombudsman for the Alabama Department of Senior Services, said most who enter nursing homes do so “because they can no longer provide general care for themselves on a day-to-day basis.”
The first recommendation for nursing home care often comes from a doctor who may see a need for the 24-hour care a nursing home can provide.
In many cases, family members work hard to keep their loved one at home but are overwhelmed by the care demands.
“Certainly the doctor has to give an order for a patient to go to a nursing home, but the family ultimately has to decide, and that’s where the work comes in,” Moore-Bell said.
Ideally nursing home decisions should be made in the best interest of the patient, free of financial concerns.
Financial considerations cannot be ignored, however, because nursing home care can be expensive. Private insurance, including long-term care policies; public assistance; and individual assets are all ways to pay for that care, but it is a good idea to know in advance what the costs will be, Moore-Bell said.
“We’re all aging and whether you would choose to go to a nursing home or not, it’s always good to be familiar and informed about services and the types of care available,” she said. “It’s important to become educated about what nursing homes do, the type of care that’s expected and what personal care you would like your loved one to receive.”
Whether the decision must be made quickly or with time, there are four main steps to choosing a nursing home, Moore-Bell said.
• Find out about the nursing homes in your area. Ask people you trust, including family members, friends or your pastor, for recommendations and advice.
• Find out how the nursing homes compare in quality. Once you have a list of possible facilities, visit the Medicare Web site (www.medicare.gov) to view information about the facilities, including inspection reports, resident characteristics and staffing levels. The Alabama Department of Public Health Web site (www.adph.org) also includes a section titled “Statement of Deficiencies” that reviews survey results and complaints against nursing homes in the state.
• Visit nursing homes of interest. Make an appointment so you can view the facility, meet the staff and possibly meet some residents. Do not enter resident rooms or care areas, however, without permission from the resident and nursing home staff. Carry a list of questions, and address any concerns you might have. Then visit the facility on a different day, perhaps at a different time, or have someone else visit and compare notes.
• Choose the nursing home that best meets your needs. Once you have all the information, discuss your options with your family, friends, doctors and pastor. Consider which facilities best fit your personal values and preferences. Remember that quality of care is important but so is quality of life.
“An important factor is not just the quality of the nursing care, but also where your family is,” said Ernest Hill, minister to senior adults at Mount Zion Baptist Church, Huntsville, in Madison Baptist Association. “If you are in a nursing home, you need family to give you support.”
Family members need to visit their loved one as often as possible, Moore-Bell said.
Tom Randall, vice president for ministry with The Baptist Foundation of Alabama, said frequent, unscheduled visits can help family members monitor a patient’s care. “Ask questions of the patient … to get an idea of how things are going.”
He said the best situation is for all involved to work together to ensure the best care for the individual. “No facility or caregiver will be perfect,” he said. “It is good to keep that in mind and be somewhat flexible and diligent in bringing about improvement.”
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Visiting prospective facilities
Tom Randall, vice president for ministry with The Baptist Foundation of Alabama, recommended families consider and do the following when they visit prospective nursing homes.
Things to ask:
1. Ask about the state survey report and the facility’s evaluation.
2. Ask about the facility’s admissions process and room availability.
3. Ask for the admissions application and other paperwork.
4. Ask about any applicable fees, including basic costs plus incidentals. Also ask about Medicaid’s effect on costs.
5. Ask about the medical staff and facility medical director.
6. Ask about provisions for dementia or Alzheimer’s patients.
7. Ask if the facility provides transportation to medical appointments.
8. Ask about religious and social activities.
Things to notice:
1. Does the general appearance give you the impression that the owner(s) and employees take pride in their facility?
2. Is the facility neat, clean, well-kept? Are there any odd or unpleasant odors present?
3. Do the residents appear to be well taken care of? Are they dressed and situated appropriately at the time of your visit?
4. Eat at the facility. Is the food appetizing and well served?
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