Frequently during a hospital stay, the choices of what do we do after the hospital arises. Sometimes going directly home is an option, but sometimes the possibility of a short term stay in a nursing home is the best solution to some problems. Regardless of age, nursing homes can sometimes be the best option for short term rehabilitation, physical therapy treatments mostly, necessity of a high level of nursing care that is unavailable at home because of insurance reasons, strength increase, and extension of activity toleration. Sometimes a nursing home is the only option for people...their health condition precludes them from their spouse or family being their caregivers, or there is no family ready or willing to help the patient. For some their previous environment is no longer safe for them to continue to live there.

  For most it is not the news they want to hear.Some are oblivious to the choice. For family members presented with the choice, it is most difficult. There are a few guidelines that one should follow when faced with this situation. In the best case scenario, placement in a long term care facility or skilled nursing facility is anticipated abd plenty of preparation time is available. For some the news is unexpected and guilt ridden. But these guidelines can give you some information to assist in making the best call you can at the time.

  Firstly, be aware that different insurances cover long term and rehab care differently. The social worker at the hospital in which the person is a patient should be able to interpret the insurance lingo for you and be able to identify the benefits, if any, covered. If there is none, state or federal assistance is an option and the social workers and finance department personnell should be able to assist in applications for those programs.

  And now...the choice. How do you go about it?

  Firstly, if you feel that your loved one is being released without adequate preparation and they are on Medicare( a federal program) you can file an appeal to Medicare to buy yourself a little more time. If you just found out this morning that a long term care facility is the destination for your loved one, you can file the appeal and spend a FAST couple of days on a reconnisance mission.
  Get a list of facilities in your area...you can get this from the social worker or discharge coordinator. Lists are also available form your local area council an aging plus a national Eldercare agency.
  Look close to home initially. You may be in an area where the needs of your family member exceed the care level of the closest facility, and then you must expand your search area. But if possible, close proximity is the best for ability to frequently visit. You may find that you don't like the closest facility, and that's okay, but make that one of the first considerations.
  Go to the facility unannounced. the best foot forward concept we are all familiar with whne company is coming, so an unannounced visit allows for some semblance of the true picture. Quality facilities should have no objection to a spontaneuos visit, and if they do, that could be a big red flag. Ask the question...why do you object to me seeing the facility now? Normal office hour visits are most appropriate. They may just want the person who can best answer your questions to be there, but find out why.
  Look at and for residents. Are the ones in the hallways and dining and entertainment areas clean, clothes not soiled, hair combed, in wheelchairs or chairs appropriate for them? What about restraint use? Using chairs with trays(similar to high chair set up) that do not allow resident movement on their own, are they tied with a waist belt in the chair, do they have a wrist band sensor type system for those residents who frequently try to elope the facility, and what about after hours safety features for the facility itself? If you see residents being changed that should say something about the facility's emphasis on patient privacy and dignity of the resident. Point is....you should NOT be seeing them being changed.
  Check out the food! Folks who are on the mend have funny appetites. Some eat very poorly by nature, so attractive food may assist in increasing their appetites. Check out the appearance, smell, ambiance....TASTE IT.
Palates in nurisng home are not dead, merely dulled so good food is a must. Check out the kitchen. Is it clean? Food well stored?Specialty diets well accomodated? Are the staff approriately attired to serve food, like hairnets? And what about snacks? If possible and appropriate for your loved one, can they eat when they want or only at designated times. Can they have food in their rooms? What if they have a diet soda fetish and it's okay with the doctor?Where can they keep that? And what about water? The risk of dehydration in the eldery is very high, so what is the provision for that? Is there a reachable water fountain? Fresh water at the bedside daily?
  Check out the state inspection reports. All facilities are required to have state inspections on a periodic basis, your state makes it's own rules so check with them. If the facility accepts Medicare patients they also are required to have federal inspections, so check with them as well.
  Ask the residents. All facilities are required to have resident councils where some decisions are made. Sit in on a meeting if possible. Or just walk the halls and ask people what they think. You will be directed by facility staff to the most positive take residents, but veering off the directed path may take you to other opinions. byt remember, you may ask soemone who does not know who they are, much less have a grasp on the facility they are in.
  And last...if you have the time...visit again and again and again. Each time you will glean something new. You will talk to more people, you will get more opinions. And you will come to the conclusion as to whether or not thid facility is right for you and your loved one.