Nursing homes still best for those needing special help

By Jim DeBrosse

Dayton Daily News (OH) – Monday, December 6, 1999

(C) 1999 Dayton Daily News 

For elders who need around-the-clock supervision or who have complex medical conditions that require special attention, a nursing home may be the best choice. They’re the only facilities licensed by the state to offer residents skilled nursing care 24 hours a day. 

That’s exactly why Miriam Johnson of Harrison Twp. felt that her mother would be more secure and better cared for in a nursing home than an assisted living facility. Her mother, 89-year-old Ethel Flaugher, suffers from dementia and is fearful of being left alone. “Assisted living was just never an option,” Johnson said. “She needed to have a nice, cozy feeling, and that’s where she is.” 

Nursing homes may include special care units with services specifically for persons with Alzheimer’s disease, dementia, head injuries or other disorders. Be wary of such claims, however, because the state has no separate licensing for special care units and they may have no more staffing or services than a regular nursing home unit. 

Whether you decide a nursing home or a less institutional setting best serves you or your loved one’s needs, the process of choosing a quality provider is much the same. Remember, older Ohioans seeking admission to a nursing home must first receive approval from their local PASSPORT office (Greene, Montgomery counties: 341-3063; Miami, Darke counties: 498-4593). 

To qualify for nursing home admission, patients must require assistance with at least three Activities of Daily Living, or ADLs, such as bathing, dressing or eating. 

* Plan ahead – Don’t wait until a loved one has been hospitalized to start your search. Under pressure from insurers, hospitals are discharging elderly patients to nursing homes with only a few days notice or less. 

* Get help – Contact the Long-Term Care Ombudsman Program at (937) 223-4613 or (800) 395-8267, or the Area Agency on Aging at (937) 341-3000 or (800) 258-7277. The ombudsman’s office can provide a checklist for selecting a home as well as access to inspection reports and complaint histories on specific homes . Also, talk to your hospital discharge planner, family physician, religious organizations and close friends or relatives. 

* Visit homes – Talk to residents, families, staff and administrators. Ask about staffing levels, activities, services and quality of care. Do staff members have time to interact with patients, or are they too busy performing basic tasks? Ask to sample the food and tour the kitchen. 

* Trust your instincts – Homes with fancy decors don’t necessarily offer the best care. Keep your eyes, ears and especially your nose open as you tour the home. A pervasive bathroom smell means patients aren’t being properly attended to. 

* Read the inspection survey – By federal law, every nursing home certified for Medicaid or Medicare must make available its most recent state inspection survey. You also can get online at the federal website http://www.medicare.gov/ nursing/home.asp that lists nursing homes by state, county, city and even zip code. Click on a name to call up its most recent inspection report. The service is also available by calling (800) 633-4227. Ask the administrator if identified deficiencies have been corrected. Remember, conditions can change quickly in any nursinghome . 

* Involve the loved one – As much as possible, have the family member needing care participate in the selection of a facility. Early on, discuss the possibility of nursing home or assisted living placement to help overcome their fears. Take them on visits to homes . 

* Match services to need – Make sure the home offers the medical and recreational services to meet the specific needs of your loved one. What is the `typical profile’ of a patient in the facility? Do they specialize in treating Alzheimer’s patients? Can they supply special diets for religious or medical reasons? Do they offer activities of interest to your loved one? 

* Payment considerations – Does the home qualify for Medicaid or Medicare payments? Does it require a resident to sign over personal property or real estate in exchange for care? In addition to the room rate, are there charges for ancillary services such as oxygen, medications and special supplies? 

* Tuesday’s consumer information: How to pick a program that’s right for you 

* Library note: a full version of this series, with all published photos and graphics, can be found at http://www.daytondailynews.com/projects/1999/Elder_Care

Memo: Elder Care Series: 
* Sunday: The frail elderly are at the mercy of system. 

* Today: Nursing home operators have little to fear from those who police them. 

* Tuesday: A consumer’s guide to making the right choice on long-term care. 

* Wednesday: Oregon offers, and helps pay for, nursing home alternatives.