A skilled nursing community (nursing home) provides direct 24-hour medical oversight for individuals who have health conditions that need daily medical monitoring. A skilled nursing community will provide a semi-private or private room, meals, activities, medication management and 24/7 health monitoring for their residents. Many skilled nursing communities have secured units that provide specific care for the resident who is living with Alzheimer’s or another form of dementia.
Many skilled nursing communities also provide “therapy and rehabilitation” services funded under Medicare—this is sometimes called Med-A Therapy, where the individual goes for short-term rehabilitation after a three- day or longer hospital admission. The objective of the Med-A therapy is to get the individual as highly functioning as possible, so they can successfully return home.
Assisted living is a “supportive service” environment for individuals needing help with activities of daily living (ADL’s) which includes dressing and grooming, meals and medication management. Assisted living does not provide regular oversight from a physician.
Another consideration is the level of care your loved one is at going into assisted living—if they are very dependent, it may only be a short period of time before they would have to move again from assisted living to skilled nursing to accommodate the higher level of care. It can be taxing on the individual to have to adjust to another move.
The cost of skilled nursing communities (nursing homes) depends on the level of care and type of accommodations you choose. The fees will cover the room and board, daily care, meals, and activities at the community. Some nursing communities charge “ala carte” fees for additional services, such as incontinence care.
It is also wise to check with the skilled nursing community to see how many Medicaid beds they have and what their Medicaid policy is. Ideally, when the resident begins running low on funds, the skilled nursing community should be able to accommodate moving the resident into a Medicaid bed once the family applies for Medicaid, versus not having a bed available and causing the resident to move to a different skilled nursing community.
The primary source for funding the nursing home is private funds. Some long-term care insurance policies cover a daily portion of the costs. A Medicaid program is available to pay, but there are requirements that need to be met before the individual is approved.
Tours of nursing homes should be available anytime. It would be best to call and schedule a tour with someone (at Bethesda it’s our Resident Services Coordinator) who will be able to answer specific questions that you will have while touring. If you are still unsure, you should be able to drop in anytime and make observations at different times—but please be mindful that this is the “home” of their residents.
The best tool to use while touring is your own senses—each nursing community has a distinct feel when you are there. What do you see—are the residents engaged in activities or with other people, and do the staff greet you and do they seem pleasant, are the residents and community clean, is there space for privacy and is there available outdoor areas to visit? What do you smell—there should be no offensive or masked odors. What do you hear—are people engaged in conversations, do you hear laughter and activity? Most importantly, you trust how you feel when you leave—it is very hard to make this decision for someone you love, but the “environment” is more that nice curtains and furniture; it is the care being delivered, and the staff that “makes the difference” and create the “personality” of the community.
