Explain Nursing Home Placement to a Patient
Explaining nursing home placement to a patient can be an unpleasant task because there are emotional issues that confound the situation. Many times family members and/or spouses of the person to be placed in the nursing home feel guilty about the placement. Couple these emotions with those emotions of the person who is going to live in the nursing home, and it can sometimes be a highly charged exchange.
Instructions
1. Before initiating any conversation with the person who will be placed in the nursing home, ensure you are making your decision with complete and full information, including medical condition(s) and prognosis, recommendations by the person's health-care provider(s), information on the nursing home(s) under consideration and the person's ability to perform activities of daily living.
2. Some medical conditions may have a favorable prognosis, such as a stroke, where the person may need therapy and rehabilitation for a specific period of time, and then be able to return home. This is information you'll want to know--and the person going to the nursing home will feel motivated to participate in therapy in the hopes of recovery and a return home.
Don't give your family member/spouse false hope for a return home. If the possibility exists that there could be sufficient recovery through therapy or other extended care at the nursing home, share that with the person. If a return to home isn't feasible, be honest.
Other medical considerations include the need to take daily injections, apply pressure stockings or take multiple finger sticks daily to check for glucose levels. These are all activities that need to be taken into consideration when nursing home placement is being considered.
Often, physicians, nurses and/or social workers will make recommendations before the person is discharged from the hospital, if hospitalized, or after a visit to the physician's office. If the recommendation is for nursing home placement for your family member, ask what criteria about this person requires such care.
3. Take time to check out the nursing homes with available openings in your area. Visit unannounced. Facilities with nothing to hide will not mind such visits and understand your reasons for coming.
Gather whatever information the facility may have about its services. This will be something concrete to share with your family member when the time comes to discuss nursing home placement.
Check with your state nursing home licensure board and/or Medicaid/Medicare certification board to learn how well the facilities you are choosing from comply with state and federal regulations. If your state has a nursing home ombudsman program, check for any complaints about the facilities and whether such complaints were founded or unfounded.
You and your family member will likely want to choose a long-term care facility close to home, but don't let proximity be the only factor in your choice. Quality care for your family member should not be sacrificed.
4. To know how much care your family member is going to need, understand how much or how little the person is able to do for herself in personal care, toileting, ambulation and eating. Can he take his medication without special preparation? Does he need a wheelchair that his current living situation cannot accommodate?
Are there steps to your family member's current living quarters that would prevent him from entering and exiting without assistance? Can he care for his toileting needs, including being able to get on and off the toilet?
Does the person need round-the-clock supervision due to memory impairment? Might he be a danger to himself when cooking, such as forgetting to turn off the stove?
Many activities are taken for granted once we learn to do them, but mental and/or physical impairments can sharply affect our abilities.
5. A last consideration will be whether your family member is competent (able to make his own decisions) or has been deemed legally incompetent (unable to make his own decisions). In many states, a person, no matter how apparently impaired, is considered to be a competent person until the court has deemed otherwise.
Now it is time to sit down with your family member and, as calmly as possible, explain the situation as you know it. Have ready the information you have gathered, so you can share it with your family member. Expect that the person may express anger, disappointment or disbelief.
You may want to keep the initial conversation about nursing home placement brief, allowing time for your family member to consider the situation and the information you have presented.
Allow your family member to make whatever decisions they are able to, such as choosing between two quality facilities. Nursing home placement represents a major loss of independence. Promote whatever independence the situation allows.
Tags: family member, your family, your family member, nursing home, home placement, nursing home, nursing home placement