What To Expect in A Skilled Nursing Facility

Affordable Service Tailored to One’s Budget

Skilled nursing homes have provided an opportunity for senior citizens to have a lifestyle they often dreamed of and envied. With annual expense at some in-house senior care centers approaching close to the entire pension these people draw after their retirement and some living facilities charging more than they could afford in their lifetime, many people question whether they can afford skilled nursing homes for their future. More than a decade ago, this was not possible for an average person. But now, with many such facilities expanding their businesses throughout the country, there are hundreds to choose from, some even affordable than living in a single family home.

High Quality of Life

Once known as a private home care facility for elders and disabled individuals, nursing homes were indeed institutions where the adults, often the ones who were unable to care for themselves in their homes resided. Today, they are simply boarding facilities with a wide range of ‘comfort dressing’. Most have health care and extended care services, and the facilities state quite clearly all the benefits they offer before admission.

The majority of nursing homes in the United States are Medicaid and Medicare certified, either for-profit or non-profit organizations. Unlike other assisted living facilities across the country, nursing homes that are skilled have a widely varying mix of boarders. Like all hospitals, each nursing home has its own “personality”, which requires to be examined by the potential resident to see if it meets his or her needs. A handful of such facilities are affiliated with government agencies and few others are run by private investors.

Features Not Found in Other Senior Care Centers

A substantial difference between a skilled nursing home and other conventional care facilities is the tremendous benefits it provides such as 24 hour supervision, customized meals, group activities, individual attention to residents by trained staffs and help with daily chores. For many residents, skilled nursing home is fun and living a perfect lifestyle.

Skilled nursing homes usually have an atmosphere just like in a hospital where the staffs offer care – physical as well as psychological – through occupational therapy, counseling and other means. Many facilities also provide open living option where couples can live with other couples under the same roof. Nevertheless, nursing facilities can serve as viable private home alternatives for elders who otherwise have to choose substandard homes as resident alternatives. Nursing home for an entire life can be particularly satisfying if several senior citizens from a similar background and with common interests live together – in that way they have one another as a social core group.

Advanced Health Care Programs

The wide range of support provided by nursing homes also includes wound care, monitoring of medication and resident’s overall well-being, managing mild and serious illnesses such as diabetes, heart condition and respiratory problems. Elders with Alzheimer and dementia are given greater priority through specialized care from registered nurses and receive several hours of individual attention from licensed practitioners and aides.

A private skilled nursing home is usually far more accessible for its residents than other assisted living or home care facilities. Residents can walk or take private vehicle provided by the home to and from the campus by themselves or with the help of hired assistance. And they can often walk or take public transportation to their place of interest with those helpers. Moreover, the nursing home normally has easy access and frequently take the residents to cultural attractions, around the place they live in, such as concert, operas, museums and major events that make their organization available to senior citizens. This can be of utmost important for those residents who want to perceive a hobby during their golden years.

Safe and Secured Atmosphere

Part of any skilled nursing home’s environment is the carefully worked out policy nad the degree of safety that it offers to its residents. Almost all good facilities keep the intruders out, have strict supervision on campus and ensures that the residents are comfortable living in the rooms assigned to them. The facility also takes adequate steps to protect the members against fire, smoke and other hazards on a regular basis.

The Role of Nurses in a Nursing Home

A nurse in a nursing home facility has many responsibilities. They have the task of not only caring for the elderly residents, they are also in charge of other employees and have to make sure the operation runs smoothly. Caring for the elderly in a nursing home is a huge responsibility as many of the residents need some type of medical attention. Just like any other business, there are various levels of responsibility among the employees.

Overview of Nurse Types

There are basically three types of nurses in a nursing facility: Registered Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nursing Assistant (CNA), and sometimes a Nurse Practioner (NP). Also, an RN who takes specialized graduate courses in geriatric care and obtains a certificate or degree are designated as a Gerontological Nurse.

Depending on the level of care rendered to its residents, the nursing home may employ all three nursing types or sometimes just CNA’s and one or two registered nurses. In any case, each type of nurse has their own job description and different level of responsibility.

Description of Each Nurse Role

The Registered Nurse usually has more training and education than other nurses. These are the nurses who are the supervisors and they work under the direct supervision of the medical doctor. Their professional title is usually Head Nurse. They are responsible for overseeing the LPN’s and CNA’s by designating the nursing assignments and are also responsible for making up the working schedules.

Aside from their supervisory role, RN’s have specific jobs to do. They are also responsible for the total care of the residents by initiating treatment plans and administering medicine. They also prepare IVs, draw blood, give injections, and taking vital signs. Their nursing responsibilities go even further as they are required to monitor the health of their patients and to make sure they are getting the proper care. In addition, an RN is responsible for interacting with the patient’s family by reporting any changes in the patients health or living situation.

The LPN’s role in a nursing home is direct bedside care. Under the supervision of the Head RN, LPNs carry out the routine care for their patients. Basically, they are responsible for the patient’s personal hygiene and day to day care. LPNs have a very physically demanding job as they may be responsible for getting the patient out of bed or moving the patient into a more comfortable position. They may work right along side of an RN or work independently.

LPNs are responsible for taking the vital signs of the patient such as blood pressure, temperature, heart rate, oxygen level, and respiration. They also give enemas, may initiate medicine, apply bandages and dressings, insert catheters, and monitor the IVs. Also, they may feed the patients and record any changes in the patient’s health or vital signs. Basically, they are responsible for doing any tasks that need to be done for the sake of the patient’s comfort. If a problem arises, the LPN always reports back to the RN in charge.

The CNA’s role in a nursing home is to assist the LPNs, and they are also required to be state certified. Many community colleges have programs for CNAs. Essentially, a CNA does some of the tasks that an LPN does but there are some things a CNA cannot do. For instance, a CNA cannot administer medicine or supply IV medicines. Also, a CNA cannot start an IV where an LPN can.

Some of the basic tasks a CNA might do are: changes bed sheets, bathe patients, change bed pans, feed patients, walk the patient, helps with personal hygiene, transport patients, and any other tasks that are designated by the LPN or RN.

Conclusion

As you can see, being an RN, LPN, or CNA in a nursing home is a big responsibility as both the patient’s health and well being are the prime concern. Some of these patients cannot care for themselves and they are totally dependent on the staff for their care. A nursing-home nurse not only needs the proper education and degree for the job, they also need to be totally dedicated as their job can be a very demanding one.

MRSA UTI Prevention – 5 Contributing Factors to Developing a MRSA UTI in a Nursing Home

Methicillin Resistant Staphylococcus Aureus (MRSA) UTIs are increasing throughout the United States, and transmissions acquired in hospitals and care facilities are of particular concern. A MRSA UTI cannot be treated with traditional antibiotics and the prevalence of antibiotic resistant bacteria is a growing problem, especially for the elderly living in residential care facilities, as more strains of bacteria adapt to commonly used antibiotics.

Elderly residents are likely to have taken antibiotics over the years, allowing for the development of some resistant bacteria, and the combination of debilitated patients with compromised immune systems, and a certain level of antibiotic resistance places them at greater risk of MRSA infections.
Several specific factors contribute to the likelihood of contracting a MRSA urinary tract infection (UTI) in a nursing home or other long-term care facility.

MRSA UTI Risk Factor #1: Exposure to Carriers

Studies have shown that residents in long-term care facilities are more likely to be carriers of MRSA in general. It is believed that patients often contract MRSA during a stay at a hospital or acute care facility, rather than in a nursing home or long term care residence, however, facilities where many people are living in close proximity to one another can be prime areas of contagion. While infection control protocols are in place in most facilities, research has indicated that none are substantially effective in reducing the spread of infections, partially due to the highly contagious nature of MRSA and also to the fact that it may be unreasonable to attempt to limit residents’ mobility and social interactions given that the facility is their home.

MRSA UTI Risk Factor #2: Invasive Medical Devices

Use of invasive devices like urinary catheters: Since MRSA, like other staph organisms, can live on the skin, hygiene is the first line of defense in controlling spread of infection. While healthy people can carry staph on their skin without being infected by it, elderly residents have a much harder time fighting off stubborn organisms like MRSA. Urinary tract infections are common in nursing homes and long-term care facilities. Many elderly patients have poor bladder control and depend on a urinary catheter which can provide bacteria a direct route into the body, particularly if the catheter is left in place for long periods of time without being replaced.

MRSA UTI Risk Factor #3: Impaired Cognitive Function

Increasing the amount of fluids in the person’s diet will help to flush out bacteria from the bladder and urinary tract, but elderly residents may not remember to drink enough without close monitoring. In addition to being incontinent, long-term care residents may be mobility-impaired and confused which contribute to the possibility of a UTI. Patients who do not have a catheter but still have issues with incontinence may refrain from drinking larger amounts of fluids in an attempt to avoid accidents, and this provides an opportunity for bacteria in the bladder and urinary tract to thrive.

MRSA UTI Risk Factor #4: Impaired Immune Function

If poor clinical status and chronic illnesses are the norm in residences for the elderly, endemic infections may not be preventable. Residents may have chronic medical conditions that decrease the effectiveness of their immune system, and this makes MRSA infections more dangerous and potentially even life-threatening. The inability of many elderly patients to communicate adequately with staff, combined with a high frequency of asymptomatic MRSA UTIs may create a nearly impossible situation. The use of high-power antibiotics that are effective on resistant bacteria like MRSA can be very hard on the patient in treatment, and may affect kidney function as well.

MRSA UTI Risk Factor #5: High Potential for Contagion

MRSA is highly a highly contagious organism that can be transmitted by direct contact with infected persons, towels, wash cloths, bedding, drinking glasses or any other items handled by infected residents, especially if cognitive changes are present that prevent patients from being fully aware of things like proper and frequent hand-washing. MRSA that may begin as a nasal or respiratory infection can easily be transferred to other parts of the body.

 

Nursing Shortage: What the Future Holds for Nursing Homes

The nursing shortage in the United States adds to the growing problem of how to provide appropriate care for senior citizens who need nursing home services. Nursing homes have lost funding in recent years; in addition, more and more senior citizens are in need of nursing home services. Thus, experts predict that by the year 2050, there will be 18,000 more seniors who need nursing home care than there will be beds to house them. There are several factors that contribute to the nursing home shortage; if the economy improves, some of these problems may resolve themselves, but something still needs to be done.

Decline in Construction of New Homes
Many nursing homes were built with federal dollars during the 1960s. But now that these homes are getting older, sometimes they have to be closed. The federal government has cut funding to construct nursing homes or to maintain existing ones. This means that many nursing homes are closing and new ones aren’t being built.

Housing Market Collapse
The housing market collapse has also affected nursing home care. In the past, senior citizens or their families often sold their homes in order to pay for nursing home care. However, due to the housing market collapse, it’s becoming more difficult for senior citizens to sell their homes. Their homes may not be worth as much as they were when they bought them; in addition, people are not buying houses as much as they used to. Thus, more seniors are finding themselves without a source of funding and having to depend on Medicare and Medicaid.

Cuts in Reimbursement
Since most seniors rely on Medicare and Medicaid to help them pay for nursing home care, cuts in these programs significantly affect how many people can afford nursing care. In 2011, the federal government cut reimbursement to nursing homes from Medicare by 11 percent. Nursing homes tend to lose money on Medicaid patients, as Medicaid doesn’t pay for the entire cost of the patient’s treatment. However, it is illegal for Medicaid certified homes to turn any patient away who is on Medicaid and/or no longer has enough financial resources to pay for care. As a result, nursing homes don’t have the money they need to keep themselves open and provide appropriate care to all patients.

The main consequence of these problems is that many nursing homes have had to cut staff, and more cuts are expected in the future. Nursing homes simply cannot afford to pay for all of the staff they need to stay open because of lack of funding and their patients’ inability to pay for nursing home care themselves. As a result, nursing homes tend to be understaffed, and this problem is going to get worse over time.

While nursing homes are struggling to admit patients and care for them properly, the number of patients that need nursing home care services is steadily increasing. People are living longer–it’s not uncommon for people to live into their 90s or even reach 100 years of age–and the baby boom generation is reaching retirement age. According to MSN Money, by 2030, 20 percent of the US population will be over 65, and the number of 85-year-olds and 100-year-olds will double or triple. Many of these people will need nursing care services.

Nursing homes will need more funding in order to keep up with these changes in demographics. If funding continues to decline, there will be less nursing homes available to take care of the number of patients needing nursing care services, and those homes that are open will not be able to hire enough staff to take care of the patients.

 

Comparing Nursing Home Options: 5 Important Factors

Making the decision to put a loved one into nursing home care is one that is never taken lightly. Not just any facility will do when it comes to the comfort of a family member. Reports of nursing home abuse and neglect are everywhere, and the question of how one nursing home compares to another is something on many people’s minds.

There are many different factors to consider when looking into a senior retirement home, and each must be weighed carefully against the others.

What Others Have to Say

Nothing is more telling of the quality your loved one will receive than the words of those who have experience in the particular facility. Talking to the other residents in assisted living homes will give an insight into the level of care and services that are provided. Staff and volunteers are also a good source of information since they are there often and have a working knowledge of policies and routines of daily life in the nursing home. Volunteers are especially helpful, as they have no paycheck to worry about and most likely wouldn’t be there if they didn’t agree with the quality of care being provided.

Daily Retirement Home Living

The daily life of the residents and how they will be affected by their new home is influenced by a variety of factors. Location determines whether other family members are able to visit often. The home should also reflect the personal desires of your loved one for either a rural or urban setting. Gardens, lawns, and other natural spots can be helpful for relaxing. Take note of the number of residents who are currently living there to see if the home is overcrowded. The food that is served is what your family member will be eating for several years, so it must be something that is both nutritious and agreeable to them. The staff-to-resident ratio should be high so there is always someone available if there is a need for help. The safety measures in place, the comfort of the rooms, and the cleanliness of the facility are all important aspects that will affect a loved one’s life on a daily basis.

Entertainment and Activities

You should look at the types and number of activities that are offered to occupy the residents’ time. Activities should be both indoor and outdoor to accommodate whatever all need. The presence of a dedicated activity director means that the residents receive things to do that are more in-line with their desires. The types of activities offered should match the interests of your loved one so they will enjoy themselves. If your family member has physical or mental disabilities, make sure that the caregivers will take the time to assist them so that they can participate in the activities.

Cooperation

The flexibility of a facility is important. Fewer restrictions in place makes residents feel like they have some control. The amount of control that your loved one has over their schedule and daily activities can be very important as well, depending on the person. Policies on visitation and whether a family member can be taken out on any given day or for a weekend trip should be in line with potential plans and needs.

Expenses

Though not something you want to think about, costs are a huge factor in determining the quality of care your loved one will get. Nursing homes can be quite expensive and are getting more so every year. The average cost per year is $70,000 and the average stay for a resident is 2 ½ years. This can quickly become unmanageable for many people. Balancing the costs with the level of quality can be tricky, and each factor of importance should be compared to this cost to ensure that your loved one gets all that they need at a price that is not impossible to afford.

Ultimately, the decision may take quite some time to make. You should visit each home several times and observe the interactions between residents and staff to get a feel for the true atmosphere and level of care. Making a list of what is essential and what is not can help. Narrow the list down and let your family member share in the decision process to ensure that the correct choice is made.

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10 Tips for Choosing a Skilled Nursing Facility

The desire of an elderly person to stay in their own home must be weighed against the type of care they require. A time may come when your parent or grandparent will have to be placed in a skilled nursing facility. Otherwise known as nursing homes and convalescent homes, these facilities are able to provide the extensive nursing care that your loved one may need. Here are some tips to help you choose the right home and elder care help when the time comes.

  1. Staff Matters
    Ask about the staff turnover within the home. Working in a nursing home is an extremely demanding job both physically and mentally. Any nursing home will have a high turnover rate, but a quality one will also have staff members who have been there for many years and seem to be happy.

Staffing during the workweek is usually adequate, but ask what the specific staffing levels are on the weekends, holidays, and evenings. Elderly care never ends; you want to choose a facility that maintains proper staffing even during these non-peak times.

Does the staff seem to genuinely care about the residents in the home? Do they interact with them and talk to them with respect and care? The job satisfaction of the staff will have a profound impact on the quality of elder heath care they provide.

  1. The Other Residents
    Take a good look at the other residents. Ask yourself if they seem to be happy. Look to see if any are actively engaged in activities or games. Are they clean and groomed; wearing clean clothes. Try to observe the nursing home during meal times as well as during activities.

If you happen to encounter another visiting family, stop and ask them how happy they are with their elder care services and the home in general.

  1. The Facility
    Look for a facility that is clean and does not have any strong odors. A heavy deodorizer scent may be masking the smell of urine. Check above door jams to see if areas are being dusted regularly. Look at fire extinguishers to see if they are being turned and shaken every month in accordance with fire code.
  1. Meals
    A quality facility will have dieticians on staff to ensure that a balanced diet is being served. Find out if they can handle special dietary needs. Ask if special treats or meals are allowed to be brought in for your family member. Do the residents all enjoy meals together in one large room or do they eat separately?
  1. Activities
    Regular activities are important for people of all ages, including the elderly. Find out if they have an activity director. If not, ask how they handle having regular activities for the residents. Find out if outdoor activities are included as well as indoor options.
  1. Experience
    Find out if there are people on staff who are experienced in elder care nursing and can handle your loved one’s condition. Whether the concern is diabetes or Alzheimer’s, you want to know that there are people in the home who are familiar with the condition and will be able to help manage it.
  1. Licensing Requirements
    Ask to see the licenses held by the facility. Choose one that has all required state licenses. Find out what the state requirements regarding the ratio of staff members to clients and then make sure the home you choose consistently maintains that ratio.
  1. Location
    The location you choose is extremely important. You want to choose one that is close to home so it will be more convenient for you to visit. Choosing one that is nearby can also make it easier to bring your loved one home for holiday visits and other special occasions. Location should not be the only deciding factor, but it should definitely be kept in mind.
  1. Check for Complaints and Violations
    Violations of state code become public record. Don’t just look at the number of violations; look to see what they are for. Violations can range from a minor housekeeping issue to serious issues of abuse or neglect. Check into the facility’s record before making any final decisions.
  1. Surprise Visit
    Any nursing home worth using will be willing to let you drop in for a visit. If they require that you schedule a visit days or weeks in advance, ask them why they require that much notice. Visiting at the last minute will provide you with a solid glimpse of how clean the facility normally is, how it usually operates, and what level of elder health care they are providing.

For Information on Nursing Homes and Assisted Living: