Myth #1: Nursing home facilities smell bad.

Reality: Most good nursing home facilities rarely smell bad, and when they do, chances are, it will be taken care of promptly. Not only are nursing home facilities inspected by each State on behalf of the Medicare administration every twelve to fifteen months, but they are also inspected by family members and other health professionals, albeit more informally, on a regular basis. So while you may encounter an unpleasant odor on one visit, it’s likely you may never experience it on subsequent visits. If you do, take it up with the administrator. Nursing home administrators are typically very sensitive to this issue and will take action quickly.

Myth #2: Nursing home facilities are like hospitals.
Reality: Nursing homes are residential facilities that provide medical care, but they are not like hospitals. The environment in nursing home facilities is much less clinical, for one thing. In addition, community living has a much different feel than a temporary stay in a hospital. Nursing homes offer activities to keep residents engaged in the community, and interacting with one another. And as neighbors, residents often form lasting friendships.
 
Myth #3: The people who live in nursing home facilities are all dying.

Reality: Nursing homes provide continuous medical care for people whose medical conditions require around-the-clock care or monitoring. While it is true that some elderly and terminally ill residents may be dying, at that point they are certified by their doctor to receive hospice (i.e., end-of-life) care, and that is certainly not the case for all residents. Many nursing home residents simply need a higher level of care than is available at an assisted living facility.

Myth #4: All nursing homes are the same.

Reality: This couldn’t be farther from the truth. It is important to carefully research the nursing homes you are considering, because despite stringent federal regulation, all nursing homes are different. This can be a wonderful thing-for example, when it creates a strong sense of community among residents-but it can also have a down side, especially when a facility does not address problems that affect residents’ quality of life and/or quality of care.

Myth #5: Caregivers can use restraints to control residents.

Reality: Restraints may only be used when it is medically necessary for a resident’s safety or the safety of others. It is unlawful for nursing homes to administer physical or chemical restraints for any other purpose.

Myth #6: Insurance will pay for my nursing home care.

Reality: It depends on the type of coverage you have. Many people are surprised to learn that Medicare only pays for 100 days of nursing home care per illness, and prior to that, you must meet a number of requirements before you are eligible for benefits. Also, only the first 20 days are covered in full; the rest requires a significant co-payment ($133.50 per day in 2009). After that point, you are responsible for paying for expenses out of pocket until you become eligible for Medicaid. Some long-term care insurance policies provide coverage in a nursing home facility, but not all. If you have a long-term care insurance policy that provides nursing home coverage, check your policy to determine your coverage limits and restrictions.

Myth #7: There is no privacy in a nursing home facility.

Reality: It’s true that there is typically less privacy in a nursing home facility than in other types of senior housing. Most rooms are shared by two residents, and caregivers may enter the room as needed-visitors, too, as desired. However, nursing homes are required to maintain a private area for visits with family, and most facilities try to respect residents’ privacy as much as is possible. Residents have the right to privacy, and to keep personal belongings and property as long as they don’t interfere with the rights, health or safety of others.

Myth #8: Nursing home residents have limited rights.

Reality: Nursing home residents retain all of their legal rights once they move in. In addition, Medicare has established a Nursing Home Residents’ Bill of Rights that clearly defines residents’ rights pertaining to: respect; services and fees; money; privacy; and medical care.

Myth #9: A move to a nursing home facility is a permanent move.

Reality: Most nursing homes have wings for both long-term care and short-term care. The long-term care wing is for residents, while the short-term care wing houses people who are recovering from an illness, injury or surgery and require rehabilitation. So while a move to a nursing home facility may be permanent for some people, many others return home once they have sufficiently recovered.

Myth #10: Nursing home residents are always on caregivers’ schedules.

Reality: It’s true that a structured schedule can enable caregivers to do their jobs in the most efficient manner possible. However, more and more rest homes are recognizing the need to address residents’ needs in a more holistic manner, and in a way that honors their dignity and preferences. This includes empowering residents with more options and autonomy in setting their own schedules.

Benjamin Franklin said it best – “nothing in life is certain except death and taxes” but with daily advancements in science, technology and health care, Americans are living longer than ever before*. This blessing however, has created a unique dilemma for modern American families: How to plan for and prepare for one’s retirement years.

Have you taken a road-trip lately? Almost every highway is graced with large bill-boards providing the locations of new planned communities where couples can spend their retirement years dedicated to recreational pursuits. I doubt you will find a local newspaper that doesn’t have at least one ad promoting the amenities found at a local assisted living facility. Try to search for “nursing homes in Virginia” on the Internet and thousands of web pages will appear. Each and every day new facilities offering different programs are being built and marketed across the state.

Is such a facility right for you and your family? If so, which facility? We often hear the terms “retirement community,” “nursing home,” and “assisted living facility” but rarely consider what these terms actually mean. The differences however, are striking and it is imperative to understand these differences when making choices for yourself or your loved ones.

NURSING HOMES

In Virginia, a nursing home means any facility with the primary function of providing long-term nursing care, nursing services and health-related services on a continuing basis, for the treatment and inpatient care of two or more non-related individuals**. Put simply, a nursing home is a facility designed for someone who needs less care than a hospital, but requires daily health care assistance.

The Virginia Department of Health licenses such facilities and has established guidelines regulating various aspects of their operations, programs, and staffing needs, etc***. For example, a nursing home must: (a) have written policies and procedures regarding the treatment of residents and the management of resident care which are available to residents and their families (12VAC5-360-20); (b) provide emergency medical services within 15 minutes, under normal conditions (12VAC5-360-50); (c) be subject to unannounced on-site inspections of the nursing facility by State employees (12VAC5-371-60); (d) have a written agreement with one or more physicians licensed by the Virginia Board of Medicine to serve as medical director (12VAC5-371-230); and (e) each resident shall be under the care of a physician licensed by the Virginia Board of Medicine (12VAC5-371-240).

In addition, residents of nursing homes are also given certain rights as defined by Virginia Code §32.1-138. See http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+32.1-138. Nursing homes are the most regulated and structured residential options for our Seniors requiring some level of daily health care. If the facility provides care through Medicare and Medicaid programs, it is deemed a “Certified nursing facility” (Virginia Code §32.1-123; Virginia Code §32.1-127) and must be in compliance with both federal and state laws.

Of course, the more rules and regulations that define and control the daily operations of a nursing home, the greater the responsibility of the staff. These are the people who will be charged with the daily task of caring for your loved one, and making sure they are in compliance with state and federal laws. No matter how nice and or attractive the facility might be, the staff will make the difference between your loved one being cared for and encouraged, or not.

A nursing home is best suited for someone:

Who requires daily health care – such as assistance getting in and out of bed; taking medicine; or using the restroom.

Who may have dementia or Alzheimer’s and as a result, is unable to eat and or bathe daily without reminder or assistance;

Who is recovering from a fall or accident and is therefore unable to walk, dress and or eat without assistance

ASSISTED LIVING FACILITY

“Assisted living facility” means an adult care residence which has been licensed by the Virginia Department of Social Services to provide a level of service for adults who may have physical or mental impairments and require at least moderate assistance with the activities of daily living. Within assisted living, there are two types: regular assisted living for those seniors (typically) who need assistance with one or more daily activity; and intensive assisted living for someone who may be incapable of performing activities due to mental and/or severe physical impairment (12VAC30-120-450).

The Virginia Department of Social Services licenses assisted living facilities but does not regulate in the way the Department of Health regulates nursing homes. While there are Virginia guidelines regulating aspects of assisted living facilities, they are limited: An assisted living facility must: (a) provide or coordinate personal and health care services; and (b) provide 24-hour supervision.

As reflected in the table below, assisted living facilities have no obligation to provide health care and/or have health care staff available to assist your loved one. In addition, with no obligation to provide such services, there is the question as to whether or not they owe a duty to warn or treat residents with illnesses or diseases that could be transmitted from other residents.

While a nursing home will have many nurses on staff and doctors hired to monitor the residents, assisted living is more analogous to an apartment building or college dorm where laundry and food services are provided and residents are on their own for the rest of the day.

An assisted living Facility is best suited for someone:

Who is basically independent but may not be able or willing to prepare their own food or drive to doctors’ appointments;

Someone who wants to scale back and anticipates needing assistance with laundry, cooking, etc. in the near future.

A couple where one spouse is independent but may need assistance in feeding and or providing for needs of other spouse.

CONTINUING CARE RETIREMENT COMMUNITY

In Virginia you may also see advertisements for a retirement community. They are popping up all around our favorite College Towns and Tourist destinations.

A Continuing Care Retirement Community provides care depending on your current needs. Like an insurance policy, the resident pays an entrance fee and periodic adjustable payments, which in turn gives the resident a package of residential and healthcare services that the CCRC is obligated to provide at the time these residential and health care services are required. For example, if upon entering, all you want is help with your meals, that is the only service which will be provided. If you require intensive physical therapy or God forbid, daily assistance for a Dementia patient, the CCRC has assisted living services or nursing home services available under your contract. Continuing care contracts are regulated by the Virginia Bureau of Insurance of the Virginia State Corporation Commission.

Many CCRCs can have nursing home services available either on-site, or at licensed facilities off-site (12VAC5-360-10). While you may be entering the Retirement Community as a very healthy independent and capable resident, as your needs change, so will your contract with the Community and in turn, the facility’s obligations to you.

A Continuing Care Retirement Community Facility is best suited for someone:

Who is basically independent but anticipates the need for daily health care for themselves or a spouse in the near future;

Someone who is physically disabled and would be unable to care for themselves or a spouse if the disability grew worse.

With at least three very different choices, it is very important to do your research:

To research assisted living facilities in Virginia, go to Department of Social Services website: http://www.dss.state.va.us/facility/search/alf.cgi.

To research nursing homes, go to Medicare’s website: www.medicare.gov.

AND LAST BUT NOT LEAST

It is always best to speak to a family member of a current resident and spend time getting to know the staff, no matter what type of facility you are looking into. If looking and researching is not enough, then consider the chart below – a comparison of the legal duties of a nursing home compared to the legal duties of an assisted living facility in Virginia.

DUTY or REQUIREMENT

NURSING HOME

ASSISTED LIVING

Duty to provide nursing care and or monitor resident’s health?

YES

NO

Doctor required to supervise residents?

YES

NO

Each resident shall be under the care of a physician licensed by the Virginia Board of Medicine?

YES

NO

Must have nurses on staff?

YES

NO

Must offer rehabilitative services?

YES

NO

Must have ongoing consultation from a registered dietitian or dietitian on staff?

YES

NO

24 Hour Supervision required?

YES

YES

Must develop a written plan upon admission of resident?

YES

YES

Staff must undergo criminal background check?

YES

YES

Monitored by Virginia Center for Quality Health Care Services and Consumer Protection

YES

NO

Monitored by Department of Social Services

NO

YES

*Life expectancy increased dramatically during the past century, from 47 years for Americans born in 1900 to 77 years for those born in 2001. These same factors—improved medical care and prevention efforts— that are partly responsible for the dramatic increases in life expectancy have also produced a major shift in the leading causes of death in the United States in the past century, from infectious diseases and acute illnesses to chronic diseases and degenerative illnesses.” The State of Aging and Health in America 2004, published by the Center for Disease Control, available at http://www.cdc.gov/aging/pdf/State_of_Aging_and_Health_in_America_2004.pdf.

**See generally, Virginia Code §32.1-123, as amended and Virginia Administrative Code § 12VAC5-360-10.

***It is a Felony under Virginia law to operate a nursing facility without a license. See generally, 12VAC5-371-30.

According to the Occupational Outlook guide, the nursing profession is among the fastest growing of all career paths. Within nursing, the single specialty expected to grow by leaps and bounds is gerontology. The aging of the baby boomers has increased the average age of the typical patient. According to one survey, patients over 65 make up 60 percent of adult primary visits, 48 percent of inpatient hospital admissions and 85 percent of nursing home residents. By the year 2020 – less than 15 years from now – a study from Occupational Health and Safety Administration predicts that the need for registered nurses in nursing homes will increase 66%, for licensed practical and vocational nurses by 72% and the need for certified nursing assistants will increase by 69%. For nurses working in home health settings – which include ‘managed care’ nursing home settings – those numbers are even higher – well above 250% increase in nurses needed at every level of licensing.

In other words, if you’re planning a career in nursing or are already a nurse, there are thousands of jobs available for you in nursing homes and chronic care facilities. The face of geriatric nursing has also changed considerably over the past decades. If your image of a nursing home is one of bleak halls and hopeless, helpless patients, then a visit to many of today’s nursing homes will offer an unexpected and pleasant surprise.

Nursing Home Jobs In the New Millennium

This generation of seniors is more active and more determined than any other that has come before them. It’s led to major changes in the practice of long term elder care. If you decide that a nursing home job is for you, here are some of the options that you can explore.

On Site Nurse in Senior Housing

Many seniors don’t need round the clock nursing care, but do need some nursing supervision. Senior housing communities often have an on-site nurse who is available to help residents with medication problems, take care of routine medical care and be available in case of an emergency. The nurse on site will also often consult with doctors who work with individual residents to help manage any medical care that they need. The pay scale is generally quite good, and the hours closer to a regular work week than in many other geriatric nursing jobs.

Continuing Care Retirement Community Nursing Jobs

Unlike traditional nursing homes, residents of CCRCs have and maintain their own apartments with whatever support they require to remain as independent as possible. Nursing job opportunities in CCRCs range from managed care nursing similar to the duties of a head nurse in a hospital to providing personal care to individual residents. CCRCs offer opportunities for skilled nursing care, medical case management and licensed practical nursing.

Rehabilitation Facilities

Not all nursing homes cater to long-term geriatric patients. As hospital costs have risen, the trend has been to discharge patients to rehab facilities and convalescent homes rather than keep them in the hospital until they’re ready to go home. Nurses in rehab facilities and convalescent homes get to be part of the recovery process, and many take great pride and joy in watching a patient advance and recover. Convalescent home jobs include charge nurses, floor nurses and nursing assistants as well as physical and occupational therapy specialists.

Traditional Nursing Home Jobs

Even traditional nursing homes are far different than they were a few decades ago. A nurse specializing in gerontology in a nursing home can expect to work with patients in the long term. The jobs available range from head nurses for an entire facility through floor charge nurses who are responsible for overseeing the care and medical needs of one wing or floor and certified nursing assistants who do much of the hands on nursing care.

Selecting the proper medical care facilities may now be a simpler task, courtesy of a wide variety of services that are available now for the elderly. Some of the assisted living facilities available for retired folk may look like a state or a tiny community of their own. You may also have an in-house care should you want to remain in your own house. Below are some axioms on how it’s possible for you to choose the right one.
First, you will need to help your elderly member of the family into going thru an assessment process. This is an important step to help work out what level of healthcare your loved one may need from the home. If your beloved one is still independent and doesn’t have any repeated or pressing mental or physical problems that may require a more close-knitted care service, then you’ll go together with home care. This permits the one you love to stay in their homes while still getting correct assistance. You are also much safer when you choose to sign up with accredited assisted living facilities. Many people focus on location alone for their selection criteria, but the facility should be visited and investigated to make sure they have all the amenities needed. Today in this world of passionate work style, the elderly, who are medically unfit, also have an opportunity to live a high quality life at their home.
Certain care facilities provide community-based activities such as congregate meal programs, financial support programs and home maker services. This can help boost the output of the aged, and encourage them to contribute to society even at their late age. This service plan is based upon the resident’s individual needs and desires. These individual plans are implemented by a staff of qualified and caring nurses, certified nursing assistants, and aides. .

There really comes a time in our lives when we find it difficult to look after ourselves. The change comes in dramatically like when we have just come from a recent illness or just suffered an accident. Whichever is the case, we are forced to stay home and seek the help of other people. It will be good if we have family and friends whom we can depend and who will extend their assistance. If this is not possible, then there are support social services such as the National Health Service or home care facilities that will provide district nurses to come and visit you. Yet others will be forced to stay either in assisted living facilities or in Florida nursing homes, whichever accommodation would satisfy them and be able to meet their needs.

Florida nursing homes, or if you wouldn’t be comfortable with that, could also called be called Florida convalescent homes, care homes, skilled nursing units, or just a rest home. It is a place where people who need care due to physical deficiencies or who could not sustain the activities of daily living will be attended to. While it may be very popular for the elderly and the seniors who have gone past their retirement age, it can also be a facility for younger adults, specifically 18 years or older, who have physical, mental, and emotional disabilities. Proper treatment and care are given them depending on their needs. There will be physical, speech, or occupational therapists who will focus to all their needs.

Among the services provided in Florida nursing homes are the services of registered nurses, nursing aides, and nursing assistants and a couple of therapists–speech, physical, and occupational. There are also recreational assistants and social workers who will likewise provide any kind of assistance that the residents would need. There are 4 nursing assistants for every 10 residents while 7 to 13 registered nurses for every 100 residents. Room and board for the residents are also among the services in Florida nursing homes. That is why in most nursing homes, care is facilitated and provided by certified nursing assistants but is strictly supervised by their skilled professionals.

As opposed to the concept of nursing homes, assisted living facilities are another option for those considering of senior care. It is another type of residence basically for seniors and elderly who can be independent but will need help in managing some of the basic day-to-day activities. Typical assisted living facilities would resemble an apartment community with each resident living in separate units. The staff would be there each day to check on them and help them with some of their personal chores while a licensed nurse would be on a 24-hour duty to respond to emergencies. Most residents in assisted living facilities would include individuals who still maintain an active lifestyle but for the peace of mind of their family members would admit them in assisted living facilities for constant care and assistance if and when needed. Some assisted living facilities would even provide transportation for their residents when they would go on a medical appointment or when they need to go out for a scheduled outing.