Your Complete Guide to Nursing Homes

What is a nursing home?

Nursing homes, sometimes called skilled nursing facilities, provide nursing care and long-term housing for seniors. Elderly adults who need long-term care at a nursing home facility often have significant physical or mental health conditions that require 24-hour nursing and personal care. These facilities offer the highest level of care for seniors who need medical care, but don’t require hospitalization.

Nursing homes also provide short-term, rehabilitative care after a hospital discharge. Rehabilitation programs at nursing home facilities help seniors recovering from an illness or accident regain mobility, strength, and function until they can return to normal activities.

What’s the difference between nursing home facilities and other senior care types?

Nursing homes offer a high level of medical and skilled nursing care that is not available in other types of senior living facilities. While many senior living and care communities may offer help with personal care and daily activities, only nursing homes provide residential and skilled nursing care for seniors who need specialized medical care throughout the day, but don’t need to be hospitalized.

Nursing homes vs. other senior care types

Nursing homes vs. assisted living

Nursing homes and assisted living differ in important ways, although some people may think of these two types of senior care facilities as synonymous. Both nursing homes and assisted living facilities offer housing, meal services, and help with personal care. However, seniors in assisted living communities are generally active and relatively independent, although they may need help with certain daily tasks. Nursing home residents typically have debilitating health problems or serious chronic conditions that require 24-hour care, skilled nursing services, or rehab therapies.

Like assisted living, nursing homes also offer social activities for residents, although options may be more limited than in assisted living facilities. This is because nursing homes often focus on medical care, while assisted living communities aim to improve quality of life through personal care and social engagement.

Nursing homes vs. memory care

Both nursing homes and memory care facilities offer 24-hour care and supervision, assistance with activities of daily living, and prepared meals. However, nursing home services cater to people with a variety of severe health problems, while memory care specializes in caring for people with memory loss.

There are other differences between nursing homes and memory care. Memory care doesn’t provide skilled nursing services like nursing homes often do. And while nursing homes usually focus on residents’ physical and mental health, memory care aims to enhance the quality of life for people who have Alzheimer’s disease or another form of dementia through specialized care and  activities in a secure environment designed to reduce confusion and prevent wandering.

Nursing homes vs. home care

Home care offers care for seniors who wish to age in place and provides support and respite for caregivers. Home care aides are trained in senior care and can help with personal care, light housekeeping, cooking, transportation, and more.

Home care doesn’t offer the skilled nursing care provided at nursing homes. However, it’s possible to combine home care with home health to receive skilled nursing care at home from licensed health care professionals. Home health is different from home care and must be prescribed by a physician. Home health services include short-term rehab therapies, nursing care, wound care, injections, and more.

Even when combined with home health, home care may not be sufficient for seniors who need 24-hour care or for those who need more intensive therapies. Home care costs may also be prohibitive to seniors who need round-the-clock care, as fees are charged by the hour and based on the level of care needed. Plus, caring for an aging loved one at home may also require difficult or costly modifications to make the home safe and accessible, including additions such as ramps, wider doorways, chair lifts, and walk-in showers.

Is a nursing home right for my loved one?

Many people use the term “nursing home” to describe all types of senior living. However, senior living has greatly evolved over the years, and nursing homes are no longer the only senior care option. Seniors and families can choose from a wide variety of senior care services and senior living communities to find the best fit for their needs, lifestyle, and budget.

Nursing homes are for seniors who are seriously ill or have a severe health problem, or for those who are recovering from injury or illness and need short-term skilled nursing or rehab care. Nursing home residents often need a higher level of care than what assisted living facilities offer.

Common health conditions among elderly adults in nursing homes include Alzheimer’s or other forms of dementia, arthritis, high blood pressure, and heart disease, according to the Centers for Disease Control and Prevention (CDC). Seniors in nursing homes may be severely incontinent, bedridden, or on a feeding tube, and typically require 24-hour specialized care from a licensed health care professional, such as a registered nurse or physical therapist.

A nursing home facility may be the right choice for your aging loved one if they:

• Need medical or skilled nursing care throughout the day.
• Need rehab or skilled nursing care after a hospital stay.
• Require 24-hour care and supervision.
• Need significant help with mobility and transfers.
• Are at high risk for falls.
• Suffer from urinary or fecal incontinence.
• Need help with activities of daily living, such as bathing and grooming.

What qualifies a person for nursing home care?

Before determining whether a nursing home is the right choice for your aging loved one, it’s important to understand the requirements for admission at a nursing home facility. Eligibility for nursing home care varies by state. This means a senior may qualify for nursing home care in Kansas, but not in New York. It’s important to contact your Medicaid or government county agency to understand your state’s requirements.

In general, seniors who qualify for nursing home care are severely debilitated or have serious chronic conditions. A physician must document any medical needs for skilled nursing or rehabilitative services, as well the need for assistance with daily activities and continuous supervision, or care for serious cognitive impairment.

A physician determines need by performing a physical examination and obtaining a medical history. Other medical tests may be required. The evaluation also helps determine which medications and treatments will be provided to a senior who qualifies for care at a nursing home facility.

Elderly adults who are eligible for nursing home care will need to fill out state and admission forms before moving. Those who don’t qualify for a nursing home but need help with personal care or medication management may find an assisted living facility or memory care community good senior care options instead.

When is it time for nursing home care?

For many families, moving a family member to a nursing home may be a difficult decision. However, when it’s no longer safe for a senior loved one to live on their own, considering senior care options may be the most caring thing to do. It may be time for a nursing home if your senior loved one:

• Needs 24-hour medical or skilled nursing care. If your family member is gravely ill or has a serious, progressive medical condition, they may need specialized care from the licensed health care professionals at a nursing home.
• Isn’t mobile. Seniors who are bedridden or need significant assistance with mobility or transfers may require nursing home They may need help with daily activities, incontinence care, and nursing care for bedsores.
• Are at high risk for falls. Falls are leading cause of serious head injuries and hip fractures in elderly adults. Nearly three million older adults end up in the emergency room each year because of fall injuries, according to the CDC. If your loved one falls frequently or is at increased risk for falls, they may need care from specialized staff who know how to minimize fall risks.
• Can’t feed themselves. Elderly adults who can’t feed themselves or are unable to maintain dental hygiene on their own may benefit from nursing home

Seniors who are recovering from injury or illness may also benefit from rehabilitative care at a skilled nursing facility for a short period of time after being discharged from a hospital. However, skilled nursing facilities are not the only option for those who need rehab. There are several factors to consider when choosing between a skilled nursing facility and a rehab center, including the length and intensity of the rehab program, access to specialists, costs, and insurance coverage. In some cases, it may also be possible to receive rehabilitation care at home or at an assisted living community. It’s important to discuss rehabilitation goals with a doctor to choose the best option for your loved one.
In addition to thinking about your loved one’s needs, consider your own well-being when assessing whether it’s time to move your family member to a nursing home:

• Can you provide the level of care your senior loved one needs at home? Seniors who have a serious health condition or cognitive impairment may need full-time care from licensed health care professionals that a caregiver simply can’t offer at home.
• Can you provide full-time care? More than 60% of caregivers have to juggle caring for a senior loved one with a career and other family responsibilities, according to a 2020 AARP Survey. In some cases, caring for an elderly family member who needs 24-hour care while also maintaining a job may not be possible without significant help. Hiring an in-home caregiver can provide support and respite for family caregivers, but it may be costly, depending on how much care is needed.
• Is caregiving affecting your health? Even if you don’t work outside the home, you may have little time to care for your own health or other relationships while caring for someone full time. The 2020 AARP Survey indicates that one in five family caregivers rate their health as fair or poor, and 23% of the survey respondents say it’s difficult to care for their own health while caring for a loved one.
• Are you feeling burned out? Caring for an aging loved one can put a caregiver at risk for stress, depression, and chronic conditions, like diabetes or heart disease. If you feel like you can’t care for an aging parent any longer, it may be time to consider senior care options.

How much does a nursing home cost?

Nursing home costs depend on certain factors, including location and the level of care your loved one needs. The median monthly cost of nursing home care in the U.S. is about $7,989 for a semi-private room and $9,086 for a private room, according to Genworth’s Cost of Care survey.

The cost of nursing home care is high because residents at these facilities often have a variety of chronic medical needs and typically require more help with personal care. The level of care provided at nursing homes is also higher than what other senior living communities offer, with services ranging from dialysis to wound care, injections, and more.

Nursing home costs vary greatly by state. Seniors living in East Coast states, Hawaii, or Alaska will pay more for nursing home care than those living in the Midwest or Southern states.

Typically, nursing home costs will cover a semi-private or private room, meals, skilled nursing care, rehab services as prescribed by a physician, and recreational activities offered at the facility.

How do nursing home costs compare with the cost of other senior care types?

Because nursing homes offer a higher level of care, the cost of care at nursing homes is significantly higher than assisted living and home care costs. And although increased security, specialized staff, and more one-on-one time for residents add to the cost of memory care, nursing home costs are still higher in comparison.

It’s important to note that the cost of care at senior living facilities varies based on many factors, including location, level of care needed, community amenities, type of room or apartment, and whether accommodations are private or shared. The cost information below is the monthly median cost, according to Genworth’s Cost of Care Survey and 2019 A Place for Mom Move-in Data.

Sources: Genworth Cost of Care Survey and 2019 A Place for Mom Move-in Data

How do you pay for nursing home care?

Once you’ve determined that your loved one is eligible and a nursing home is the right choice for them, it’s time to understand your options for financing care. Do some research to be sure you understand all your options. There are many ways to pay for nursing home care, including:

• Medicare. Long-term nursing home care isn’t covered by Medicare. However, Medicare does cover the costs of short-term care or rehab services at skilled nursing facilities. This may help cover the cost of care for seniors recovering from an injury or illness after a hospital stay.
• Medicaid. Seniors with limited income and resources may qualify for financial assistance for long-term care at a nursing home under Medicaid. However, eligibility requirements vary by state. It’s important to contact your state’s Medicaid office to understand the requirements in your area.
• Veterans’ benefits. A veteran or their widowed spouse may benefit from the VA Aid and Attendance program. If your loved one is eligible, they may receive a supplemental income to help pay for senior care at a nursing home. The VA also provides a pension to eligible veterans that may help cover the costs of nursing home
• Bridge loan. Short-term loans can help fund senior care at a nursing home while you’re waiting for veterans benefits, selling your parent’s home, or liquidating other assets to cover costs.
• Home equity. You may be able to sell your parent’s home, rent it, or apply for a reverse mortgage to convert equity into funds to pay for nursing home
• Long-term care insurance. Ask your loved one if they’ve purchased long-term care insurance. Often, this type of insurance can be used to cover long-term care costs at a nursing home facility.
• Life insurance. Check if your loved one’s life insurance policy may be sold for a lump sum to help fund long-term care.

How do I choose a nursing home facility near me?

Finding a nursing home for your loved one may feel overwhelming. You may have many different facilities to choose from, so how do you know which one is right? Experts suggest starting with your family member’s prioritized needs.

Ask yourself these questions:

• What medical conditions does my loved one need care for?
• How much help with daily activities do they need? What can they do on their own?
• Are they mobile? Do they need help with transfers?
• Do they have any dietary restrictions? For example, do they have diabetes or kidney disease?
• Are they willing to share a room or do they need a private space?
• What type of social activities do they enjoy?

Some key factors to consider include:

• Medical services. When visiting nursing homes in your area, it’s important to understand the types of medical care offered — services may vary from one facility to the next. Ask specific questions about the care offered based on your loved one’s condition.
• Staff expertise. Ask about the staff training and experience. Nursing homes typically have doctors, nurses, therapists, dietitians, and other licensed health care professionals onsite. Also be sure to ask how many nurses and other staff are available per resident during the day and night.
• Facility safety and cleanliness. When visiting a facility, pay attention to whether common areas are clean and free of unpleasant odors. Notice whether the facility looks well maintained, and if it has adequate lighting, clearly marked exits, and accessible features, such as grab bars in hallways and bathrooms.
• Care plans. How are care plans developed and how often are they updated? What happens if your family member’s health changes?

Other considerations when choosing a nursing home include cost and facility amenities, recreational activities, meal services, and whether menus cater to dietary preferences and restrictions. It’s also important to notice whether residents seem clean, happy, and well cared for, and how staff keep families informed of their loved one’s health and care.

Ultimately, there’s no substitute for visiting and experiencing a typical day. Touring a facility provides opportunities to see the building, assess cleanliness, witness staff interactions with residents, observe meal time, and talk to other residents.

As you tour different facilities, be sure to ask whether the nursing home you’re visiting is Medicare or Medicaid certified and licensed. You may also check the facility’s rating on the Medicare website.

How do I move a loved one to a nursing home?

Moving a parent to a nursing home can be an emotional and sometimes stressful experience. You may feel guilty or anxious about the move, and wonder whether your senior loved one will adapt and receive the care they need. Your family may not agree with your decision, or you may be struggling with how to talk with your parent about moving.

Taking a step-by-step approach can ease anxiety and make the move smoother for your family and your aging loved one.

Talking to your loved one about nursing home care

Elder care is a difficult but important topic that families ultimately can’t avoid. Having regular conversations about senior care before an emergency situation arises is often best. Planning ahead will give you and your family time to think about options and discuss what you need to do to prepare.

However, if your aging parent needs immediate help, it’s time to hold a family meeting. Consider your family dynamics to decide who to include. If your senior loved one is in good mental health, it may be a good idea to involve them.

Set aside dedicated time, without distractions, to discuss their needs and potential solutions. It’s also important to be open to having a series of conversations before your family agrees on the right senior care choice.

Planning for moving day

If you’re stressed about moving day, plan ahead and consider finding expert assistance to help with this major transition. A senior move manager specializes in helping seniors downsize, relocate, and move. Delegating what can be an emotional task may help reduce tension, prevent family conflicts, and ease the burden on families and caregivers.

Before deciding what to take when moving your family member to a nursing home facility, it’s important to understand the space your loved one will have after they move. Whether they share a room or have a private space, they might want to bring some personal items, such as toiletries, clothing, photos and keepsakes, jewelry, and eyeglasses. They may also want to bring certain items for entertainment, like books, hobby supplies, and a computer or tablet.

Before moving day, also be sure to ask staff at the facility whether:

• Bedding and towels are provided.
• A TV is available in the room.
• It’s possible to bring a small fridge.
• Laundry services are included.
• Internet access is available for residents.

Make your loved one’s new space feel more like home with familiar items and photos of family and friends before they arrive. Arrange their belongings in a way that reminds them of their previous home, but avoid cluttering the room. Instead, try to create a calming, comfortable space for your loved one.

Before moving day, remember to also:

• Set up mail forwarding with the U.S. Postal Service.
• Cancel current utility services.
• Inform friends and family about your loved one’s move.
• Add the community’s contact information to your devices.

How do I find a nursing home near me?

With so many options and factors to consider, determining whether or not a nursing home meets your loved one’s needs may seem like an overwhelming task. Our Senior Living Advisors can help you consider your aging relative’s needs, your expectations for care, and your financial resources to find the right care for your loved one.