Skilled Nursing Facilities and Custodial Care

As the population ages, more of us are faced with the prospect of moving either ourselves or an older family member into a nursing or convalescent home. It may be a decision that arrives suddenly following hospitalization, or gradually as needs become more difficult to meet in other types of housing.

Deciding to move can be stressful, often due to misconceptions about these facilities. To make a decision that's right for you or a loved one, it's important to learn all you can about nursing homes.

A nursing home is normally the highest level of care for older adults outside of a hospital. Nursing homes provide what is called custodial care, including getting in and out of bed, and providing assistance with feeding, bathing, and dressing.

However, nursing homes differ from other senior housing facilities in that they also provide a high level of medical care. A licensed physician supervises each patient's care and a nurse or other medical professional is almost always on the premises. Skilled nursing care is available on site, usually 24 hours a day. Other medical professionals, such as occupational or physical therapists, are also available.

This allows the delivery of medical procedures and therapies on site that would not be possible in other housing.

The label "nursing home" has negative connotations for many people. Yet nursing homes provide an important component of senior housing options. It's important to separate nursing home myths from facts.

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Myths about nursing homes

If I can't take care of myself at home, a nursing home is the only option.

Today, there are many options to help older adults stay at home, ranging from help with shopping and laundry to caregiving and visiting home health services.

If home care options are no longer possible, other options, such as assisted living, maybe a better fit if the primary need is custodial care rather than skilled medical care.

Even if hospice care is being considered, home care is also often a possibility.

Nursing homes are for people whose families don't care about them.

Many cultures have strong beliefs that it is a family's duty to care for elders. However, in today's world of smaller families living farther apart, work conflicts, and people living longer with more chronic illness, it simply may not be possible.

Considering a nursing home does not mean you don't care about your family. If you cannot provide the necessary care, it is the responsible decision to find a place where your family member's needs will be met.

Nursing homes are poorly run, and I or my family member will get awful care.

While it is key to research homes thoroughly and visit frequently, it is not true that all nursing homes provide poor care.

There are more and more safeguards in place, and a facility's staffing information and any previous violations are available to the public to help you make your decision.

Once I'm in a nursing home, I'll never leave.

Some illnesses or injuries have progressed to the point where both ongoing medical and custodial care may be necessary through the end of life.

However, many people encounter a nursing home for the first time after a sudden hospitalization, such as from a fall or stroke.

After rehabilitative care, either returning home or to another housing option may be a better fit.