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May 17, 2022

You'll never be completely prepared to place your parents or a disabled loved one in a nursing home. But, it's best to be ready if and when that moment comes. It is estimated that 50% of the older adults in the U.S. will spend at least a night in a nursing home.

However, it's sad to note that many families only check out a nursing home when forced by a medical emergency. As a result, they are often unprepared and make fast selections regarding which facility would work for what may be a long time.

Yes, it is a harsh reality, but don't be concerned. Sure, it should make you feel a little more pressured about your plans and the possibility of needing to make this terrible decision for your parents or loved ones, but that's where This Is Getting Old can help.

Watch the full episode or listen to the podcast of Episode 106: What is a Nursing Home? Five Things to Know. Take note of the essential things you need to know about Nursing Homes and correct some misconceptions as you stay tuned.

Key points covered in this episode: 

✔️What Is A Nursing Home?

A nursing home is where you go when you need care but you don't need to be at a hospital, but you also can't be cared for at home. It's a middle ground between the hospital and home care. 

Nursing homes play an essential role in our society, yet many people still negatively think about them. 

Why is that so? The negative impression can be attributed to the history of poor care, abuse or neglect that follows this industry after 35 years of regulation by the Federal Government.

On the bright side, many good people are working in this industry, and they're working to improve the quality of care until it gets where it needs to be for older adults and people living with disabilities.

 ✔️ Who Pays For Nursing Home Care?

  • Federal Dollars: Nursing homes take federal dollars in the form of Medicare for up to 100 days, but not 100% of the bill.
  • Private Pay: After those 100 days of your Medicare coverage and you don't have supplemental insurance, you have to pay out of pocket for the difference.
  • State Dollars: Nursing homes take state dollars, which is Medicaid. But Medicaid is only for people over 65, not people with disabilities who have spent down their own money or otherwise qualify for Medicaid. 

✔️What Type Of Care Is Provided In Nursing Homes?

Skilled care! It is at the heart of distinguishing a skilled nursing home from assisted living. Skilled means that a licensed nurse provides some of the needed care each day. 

✔️Who Provides Skilled Care In A Nursing Home?

Licensed nurses provide skilled care in nursing homes. This could be a baccalaureate-prepared registered nurse, an associate degree registered nurse, or an LPN (licensed practical nurse). A nursing home must have a licensed nurse in the building 24 hours a day, which could be an R.N. or an LPN. The facility also needs to have a registered nurse that's either the baccalaureate or the associate degree level in the building eight hours a day, seven days a week and on-call 24 hours. 

How does skilled care make Nursing homes different from assisted living?

Nursing homes are very different from assisted living. Many assisted living advertised providing nursing care, but they're not actually talking about licensed nursing care.

✔️Who Provides Most Of The Care In Nursing Homes?

Certified Nursing Assistants or CNAs do the bulk of the care that's provided to nursing home residents. All nursing staff in nursing homes are underpaid, but CNAs bear the worst of it. They aren't even paid a livable wage, which has to change.

✔️What Other Things Could Be Considered Skilled Care?

Rehabilitation is another skilled care provided by nursing homes. This is done by our physical therapist, occupational therapist, or speech therapist, who are essential team members in the building Monday through Friday during regular business hours. They help our residents get stronger, help them re-learn to do things, help them be independent or they can re-learn communication skills, even help with swallowing.

If you have questions, comments, or need help, please feel free to drop a one-minute audio or video clip and email it to me at melissabphd@gmail.com, and I will get back to you by recording an answer to your question. 

About Melissa Batchelor, Ph.D., R.N., FNP-BC, FGSA, FAAN:

I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my Ph.D. in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the George Washington University (G.W.) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the G.W. Center for Aging, Health, and Humanities. Please find out more about her work at https://melissabphd.com/.