Questions most often asked about Skilled Nursing & RehabilitationPosted: Updated:
Who is an appropriate candidate for a Nursing Home or Skilled Nursing Facility?
Each senior's need for care or assistance is unique. Some individuals may have a short-term need, perhaps caused by a fall and a broken hip, that necessitates a brief hospitalization followed by rehabilitation. After a one- or two-month Nursing Home stay, the senior may be able to return home and continue receiving some services such as physical therapy from a home health care agency, if necessary.
Other people have more long-term needs, possibly due to Alzheimer's, extreme frailty, or a stroke. In this case, care is necessary on an ongoing basis.
A Skilled Nursing Facility is for an individual who meets one or more of the following criteria:
- Cannot take care of themselves because of physical, emotional, or mental problems;
- Can no longer care for their own personal needs, such as eating, bathing, using the toilet, moving around, or taking medications (custodial care);
- Requires more care than can be provided by their caregiver, and cannot live alone;
- Might wander away if unsupervised;
- Has extensive medical needs requiring daily attention or monitoring by an RN supervised by an MD;
- Is going to be discharged from the hospital and requires temporary Skilled Nursing care or rehabilitation before returning home or to a residential facility;
- Has been recommended for a Nursing Home by a physician.
Skilled Nursing Facilities provide a private or shared room with a private or shared bathroom. Some Nursing Homes allow couples to stay together, and some may even allow pets. With the emphasis on patient care, however, the general ambiance has precluded much privacy or a sense of "home".
Increasingly, however, creative architectural design has made some Nursing Home living arrangements more homelike. Through the use of natural fibers and lighting, for example, many spaces throughout the Nursing Home feel friendly and warm. Many resident rooms and hallways may be carpeted, with new carpet material that can be easily cleaned on a daily basis. In addition, outdoor courtyards and indoor plants enhance livability and personal comfort in some of today's Nursing Homes.
Another major design change that's beginning to appear is in nurse's stations. Formerly centralized for efficiency, a Skilled Nursing Facility nurse's station can now be more like a reception area where residents and staff can easily interact.
Nursing Homes/Skilled Nursing Facilities offer an array of services, in addition to the basic skilled nursing care and the custodial care. They provide a room, all meals, some social activities, personal care, 24-hour nursing supervision and access to medical services when needed.
Basic Nursing Home Services generally include:
- A clean, furnished room (private or shared)
- Dietary services: nutritious meals and snacks, in accordance with medical requirements
- Housekeeping and linen service
- Personal (custodial) care (including incontinence care)
- Therapeutic recreation and activities
- Transportation (some)
- 24-hour onsite medical staff: registered nurses (RNs), licensed practical nurses/licensed vocational nurses (LPNs/LVNs), and nurses' aides
- Supervision by physicians, some of whom are on call to consult with staff and visit patients as needed
- Resident evaluation and care planning
For an additional fee, many Nursing Homes provide:
- Rehabilitation services: occupational, physical, respiratory and speech therapy
- Pharmacy, laboratory and radiology services
- Dental services
- Special care units (see next section)
- Personal care items
- Laundry service
The key characteristics of Skilled Nursing Facilities include:
|Key Characteristics of Skilled Nursing Facilities|
Activities of Daily Living (dressing, personal care)
comprehensive assistance provided
Community Activities (social events, outings, golf, etc.)
a few activities offered
Community Services (laundry, cleaning, etc.)
many services provided
Health Services (medications, nursing care)
skilled nursing provided
Environment (personal freedom)
residents have limited independence
Overall Health (physical, emotional)
residents are in generally poor health
Adapted from SeniorHousingNet®
Some Skilled Nursing Facilities can handle the following special needs:
- Kidney dialysis treatment
- Alzheimer's and dementia care
- Respiratory care
- Parkinson's care
- Terminal illnesses (Hospice Care) in cooperation with a separate Hospice agency that visits the facility to provide specialized care
- Chronic psychiatric care
In addition, most Nursing Homes provide:
- Respite Care (care so that caregivers can take a break)
- Interim medical care (after a hospital stay)
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