Eight Nursing Home Secrets You Should Know
||Dr. Jodee Graifman Meddy, DO, MS, LNHA|
Co-founder of SeniorSite.com.
Dr. Jodee Meddy is a nationally acclaimed Doctor, Licensed Nursing Home Administrator and an expert on Long Term / Extended Care issues and Nursing Homes.
Eight Nursing Home Secrets You Should Know
There’s a quiet revolution going on in nursing homes
across the country, one that will affect millions of Americans for the
better. This year, over 2 million Americans will live as residents in
nursing homes for recuperative or rehabilitative care. But the actual number
of people touched by nursing homes is far greater, including residents,
along with their families, friends and support groups – effecting tens of millions.
1. The Placement Process: Medical Eligibility for Nursing Home
The first step in the selection of a nursing home is to establish the
medical and nursing needs of the individual to see if he or she medically
qualifies for admission to a nursing home in New York State.
To determine an individual's medical eligibility, a Patient Review
Instrument and Screening Instrument--generally referred to as the PRI and
Screen--must be completed according to the state's Department of Health
The PRI measures an individual's ability to perform activities of daily
living such as eating, dressing, bathing, transferring from bed to chair and
vice versa, and toileting, as well as the level of nursing care needed.
The Screen, based on this assessment and other social factors including
whether or not the individual has access to help from family or friends in
the community determines if the individual can be cared for in the community
with home care services or is in need of nursing home care.
2. How to get the PRI and Screen Completed
If the individual is to be transferred directly from the hospital to the
nursing home, hospital social service or discharge planning staff will help
you obtain a completed PRI and Screen.
It is important to work with the hospital social worker as the nursing home
process unfolds. If the individual is at home, you must call a certified
home health agency that has staff qualified to complete the PRI and Screen.
During the home visit, it is essential for the caregiver to be present
during the evaluation to help provide a realistic picture of the
individual's medical, nursing, and social needs and to help ensure that the
assessment is comprehensive.
3. It’s all about change.
No one likes change, but nursing homes are undergoing a staggering number of
changes to improve the quality of care and resident life. This approach is
called "culture change" and is designed to make nursing homes feel more like
home, and less like a hospital, by providing residents with a variety of
choices in their schedules to make their days less routine. Examples of
culture change include the Pioneer Movement, The Eden Alternative and
Wellspring Program. “These programs attempt to ‘deinstitutionalize’ the
facility by personalizing the environment and care process whether that
means keeping pets, moving in home furnishings or taking into account the
diversity of resident populations”, says Jodee Meddy. Being prepared for
these changes is important for residents and their families; Jodee Meddy
recommends that residents and caregivers discuss how to implement a strategy
with the facility that will make the transition comfortable and successful.
4. Meeting residents’ needs is job one.
Professional nursing home caregivers recognize the importance of
person-centered or resident-centric care, building new systems to elicit and
meet residents’ choices, providing security and care, and supporting their
personal growth. Residents and caregivers should document and share choices
and needs with nursing home professional staff. Jodee Meddy recommends
active participation in the care planning process by residents and their
families as a key ingredient to meeting the resident’s needs.
5. It’s not your grandmother’s nursing home any longer.
Many people are surprised to discover that traditional nursing homes for
older residents also provide care for younger adults, for rehabilitative
care or sub acute care following an accident, surgery or serious illness.
Jodee Meddy recommends that residents and caregivers learn about the nursing
home’s specific healthcare practice areas and specializations, to assure
they choose the facility that best meets their needs.
6. You may actually like the food.
Contrary to popular belief, not all institutional food is, well,
institutional –some nursing homes cater to residents’ cultural palettes.
Kosher, Asian and Indian cuisine are just a few of the menu variations to be
found in some nursing homes. In fact, one Southern nursing home recently
added hot sauce to the menu after residents complained about their bland
diets. Jodee Meddy recommends inquiring about the menu options available at
any facility you are considering.
7. You do have a say.
Residents and their families are actively involved in improvements to their
treatments and environments, and discussing improvements in the quality of
care and quality of life with administrators and caregivers is very
appropriate – as those residents in the southern nursing home found, nursing
homes are listening. In fact, resident councils are a federal requirement,
and some states even require the creation of a family council as well. Jodee
Meddy recommends that you ask about resident and family councils and how
they interact with the facility – perhaps you can set up some time to speak
with a council member.
8. You can shop around.
This being the “Internet Age,” there are a number of terrific resources
available for learning about long-term healthcare options and finding
nursing homes. Jodee Meddy recommends shopping around to ensure that the prospective
resident gets the most appropriate services and the best value.
Jodee Meddy contends that the industry is evolving with terms such as
specialization, diversity, service and value coming to the forefront. “So
much information is accessible online” says Jodee Meddy, “Within minutes you
can now find and contact nursing homes in a way never possible before.”
Summing up her six recommendations by noting that the industry is changing,
Jodee Meddy states “We don’t ‘put’ people in nursing homes anymore, it’s a
new world for this industry, a world that will continually evolve. The key
to a successful match is understanding the choices and doing your homework
to find the right facility.”