When Is It Time for a Nursing Home? 6 Questions to Ask Yourself

Kara Lewis
By Kara LewisMay 5, 2021
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When researching or discussing senior care, the term “nursing home” may come to mind most readily. In fact, many people use this phrase to describe all types of senior living. However, services available today are much more varied and complex: In a survey of A Place for Mom (APFM) users, only 11% of families who contacted APFM about nursing homes ended up deciding that was the right type of care for their loved one.

When is it time for a nursing home, instead of a different senior living option, like assisted living? Nursing homes, also called skilled nursing facilities or convalescent homes, may be the right choice for seniors with a high level of daily needs or health concerns. Asking yourself these six questions can help determine if your senior loved one would benefit from this highly specialized and intensive care type, along with when to recommend a nursing home for your relative. 

1. Are they recovering from an injury, stroke, or surgery?

Though many seniors live in a skilled nursing facility long-term, they may also go to a nursing home temporarily to recover from a major health event. In these cases, seniors and their families may select a nursing home instead of in-home rehabilitation if they want more frequent care or believe they’ll achieve better results.

While in-home rehab programs typically encompass two or three days of treatment a week, skilled nursing facilities differ by giving seniors access to therapies five to six days a week. Skilled nursing staff will also carefully determine when it’s safe to discharge your family member. On average, short-term rehabilitation stays in nursing homes last four to six weeks, though care plans can vary widely.

2. Do they need access to 24-hour skilled medical care?

If the answer is yes, then it may be time to place your parent in a nursing home. Oftentimes, the need arises when health conditions have become too complex or debilitating for other, more moderate types of care.

For example, assisted living helps seniors with activities of daily living (ADLs)medication management, and some health treatments as needed. Nurses oversee care plans, aides provide care, and the community offers transportation to doctor’s appointments. But depending on the state and assisted living community, there are often care limits.

In contrast, a skilled nursing facility offers 24/7 access to medical care and supervision in addition to help with many ADLs. Care providers may include registered nurses, licensed practical nurses, certified nurse assistants, physical therapists, occupational therapists, and others. For families who need extra peace of mind, or seniors with unpredictable health issues, this round-the-clock care may prove to be crucial.

3. Do they have a complex, progressive, or cognitive health condition?

Seniors with complex, chronic illnesses, such as cancer and diabetes, progressive conditions, like muscular dystrophy and Parkinson’s, or advanced cognitive diseases, like Alzheimer’s and Huntington’s disease, may require nursing home care. It often depends on the level of care they need to manage their conditions and the number of challenges they face. For example, does your loved one need catheters, IV drips, a ventilator, or other specialized medical care? This may help families and caregivers decide when to put a loved one in a nursing home. Do they have complications from diabetes, or are they able to manage their blood sugar with limited help? The more assistance they need, the more likely it’s time to place a parent in a nursing home.

If your loved one has Alzheimer’s disease or another form of dementia, memory care is a growing and popular alternative to nursing homes. In these communities, staff are trained to maximize quality of life and decrease common, difficult dementia behaviors, such as anger, aggression, and confusion. 

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4. Do they fall frequently?

Answering, “When is it time for a nursing home?” may be found in your parent’s mobility. Falls present a serious, sometimes fatal danger for the elderly. If your senior loved one falls often, this can be a key indicator they can no longer live safely at home. Nursing home staff have experience caring for older adults with mobility challenges, and facilities are designed to minimize safety risks.

5. Do they use a wheelchair? Are they bedbound?

Seniors who use a wheelchair and can’t transfer to their bed or use the bathroom independently may require a greater level of care, such as transfers and an escort to medical appointments, social events, meals, and more. Nursing homes can meet this need. If your loved one is confined to their bed, it may be time for a nursing home: They might require help with incontinence, bedsores, and many ADLs from trained caregivers.

6. Can they no longer feed themselves or maintain their dental health?

Staff at skilled nursing facilities help with a wide variety of ADLs, oftentimes addressing more advanced needs than assisted living communities do. Two examples are feeding and maintaining dental hygiene. Nursing home staff regularly assist with feeding. In other words, when to put a loved one in a nursing home might be when they can no longer complete these necessary, daily tasks. In addition, nursing home care incorporates dental exams, teeth cleanings, and other treatments to promote dental health in seniors.

Kara Lewis
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Kara Lewis

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