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

6 minute readLast updated October 2, 2023
fact checkedon May 5, 2021
Written by Kara Lewis
Reviewed by Erin Martinez, Ph.D.Dr. Erin Martinez is an associate professor of gerontology and director of the Center on Aging at Kansas State University, where she focuses on promoting optimal aging.
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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.

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Deciding it’s time for a nursing home

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, may be the right choice for seniors with a high level of daily needs or health concerns. If you’re a caregiver of an aging relative, you may be burned out by caring for a relative who has needs that outpace your skills or abilities. If this is the case, a nursing home may be a good option for your family.

Asking yourself these six questions can help determine if your senior loved one would benefit from the highly specialized and intensive care offered in a nursing home. Answering these questions can also help you be prepared when recommending a nursing home to your relative. In some cases, your elderly parent may refuse help. Try to respect their autonomy when possible.

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.

Skilled nursing facilities offer these services for recovering seniors:

  • Constant care. Skilled nursing facilities are often staffed with awake caregivers 24-hours a day. This can be a draw for families who live far away from their loved one.
  • Daily therapy. 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.
  • Professional care counseling. While in-home rehab programs typically encompass two or three days of treatment 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. Shorter nursing home stays may be covered by Medicare.
  • Meals and housekeeping. Skilled nursing facilities include meals and housekeeping services, so the only thing you and your loved one need to think about is recovering.

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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? Are they experiencing rapid weight loss? These observations 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. Do they receive Medicare-covered palliative care at home? In some cases, it may be easier to receive palliative care in a nursing home setting.

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. If your loved one frequently falls but doesn’t have other serious caregiving needs, consider an assisted living facility.

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 who can be there night and day.

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.


Meet the Author
Kara Lewis

Kara Lewis is a former copywriter at A Place for Mom, where she wrote dozens of articles related to senior living, with a special focus on veterans, mental health, and how to pay for care. Before covering senior living, she worked in journalism, media, and editing at publications. She has a bachelor’s degree from the University of Missouri-Kansas City.

Reviewed by

Erin Martinez, Ph.D.

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