Ask the Experts

How Do I Choose a Nursing Home for My Father?

Caring for a loved one with dementia can be challenging and overwhelming. Learn how to overcome feelings of guilt and make the best decision for your loved one and yourself with our nursing home placement checklist and guide.

Diane Carbo

12 Dec 2022 — 7 min read

Making the Best Choice for Elderly Loved Ones

Question:

Maria writes,

I have a 90-year-old father with dementia and mobility issues. I have provided care for 8 years. The financial strain is becoming more than I can handle. I had to quit work to provide care. I've considered hiring outside caregivers. The cost is more than I want to spend.

At this time, I am tired. I've neglected my own health, my own financial future to provide care for my father. I never expected the care would require so much of my time. I feel that I cannot continue to do this much longer.

Am I being too selfish for considering placing him in a nursing home? I promised many years ago, to never place him in a facility. I am having mixed feelings on this decision. Please help?

Response:

Dear Maria,

Are you contemplating nursing home placement for your elderly father? You're not alone. The responsibilities of caring for a 90-year-old with dementia and mobility issues can become overwhelming. The financial strain of hiring caregivers may also be taking a toll. If you're at a crossroads and unsure about the best course of action, it's important to address your feelings of guilt and make an informed decision.

First and foremost, let's talk about caregiver guilt. Many adult children, in a sincere moment of commitment, promise their aging parents that they'll never place them in a nursing home. However, when making such promises, it's impossible to foresee the extent of the care required. Caregiving has boundaries, and every person has their limits. Circumstances can change drastically, making it necessary to reconsider those promises.

When you made your commitment, you likely didn't anticipate providing intimate care, dealing with incontinence, or facing challenging behaviors such as aggression or inappropriate sexual conduct. Your initial promise was made with the best of intentions, but it's essential to recognize that there comes a point when keeping that promise is no longer a reasonable expectation.

Guilt can have both positive and negative aspects. On one hand, it can motivate us to go above and beyond to honor our commitments. On the other hand, guilt can cloud judgment and lead to emotionally driven, illogical decisions. It's crucial to find a balance.

Your father's condition appears to be in the advanced stages of dementia, necessitating round-the-clock care. Transitioning your father into a nursing home is not a failure; it's a shift from being his primary caregiver to becoming his advocate. This transition can be challenging for many caregivers, but it may be necessary for your own well-being.

Remember that placing your father in a nursing home is a decision made out of love and concern for his safety and quality of life. You've provided him with excellent care at home, and now you can ensure he continues to receive the care he needs while focusing on maintaining your own health.

Thanks for sharing your concerns,
Diane Carbo RN

Here's more information on How Do I Choose a Nursing Home for My Father?

Understanding Nursing Home Care

Nursing homes, also referred to as skilled nursing facilities, provide a higher level of nursing care and support than assisted living facilities. These facilities are equipped to assist residents with mobility issues, medical care, and memory care, making them an option for those with complex health needs like your father. Many nursing home residents receive skilled nursing care and therapies such as physical therapy, speech therapy, and medication management.

Recognizing the Need for a Nursing Home

After eight years of caregiving, your exhaustion is understandable. Balancing your father's medical conditions with your health, financial well-being, and emotional state is critical. This transition doesn’t mean you’re being selfish; it shows you’re prioritizing both his needs and your ability to continue providing support in other meaningful ways.

Steps for Finding a Nursing Home

Assess Your Father’s Needs

Consult his primary care provider to evaluate his current and future health requirements.
Identify if he needs memory care, specialized care, or specific nursing home services such as an emergency evacuation plan or social services.

Understand Financial Options

Research if your father qualifies for Medicaid services, as the Medicaid program helps cover nursing home costs for eligible individuals.
Prepare a full financial disclosure to understand what resources are available.
Compare long-term care facilities based on affordability and services provided.

Explore Local Options

Reach out to the local area agency on aging or your state’s human services department for recommendations.
Visit facilities in your area to consider the facility's location, nursing home staffing, and living arrangements.

Evaluate the Facility

Use a nursing home checklist to assess the quality care offered by each facility.
Look for inspection reports, emergency plans, and feedback from other residents and families.
Verify the presence of a qualified pharmacist, registered nurses, and certified nursing assistants on staff.

Tour and Observe

Visit during visiting hours to see how the nursing staff interacts with nursing home residents.
Pay attention to the cleanliness, meals served, proper temperature, and the condition of the dining room and common areas.

Ask the Right Questions

Does the facility provide specialized care for dementia patients?
How does it handle emergency call buttons and medical appointments?
What is the protocol for communication with family members or your personal physician?

Ensure the Right Fit

Inquire about the social worker or medical director assigned to oversee health care and treatment plans.
Check if the facility can accommodate your father's pharmaceutical services and therapy needs.
Review the emergency evacuation plan and how the facility assists residents during crises.

Making the Transition

Once you’ve selected a particular nursing home, work with the staff to create a personalized care plan. Discuss your father’s preferences, routines, and living facility expectations. Include other family members in the process to ensure everyone is informed and involved.

Overcoming Emotional Hurdles

Your promise to never place your father in a facility was made with the best intentions. However, circumstances evolve, and seeking a nursing home placement doesn’t negate your commitment to his well-being. It allows trained care providers to deliver skilled nursing care while you focus on being his advocate, companion, and emotional support.

Additional Resources

Organizations like the American Health Care Association and local elder care agencies can provide more information on comparing facilities. Tools to compare nursing homes and feedback on nursing home staffing are available online, helping you identify the right fit for your father.

Final Thoughts

Maria, you’ve given so much to care for your father. Transitioning to a skilled nursing facility doesn’t mean giving up—it means ensuring he gets the nursing home care he needs while you preserve your health and well-being. Trust yourself in this decision-making process, and know that you are doing the right thing for both of you.

Feel free to reach out if you have more questions about choosing a nursing home or navigating this journey. You’re not alone, and there are many resources to support you every step of the way.

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