Nursing Home Know-How

How to pick a quality care center

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The thought of having to place a loved one in a nursing home or of someday finding yourself in one is not a concept that is easily embraced.

But for some people such as 100-year-old Mary Larson, who has been energizing the atmosphere at Payson Care Center for several years now it can be a positive experience.

"I think a lot of everybody here," Larson says. "I don't think you'll find another establishment like this in Arizona. I think this is a lovely place."

There are, of course, other establishments like Payson Care Center not only in the state, but in Payson as well. Manzanita Manor is another local nursing home devoted to the quality of life of those who live there.

"The residents' happiness, well-being and comfort are the most important issues we deal with every day," says Ellen Stewart, who was Payson Care Center's director of nurses until she was promoted to the position of executive director in January. "What do they need? What do they want? If it takes us over budget, well, we'll explain that later."

Like most senior care centers across the nation, Payson Care Center and Manzanita Manor both of which have brand-new administrations are now implementing major changes and upgrades in their services.

And their timing is hardly coincidental. According to recent industry statistics, 45 to 50 percent of everyone turning age 65 in 2001 will stay in a nursing home at least once in their lifetime. About one-half of those admitted to nursing homes stay less than six months. One in five, however, will stay a year or more, and one in 10 will stay three or more years.

During the past two decades, the number of people over age 65 has grown by more than 55 percent. While people are living longer, the number of people with chronic illnesses or disabilities who will require long-term care services also is increasing.

And in the year 2000, almost 9 million older Americans typically older women without spouses needed long-term care services, up from almost 7 million in 1988.

The moral of such statistics is clear: The subject of senior care, for their parents and themselves, is not one that Baby Boomers will be able to avoid forever. There will come a time when hard decisions must be made.

Who will pay?

The first of those decisions can be daunting: figuring out who is going to foot the bill.

In the state of Arizona, the average cost of nursing-home care runs between $95 and $150 per day or between $33,440 and $52,800 per year according to Manzanita Manor's Victoria Shoopman, the facility's corporate director of business development, marketing and public relations.

According to a recent U.S. Department of Health and Human Services report on how nursing home care is paid for nationwide, 44 percent comes from the pockets of patients and their families; 43 percent is covered by Medicaid; Medicare took 8 percent; private health insurance only paid for 1 percent; while Veterans Administration and other sources contributed 4 percent.

As the demand for long-term care services continues to soar, federal and state governments are expected to continue backing away from the massive responsibility of paying for the health-care needs of the elderly.

These sobering facts combined with the idea of dwindling life savings and sold-off family assets are motivating many residents and their families to consider long term care insurance, which is available at premium rates that generally range between $800 and $2,500 per year with younger buyers (age 50 to 60) paying lower premiums and older buyers (65 to 80-plus) paying more.

Finding the right fit

"I want people to understand that Payson Care Center is not a nursing home," Stewart says. "A family member of one of our residents once said, 'This isn't a place that provides care; it's a caring place.' I want this to be a place where I can, if I need to, bring my 87-year-old parents and know that everything is just fine."

Of course, that's easy for professionals to say. But how can emotionally stressed and unprepared layfolks make the smartest possible decision when choosing a nursing home for their loved one?

According to the American Association of Retired Persons, these are the most helpful hints on what to look for in a nursing home:

Is the facility fresh and clean? Look past the furnishings and into corners, baseboards, and windows. Odors throughout the facility are likely to indicate a problem.

"Very often, odors can tell you more about how a facility is run than anything else," Stewart says.

Staff attitude and friendliness are of the utmost importance. Observe the staff interacting with current residents. Do they listen and make eye contact? How many staff members will be truly involved in your loved one's care?

"Very often in some facilities you'll see the staff going about its work but not really interacting with the residents," says Charles Shamblin, director of nurses at Payson Care Center. "You want to see the staff everyone, from housekeeping to dietary to administration talking with the residents, stroking them, paying attention to them as they work.

Busy residents are happy residents. Ask to watch activities. Are they well attended? Does the staff seem to be enjoying the activity as well? View the community event calendar. Do they match your loved one's interests? Look for small and large group activities, trips or outings. Inquire about religious services.

Investigate the outdoor areas for the residents. Do they feel safe and secure?

The dining room experience is very important to seniors. Discuss entree choices and ask about dining hours and procedures. Bring your loved one in for a meal to taste the food and meet some of the residents. Discuss what happens if a resident cannot make it to the dining room for a meal.

Safety and security features are very important. Are the bathrooms accessible and do they have grab bars in convenient locations? How does a resident contact staff if they have an emergency in their room or apartment? What are the staffing patterns at night versus in the daytime? How are medications managed?

Check the most recent state inspection report, which by law the nursing home must make available to you. If the home was cited for deficient practices in any quality of care areas, ask staff how they were corrected.

If your loved one has special needs (dementia, permanent kidney disease, ventilator dependency), make sure the home has experience in working with people who have had the same condition.

Trust your instincts and your heart. Can you imagine you or your loved one living there and being comfortable?

"I'd want to arrange to speak with some of the more cognizant residents and see what they feel," Shamblin says. "That will tell you pretty much everything you really need to know."

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