If You Need: Nursing Home Care
There may be times during cancer treatment when people cannot be cared for in their own homes. Sometimes a person's medical needs are complex and it would be unsafe for the person to be cared for by a loved one.
When you no longer need to be hospitalized but still are not able to go home, your doctor may suggest a nursing home. Nursing homes offer three basic kinds of care:
- Skilled care
* When the constant services of a registered nurse are needed
- Intermediate care
* When frequent but not constant nursing care is needed
* When help is also needed for tasks like getting to the bathroom or maintaining a healthy diet
- Custodial care
* When help is needed only with self-care tasks like eating and dressing.
Medicare and many insurance companies pay for skilled care, though some part of the cost is paid for by the patient. Some insurance plans also pay for intermediate care, but very few pay for custodial care. When you are choosing a nursing home, be sure to match your needs with the services available in the nursing home. Your doctor, nurse, and social worker can help you decide which kind of home is best.
Before choosing a nursing home, you and your family should visit several. At each home, talk with the staff, tour the home and meet with people who live there. You should find out:
- What to expect if you choose this home
- What the home can offer
- How much it will cost
- The quality of care given
Not all nursing homes provide certain kinds of special care, like taking care of intravenous equipment. Your social worker or discharge planning nurse will advise you about homes that provide the kind of care you need.
Nursing homes can be costly. Fees are determined by the kind of care you need. Find out the basic costs, such as:
- Room and board
- Routine nursing care
Find out which services cost extra. Nursing homes often add the costs of:
- Doctors' fees
- Medications
- Special therapies
If your insurance doesn't pay these costs or your benefits run out, you may be able to get financial assistance. Certain federal and state programs can help you pay for nursing homes. Your social worker can give you information about these programs. If you are a veteran, you may be able to get nursing home care under the Veterans Administration. Check out all these options before you make a choice.
Many people assume Medicare will cover the costs of nursing home care. For Medicare to cover the cost of a nursing home, a patient must need "skilled care." But Medicare has strict definitions of skilled care, and benefits for skilled care usually only last for a short time. Most nursing home care in this country is paid for by the person needing care or their families. Sometimes the state Medical Assistance program will help pay part of the costs.
How Nursing Home Services Can Help
Nursing home services can help by:
- Providing medical care and monitoring by your doctor or the nursing home doctor
- Providing nursing services, including consulting with the doctor about your
progress or problems
- Offering help with self-care for tasks such as dressing, eating, bathing, getting to
the bathroom
- Offering help with nutritional planning by registered dietitians who can also suggest
a special diet if you need one
- Providing physical therapy to help you maintain strength and learn to better care
for yourself
- Providing recreational therapy to add enjoyable activities and new hobbies to your
day while you are in the nursing home
- Offering social activities, a place for worship and visits by family and friends to fulfill
your need for friendship and companionship
- Offering social services to help patients and families adjust to nursing home life and
to plan for discharge when the patient is well enough to go home
How Do You Find These Services?
Talk with your social worker, nurse, or doctor about services available in your community. Also talk with friends who have needed to find a nursing home. Some nursing homes have a better reputation than others, and people who have already seen the nursing homes can give you valuable information. Ask your hospital discharge planner or social worker to suggest homes, and always check it out yourself. If you are too sick to visit, have your family do this for you. You can always change nursing homes if you choose the wrong place, but try to make the right choice the first time by looking at several homes.
Nursing homes vary in the:
- Service they provide
- Quality of care given
- Costs
If you are going to spend any amount of time in a nursing home, you need to be assured that you will be comfortable there and that the home will meet your needs. That is why it's so important to check homes out in advance. Then you can make the best choice.
Helpful Hints
Most people feel sadness and frustration about being temporarily unable to care for themselves when they enter a nursing home. Families also feel guilty because they are not able to care for the patient. The move to a nursing home is a major adjustment for you and your family. Talking about your feelings is the best way to accept this change in your life. As with all feelings that come with cancer, you should talk about them. If you don't, it may be hard for you to begin feeling good again.
Nursing home staff are not mind readers. If you are unhappy about something, speak up. Give the staff a chance to improve it. You do have rights if you live in a nursing home. Find out about the rights and responsibilities you have.
You can still be treated for your cancer while you are in a nursing home. The nursing home should arrange visits for you to your doctor or oncologist. You may need to ride in an ambulance or be driven by your family. Sometimes your doctor will be able to visit you in the nursing home. The nursing home doctor will send reports about your progress to your doctor, if you request it. If you have questions about your cancer care, ask the nursing home doctor to contact your oncologist. Of course, you can also do this yourself by telephone.
This Fact Sheet is adapted from the book, Helping People Cope: A Guide for Families Facing Cancer, written by Joan F. Hermann, ACSW, Sandra L. Wojtkowiak, RN, MSN, Peter S. Houts, Ph.D., and S. Benham Kahn, MD, and supported by the Pennsylvania Cancer Control Program of the Pennsylvania Department of Health; 1990 Revised Edition.
c 1993, American Cancer Society, Inc.
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