Nursing Homes Overview

Nusing Home Services and Staff

An elderly woman and her caregiver
An elderly woman and her caregiver

As we discussed on the previous page, nursing homes are designed to provide constant supervision and 24-hour nursing care. More than half of nursing home residents are incontinent, and more than half suffer from dementia [source: AGS Foundation]. Nearly all residents need help with the most basic activities of daily living, including getting out of bed, using the toilet and eating. Nursing homes may also house short-term patients recuperating from an injury or illness.

Most of this resident care is provided by personal care aides. It's important to consider the aide to resident ratio; the National Citizens' Coalition for Nursing Home Reform recommends that at least one aide should be present for every five residents during the day, though more may be needed at busy times of the day such as meals [source: Morris]. During the evenings and nighttimes, this ratio can drop to 1-to-10 or 1-to-15 [source: Morris].

­Personal care aides are unfortunately usually overworked and underpaid, and the position is marked by a high amount of turnover. Still, if you're a family member of a patient, it's important to get to know and work with these people as they provide so much direct care. It can be difficult to turn over care of a loved one to another person, especially when you think you know best how things should be done. You can help personal aides by sharing information that might help them with your loved one, but remember that it's their job now.

Also caring for a nursing home resident are nurse practitioners and physician assistants, who, under the supervision of a medical director, provide medical care. There will also likely be a rehabilitation therapist on staff, as well as a dietitian overseeing the meals. Social workers or counselors will be on hand to assist with the emotional changes a move to a nursing home elicits. In selecting a nursing home, it's important to consider how much interaction these people will have with the resident. Does the medical director just provide oversight, or does he or she see patients? Some nursing homes require residents to see the facility's physician, while others provide transportation to outside doctor's appointments if that doctor won't travel to the nursing home.

Nursing homes now offer far more medical services than they did in the past, including those that may have required a hospital visit before, like kidney dialysis or respiratory support. But do nursing home residents have any say in their care?