How to Consider Alternatives to a Nursing Home


Talk with family members about their feelings and opinions regarding the future living arrangements for the individual needing the care. Families often do not agree on this, so it is good to keep this in mind, and to just listen to what others have to say, without trying to get them to agree with you. Depending on their opinions, find out what role they will take in this scenario. Will they be helping out financially? Will they be the Power of Attorney and the one with health care decisions? When families pull together, each member can contribute assets or time toward the well-being of an individual, which helps keep the "burden" from falling all on the shoulders of one member.


Look in your local phone book under "nursing homes," "adult care," "assisted living facilities," and similar listings. Depending on whether a person is a VET, additional assistance, both monetary and residential may be available, even if the person did not serve more than one enlistment. It is worth calling your nearest Veteran's Administration to find out what might be available. Also, you can find this online at You also will see a section called, "Special Pension with aid and Attendance." Talk with others who may have first-hand experience with a local facility and can make a recommendation.


Consider the alternative to remain at home. Sometimes this is more workable if extra help can be hired to relieve the caregiver or help the person residing there. Prices vary, depending on who you hire. If you go through an agency, expect to pay more for services, as the agency gets a cut, but they also have conducted a background check on this individual as per license requirements. If you screen private individuals, you can also run your own background check, through your local police station. They will do fingerprints and take other information that will reveal if this person has a record or problems with the law in the past.


Try in-home help first if you can, as that often resolves the issue. Many times if help in the home does not address the level of care a person needs, assisted living may be indicated. Not everyone has to go to a nursing home. If an individual cannot feed themselves, are incontinent, behaviorally unpredictable or are at risk for hurting themselves, then a nursing home may be indicated. Most reputable facilities will assist you in deciding the best level of care for an individual. The least restrictive is always better.


Call facilities in your area, and make an appointment to go see a few. Find out whether or not the individual can come for only two days, to try out the facility before making a decision. This is often done, so do not feel shy about asking. Find out about taking a person home for the weekend, or out for lunch. Is this permitted? Ask about extra services and if there is a charge up and over the monthly fee. Find out if there are any provisions by the state or county you live in to help pay for placement if the individual is low income. Many times there are programs of this nature. The cost of a nursing home or adult residence should never fall on the family.


Know that your phone may be your best friend. By calling different agencies and facilities, you can get a lot of information to help you. Also, a home health agency can be prescribed by the physician with a social worker to help you in this process. If the individual is in the hospital, or already in a nursing home following a fall, surgery or illness, there should be a social worker already there who is involved in discharge planning. They should be informed of your concerns about the issues in remaining independent. They will guide you in making the decision and they can be a very knowledgeable source of support as you go along.


Deciding what to do is up to you. An individual's doctor will have an opinion as to where they think the individual will best be served, given the current diagnosis and level of need and risk. A doctor's opinion is just that, a conclusion based on observation and medical status of the patient.

Tips and Warnings

  • If nursing home or adult facility is decided upon, know that at any time, you can change your mind and go somewhere else. Sometimes this would require a doctor's order, as nursing homes (and sometimes assisted living facilities as well) do, but if a facility is not living up to the standard of your expectations, then you can change, depending on the person's needs and resources.
  • Many times there are added fees for extra services. Get a list beforehand that tells you what these extra fees are. If certain things, such as keeping one's doctor is important, find out whether the facility insists on the patient seeing their in-house doctor. If not, find out about who transports to their appointments.
  • Do not take anything into a facility of any kind that could be stolen, lost or misplaced. Things of value have a way of disappearing in facilities, and once they do, there is no way to recover them. Things like money, dentures, hearing aids, jewelry and glasses are constantly lost, never to be seen again. Keep this in mind, even for a two-day stay.
  • If you are caring for an elder person, or one with disabilities, you are on the front lines in the battle with your feelings on a daily basis. If you are that elder person, or one with the disabilities, the indecision may be causing you a great deal of stress regarding whether to go to a facility or not.

    Family members, neighbors and friends mean well when they suggest that someone needs more care and that they would be better cared for in a place that is designed for that purpose. However, there are many considerations to be taken into account prior to making that move.

    The availability and quality of facilities, both for retirement and nursing home living vary greatly, depending on what part of the country you are in and the availability of doctors to your area. The costs involved can also be a concern.

    Information is your greatest friend right now, as you cannot make an informed decision until you know more about the choices you have. Since statistically, only one in ten people go to a nursing home for the remainder of their lives, it bears mentioning that many people live out their lives in their homes or in an assisted living or adult facility which provides extra services.

    To know what is in your area, you will have to make some phone calls and visit some facilities to see what would be most suitable for you, if remaining at home is really not an option any more. However, many people who have extra needs for bathing, meals, laundry and housekeeping are able to stay at home with hired help, and do quite nicely, indefinitely. Others would prefer some socialization and would feel isolated remaining at home. This may be especially true for people who have recently lost a spouse.

    To determine which will be better for you or your loved one for the longer term, it is recommended that a few steps be taken to help you decide which path is the best.