Shopping For a Nursing Home 

Published in the Gazette March 14, 2004

           Shopping for a nursing home may not sound like something you want to do. Still, there are some circumstances which make a move to a nursing home for you or your loved ones a necessity: in fact, 60% of those who turn 65 will need long-term care at some time in their life.

            How do people determine when a move to a nursing home is necessary? “More often than not, it’s a gradual decline,” says Diane Bierle, Resident Advocacy Coordinator at the Heritage Agency for Aging, which serves Cedar Rapids and Iowa City. “Maybe they have a long-term illness, or perhaps the person’s caregiver, often a family member, can no longer do everything that’s necessary.”

For others, an acute illness, such as a stroke, will suddenly make it impossible for them to take care of themselves.

Before you or your loved one moves into a nursing home, it’s a good idea to make some visits. You might get suggestions from friends or even from a doctor who knows which facilities might best suit your needs. Another resource is Diane Bierle at the Agency on Aging, who visits and evaluates nursing facilities in eastern Iowa every year (319-398-5559).

Visits to nursing homes can help you decide which one best fits your needs (see the list of “What to look for” in the sidebar below). Once you decide on the right place, a social worker will meet with you to determine the patient’s needs. Usually the nursing home will have a nurse visit with the patient in order to determine his or her needs, and see whether the facility can provide for them. Nursing homes often have waiting lists, as well, and this may affect your decision.

Many people mistakenly believe that Medicare will pay for long-term care in a nursing home. Medicare will only cover the first 100 days of a stay. Medicaid will pay for those who have less than $2000 in assets, but many elderly people will not qualify. So how does one pay for nursing home care whose average cost is $55,000 a year or more?

“The first thing is to plan early,” says Barbara Hennings, Senior Financial Advisor at Raymond James Services. Long-term care insurance is available; Hennings often recommends that people buy it when they are young—50-55 years old—because it’s less expensive then, and fewer people will be turned down because of illness. But even if you haven’t bought this insurance, there are ways of making the money you have work harder for you. “There are even policies that people in nursing homes can buy that will help their money stretch,” says Hennings.


What to look for in a nursing home [sidebar]


Is it well-kept up? Look at the inside and outside—is it tidy and attractive? “Use all your senses,” says Diane Bierle: the facility should be odor-free.

Are staff helpful and friendly? Observe staff interaction with residents. Are they kind and gentle?  Do they greet residents by name?

Are there appropriate activities available? “Look for more than just T.V.,” says Kym Hauser of Iowa City Rehabilitation. There should be a variety of activities for residents, often listed on a chart.

For more information, see “How to Tour a Nursing Home,” at


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