If you need to place someone in your family in a nursing home, how should you go about finding the best one for your needs?
Start with the Information and Referral Services of the D.C. Office on Aging (724-5626). That office can direct you to public and private social service agencies that will help with nursing home placement. The office also can send you its brochure, "Long Term Care Alternatives," which lists community resources and contains a step-by-step guide to applying for Medicaid coverage of nursing home care.
The National Council of Senior Citizens also publishes a guide to long-term care in the metropolitan area. The booklet, $2.50 per copy, describes services provided by area nursing homes. Call 347-8800 for information about the booklet.
Family and Child Services' Columbia Center (829-4408) works closely with District social service agencies and will help assess the medical needs of patients, fill out financial forms, determine if nursing home care is advisable and, if alternative care is suitable, help you find the appropriate services.
The National Capital Medical Foundation (659-6450) assesses patient's' medical qualifications for Medicaid. Medical eligibility forms should be sent to Elnora Rhoads, NCMF, 1901 L St. NW, Washington, D.C. 20036.
Finding a bed is more difficult than qualifying for assistance. Private patients can search not only in the District but in Virginia and Maryland as well. District Medicaid has contracts with three suburban Maryland homes.
The District Weekly's guide to nursing homes lists where homes are, levels of care, fees and charges and whether Medicaid patients are accepted. Beyond that, though, you will want to judge for yourself the atmosphere and programs offered by the homes.
Consumer advocates and health professionals suggest you visit a home personally. You should be sensitive to the atmosphere in the home, the attitude of the personnel and the way they treat patients. Notice whaat the patients are doing and whether activities are provided.
Betty Hamburger, of the National Citizens' Coalition for Nursing Home Reform, suggests visiting the home just before lunch time.
"If the home has activities, that's when they'll be going on," she said. "We did a survey of nursing homes in Baltimore and found that many of them said they had activities when, in fact, they didn't."
Marge Rafner, a social worker with Jewish Social Services, suggests that you also judge homes with your individual needs in mind.
"If your mother has just had a stroke, then rehabilitation might be the most important consideration," she said. "I'd check with my physician about who has the best physical therapist. I wouldn't care so much about the food or the atmosphere if I were getting my mother the best physical therapy available.
"If your mother can't live alone anymore because she has periods of confusion-she might go to a store and not remember how to get home-but she's still meticulous about her dress and can carry on a conversation, then you want to place her in a home where she will not be grouped with very senile patients. That could be very frightening and devastating. You'd want a place where she was encouraged to function at her highest level and where the atmosphere was lively.
"If your mother is very senile and needs to be protected, you would want to look for a home where senile patients are locked in rather than tied to a chair or drugged to keep them from wandering away."
Rafner also suggests that any family facing a nursing home placement of a parent or close family member should seek counseling.
"The transition from home to nursing home is very traumatic for both the patient and the family. A social worker with a social service agency can help the family work things through, help them include the patient in the decision-making process and, all in all, make the transition more positive for both patient and family. They can help with feelings of guilt many children have about placing their parents in a nursing home."
"There are patients," she added, "who are better off in nursing homes, patients who can live better and function at a higher level with supervised, institutional care."