Nursing homes are the type of long-term care facility most of us are familiar with, but if you haven't been to a nursing home in years, you're in for a pleasant surprise. Ever since the Nursing Home Reform Act was passed in 1987, our nursing homes have moved toward providing a "homelike" environment where the "residents" (not "patients") are encouraged to thrive. They now have resident councils to help set policy, good activity programs, social workers, church services, very open visiting hours, comfortable rooms and day rooms, etc. Some may be better than others in different areas, and it is definitely a good idea to call and ask for a tour. But overall, our nursing homes provide excellent care.

Everyone knows in Hawaii we have a shortage of nursing home beds and that situation is not likely to improve. While we do have some more beds in the planning stage, it won't compensate for the baby boomers now knocking at the door. Most days our nursing homes are full and they all have long waiting lists. When you go on a tour, certainly feel free to ask. If you end up in a nursing home that wasn't your choice, don't give up. Speak to the social worker soon after arrival to request assistance for a lateral transfer to your first choice when a bed becomes available.

Nursing homes come in various sizes from 10 beds at Kahuku to 288 beds at Hale Nani. The size of the facility and the number of residents per room may be important to you. You can download the complete list of nursing homes with the number of beds and street address at the Department of Health Web site (hawaii.gov/health/elder-care/health-assurance/index.html). You can also review the annual inspections done by the state surveyors at the Medicare Web site (medicare.gov) - click on "Compare Nursing Homes in Your Area." That information is a snapshot of what the facility looked like for the one week the surveyors came for the annual unannounced inspection. It records the deficiencies found and the facility’s plan of correction. It’s important to remember that information is already old by the time it is posted. The facility may have completed its plan of corrections and it is now "looking good," or it may have backpedaled with the loss of a significant staff position or for some other reason. Surveys are a great place to start, but don't put all your eggs in that one basket.

If possible, try to get into a nursing home close to where your family lives or works so they can visit often and at various days and times. It does help to have family and friends there to advocate on your behalf and also to help the staff get to know your preferences and background. Today most of our nursing homes have done away with visiting hours, and arrangements can be made outside of normal business hours if necessary. Your family is part of the team and the facility should welcome family and friends.

When taking a tour of the facility, you should be looking at the interactions of staff with the residents. How residents are treated is the most important concern you should have. Do they know the residents’ names? Are they loving and affectionate to the resident? Are the residents engaged in meaningful activities appropriate for their ability? Are minutes from resident and family council meetings posted? It is not a requirement, but certainly a good practice so everyone can know what was discussed and when issues raised will be resolved. Is the administrator also on the floor to see what’s happening? All that really matters is the care provided and that can be determined by the interaction of the staff with the residents. 

If a nursing home is not for you or there are no beds available when you need one, there are other options. For more information, please call the Long-Term Care Ombudsman at 586-0100