A Guide to Choosing Between a Nursing Home and a Nursing Hospital for Dementia Patients

When parents are diagnosed with dementia, families often immediately think of nursing homes. However, if they can no longer walk independently or spend most of their time in bed, a nursing hospital might seem more suitable. It's important to remember, though, that the choice between a nursing home and a nursing hospital isn't solely based on these conditions.

Considerations Before Dementia Itself

Even with dementia, if other chronic illnesses are well-managed, a nursing home can be a viable option. For instance, if daily care is the primary need – meaning assistance with eating, bathing, and toileting – a nursing home might be appropriate. But if conditions like pneumonia or urinary tract infections recur frequently, or if bedsores worsen and require regular treatment, a nursing hospital could be a better fit.

Not Necessarily a Nursing Hospital Just Because They Can't Walk

There's no need to opt for a nursing hospital solely because someone can no longer walk on their own. If they can move with a wheelchair and require assistance with daily activities, but their physical condition is stable and doesn't necessitate frequent medical treatment, a nursing home can be a good choice. Even seniors who spend most of their day in bed can be admitted to a nursing home if they qualify for long-term care insurance. However, eligibility doesn't automatically mean they'll receive adequate care there.

• If they are bedridden for extended periods, ensure they can be repositioned frequently and receive meticulous feeding assistance.
• Check if there are enough staff and equipment to help with transfers between bed and wheelchair.
• Inquire about support available to monitor changes even during the night.

Questions to Ask Your Doctor

It's challenging for families to judge which facility is more suitable just by looking at their parents. It's best to ask the doctor who usually treats them or the medical staff at the hospital they are being discharged from about the specific treatments and care they will need going forward. Asking questions like the ones below can be helpful:

• “Have all urgent treatments been completed?”
• “How often will they require oxygen support, phlegm removal, injections, or IV fluids in the future?”
• “If their condition changes, does the medical staff need to make immediate judgments and provide treatment?”
• “Are the daily tasks more focused on assisting with eating, toileting, and mobility rather than treatment?”

Choosing Based on Changing Health Conditions

A parent's health condition can change at any time. After surgery or an infection, they might need to stay in a nursing hospital, and later, if their condition stabilizes, they could move to a nursing home. Conversely, if someone living in a nursing home suddenly develops a high fever or breathing difficulties, they must be taken to the emergency room immediately.

Ultimately, making a decision based on a single criterion is risky. It's crucial to carefully observe any recent sudden symptoms or recurring illnesses. If their physical condition is stable and the focus is on assisting with daily life, a nursing home can be considered. However, if frequent medical judgment and intervention are required, a nursing hospital would be more appropriate.

To make the right choice that meets your parents' needs, family judgment alone isn't enough; advice from medical professionals is essential. In the next post, we will explore the long-term care grade and facility benefits required for using nursing homes.