How to Make Skilled Nursing Work for You and Your Loved Ones

By Ava Emory, Eckerd Living Center

Our loved ones, like our parents or spouses, don’t always grant permission to be placed in a nursing home when the time comes. Except mine – my parents said, “When you can’t take care of me, put me in a nursing home – pick a good one! But put me in a nursing home.” They don’t want to feel like they are a burden to me.

So when and if the time comes, that’s exactly what I’ll do.

But when it’s not upon request, choosing a skilled nursing facility can be stressful and emotional. So what do you do if you find yourself in a situation where you feel like you don’t have “permission”?

1. Talk about it, if at all possible. Let them know that you physically can’t lift them, or maybe you have to work and can’t leave them home alone – emphasize safety, not convenience. At the same time, hear them and understand where they’re coming from. Long-term care is just that: long-term. It’s often perceived as the end of the road; they stand to lose all freedom, independence, personal belongings, relationships and dignity. So talk about ways you can keep that from happening. Maybe they can come home on Saturday nights, go to the beauty shop or still attend church.

2. Choose a good one. Research online, talk to friends and neighbors – and visit! Take your loved ones with you if you can. See how the residents appear in the space and see how the staff engage and respond. Don’t fall for pretty furnishings or an abundance of activities – see how many actually go to any activities. See if there is sunlight and a quiet place to visit. Observe the interactions and relationships between the nurses and residents, but also the housekeepers and kitchen staff and the residents. Choose quality care over quality furnishings, and don’t rely solely on website pictures and statistics.

3. Once you’ve made the move, be present. Visit as often and as long as you’d like, but be sure to visit. If you can’t visit, then call. Continue to provide some aspects of care – maybe take the laundry home to wash, paint her fingernails or give him a quick shave. Show that you haven’t completely handed over their care to someone else. Think of things to do while you visit – take the dog (most will welcome a well-behaved, leashed pet with their proof of vaccination). Take a newspaper, a slice of cake or the grandkids’ new school pictures. Bring personal items like a favorite recliner, pillow or quilt to add a touch of home to the room.

4. Get involved. Most facilities will have a family council or volunteer opportunities. Get to know the families of other residents, help with crafts, go on outings and share your stories. Greet the loved one of a new admission who is struggling with his/her decision. Help them understand that you do what you have to do when you can’t do it alone.

Nursing home patients come in a wide range of ages and abilities

At Eckerd Living Center, our youngest resident is 40 and our oldest is 100. About 85 percent of our residents have some form of memory impairment. Long-term care facilities (or nursing homes) generally provide a safe facility for residents who wander. You’ll find activities geared toward every age and ability. The staff are trained in memory care and care of the older adult. We often find that residents who enter the nursing home flourish after having three balanced meals a day, routine medications and physician visits, activities and daily exercise. We actually have a resident who has lived in our facility for 19 years; however, when that isn’t the case, most nursing homes either offer end-of-life care or work with a local hospice team.

Ava Emory, RN-C, LNHA, is an administrator at Eckerd Living Center at Highlands-Cashiers Hospital.

Eckerd Living Center (ELC) is an 80-bed skilled nursing facility at Highlands-Cashiers Hospital. ELC at Highlands-Cashiers Hospital, a part of Mission Health, has earned a 5-star rating from the Centers for Medicare and Medicaid Services (CMS). Eckerd Living Center is the only 5-star skilled nursing facility in the six westernmost counties of North Carolina. Additionally, ELC is one of 85 5-star facilities out of the total 429 facilities in North Carolina, putting it in the top 19 percent. Learn more about Highlands-Cashiers Hospital at

Learn more about skilled nursing facilities and Eckerd Living Center at [1].