Why is there so much misinformation and so many misconceptions when it comes to nursing homes? Probably because years and years ago, they were very unpleasant places. And unfortunately, there are still some bad ones out there. Today, most skilled nursing facilities are great places.

Admitting a loved one into a long-term, skilled nursing facility, otherwise known as a nursing home, is a difficult and extremely emotional decision for all involved.

Here we will address common misconceptions and cultural perceptions that may or may not be true, but nevertheless influence our decisions and thought processes when a loved one may need the 24/7 care of a skilled nursing facility.

When faced with the daunting task of choosing a senior living facility for the needs of the patient and the family, the process becomes overwhelming, frustrating and even frightening. It's hard to know what to believe and what to dismiss. Research is imperative and will go a long way in making you and your aging parent feel good about your choice.

Are nursing homes where people go to die?

From her 25 years of experience, Barbara Fordyce, R.N., Case Manager in Senior Resource Management, considers the belief that nursing homes are the last stop before the funeral home to be today's biggest misconception about nursing homes. She finds this is especially true for those who were adults in the 1930s and '40s.

That particular generation is living a lot longer than they expected, and really have no cultural cues in how to handle getting older than anyone else they ever knew. They've watched friends grow feeble, forgetful and die. It's frightening for them, and the prospect of going into a nursing home may be an indication to them that their time is drawing to an end.

The fact is, even though many senior adults may require the 24/7 care of a nursing home after surgery, an injury, accident or health event such as stroke or heart attack, once sufficiently recovered, they may be able to return to their previous living arrangement or released to a caregiver for the remainder of their lives.

With people in the United States living longer than ever before, it is estimated that anyone over 65 years of age will have a 43% chance of spending some time in a nursing home. About 24% of these individuals will spend less than a year in residence at a nursing home.

Even when returning home permanently is not an option, most Medicaid-certified nursing facilities will hold beds for patients during a short visit with family or friends. Each state has rules that vary, so check on how out-of-home visits are treated at any nursing facility your are considering.

Dealing with Guilt

Our culture harbors the belief that when we have a loved one who needs the care of a nursing home, the result is guilt and sadness for the family, and the end of any of life's joy for the patient. However, that does not have to be true.

Doing your homework before a relative is admitted is the first step to making you both feel good about your decision. Some ailing seniors are happy to go to a skilled nursing facility so they no longer feel guilty about the burden they feel they've been to the caregiver.

Your loved one also may be relieved to receive the medical, rehabilitative and nursing care the healthcare professionals provide in the nursing home.

And while most nursing home residents may miss day-to-day interaction with old friends, family and even pets, most facilities are upbeat, positive places. Patients often enjoy eating in dining rooms rather than in their rooms, and activities and outings offered each day to stimulate and entertain patients mentally, physically and socially.

Also keep in mind that a nursing home is not like a hospital. There are usually no restrictive visiting hours and your relative may be able to go with you for visits, family events and holidays. Expect nursing facilities to try to be home-like. People can feel comfortable, make friends, visit with family and continue life's activities appropriate to their age and capabilities.

Your research before admission and frequent visits with your loved one once moved into the facility will ensure that their time in a nursing home is beneficial and pleasant and that you can let go of any guilt.

Do residents of nursing homes lose their privacy?

Fordyce reports that many residents, in their first weeks in a nursing home, may experience a shock at their loss of privacy if assigned to a semi-private room. While they are usually allowed some personal items and clothing that help keep their sense of identity and individualism, there is a certain loss of control that many people struggle with for varying periods of time.

You should expect staff to be considerate of the need for privacy and knock on closed doors before entering the room, respect clothing choices and personal preferences when appropriate.

If you have a mother and father who would like to live together at the nursing home, you should expect to find a facility where this is allowed and their privacy is respected.

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Do nursing homes smell bad?

It's true that incontinence is a fact of life in most nursing homes, but today's cleaning methods and prompt attention to any sanitary issue is standard in most homes. If you encounter bad odors, the situation should be reported immediately. But in today's skilled nursing world, lingering unpleasant odors are no longer an issue that cannot be resolved.

Do residents lose their dignity at nursing homes?

Because in the past, we may have observed nursing home patients sitting in wheelchairs waiting to be taken to where they are going next, or people wandering the halls seemingly having discussions with themselves, many of us perceive that residents in a nursing home lose all dignity. But Fordyce reports that residents, on average, receive 2.5 hours of skilled nursing care every day. You can expect the staff to be constantly aware of resident whereabouts and needs, and if you feel this is not the case, you should report what you see.

It is true that a large number of nursing facility residents offer Alzheimer's care. However, in most homes, people with Alzheimer's or dementia live in distinct memory care units where they can be among people having the same limitations and receive the specialized care they require in a secure setting.

In your loved one's nursing home, you should not encounter lingering odors or signs of neglect or disrespect resulting in loss of dignity. If you do, exercise you option to report the conditions. You have every right to have your concerns addressed and a plan of action shared with you.

It only seems logical that private pay surely results in better quality of care than when paid through Medicare or Medicaid.

According to Hillary Kaylor, Regional Long-term Care Ombudsman in Charlotte, NC, there should be no difference in quality of care between Medicare/Medicaid payment vs. private pay vs. long term care or Worker's Compensation insurance payments. Quality is not based on payor source, but rather from influences such as the administrator, the size and number of beds in the home, and how closely the services offered at the home match the needs of the residents.

Kaylor says that nursing home operations are usually run by private corporations, hospital systems, or, more and more rarely, a "mom and pop" type organization.

All nursing homes in the United States that receive Medicare and/or Medicaid funding are subject to federal regulations. (American Association of Homes and Services for the Aging). The nursing home industry is one of the most heavily regulated operations in the United States. Each and every nursing facility is expected to meet minimum government quality standards, and undergo regular inspections by state surveyors.

Kaylor states that as an employed ombudsman, part of her job to urge facilities to do better than the minimum. If a problem is found, a prompt correction plan is required. Most areas have an active, government-supervised Ombudsman program that advocates for patients and families in the case of oversight.

Nursing homes have changed

Nursing homes haves changed a good deal over the past decade, according to Kaylor. They are no longer a place where grandma sits and waits for someone to change the television to her afternoon soaps and for her visit from the family. With more and more focus on rehab and recovery, nursing homes often have a diverse population, which includes both younger and elderly people.

A good place to start making nursing home comparisons is the AgingCare Provider Directory where you can search for a nursing home in your local area.