Strategies for Avoiding Nursing Home Placement

Urinary incontinence

Treating the cause may enable patients to remain at home. Use of timed voiding may also be helpful.

Dementia

Family members or other caregivers can be taught strategies for managing frustrating or disruptive behavior. For example, using purchased or rented monitoring devices can help with behaviors such as nocturnal wandering.

Functional impairments

Physical and occupational therapists and home health nurses can

• Assess patients in their homes

• Help determine whether placement in a nursing home or in an assisted-living facility is necessary

• Suggest ways to help patients function better

• Teach patients to use adaptive devices

• Encourage exercise

Durable medical equipment, if needed, can be provided.

Caregiver burnout

Support and respite services can help prevent family members or other caregivers from becoming resentful or worn out.

Physicians can help by listening when caregivers discuss their burdens and by providing them with information about community caregiving support groups and about options for paid respite care.