Care Plans for Nursing Homes

Creating a Care Plan

After entering a nursing home, the staff will compile medical history and conduct an assessment to create a care plan. A good long term care plan is vital to a healthy, productive and safe stay at the nursing home. The resident, family members or anyone acting on the resident's behalf has the right to be involved in developing the plan. A nursing home resident assessment begins on the first day in the nursing home. During the next two weeks, the staff will assess the resident's health, medical status and abilities. The staff will examine the resident's daily functioning activities, including dressing, eating and bathing. They will also inspect their ability to hear, speak, understand, and see, as well as their apparent strengths and weaknesses.

After no more than 3 months, the staff will reassess the resident to determine if their care plan needs to be changed. For example, a staff member may notice that a resident has begun to eat less during meals. This may alert the staff to the possibility of an underlying condition, such as cancer, pneumonia, depression or perhaps just an adverse reaction to a certain medication. Discovering the cause allows the nursing home to provide adequate care to the resident. Conducting these assessments can also alert medical staff to any abuse or neglect occurring in the facility. If a resident's health is continually changing, assessments will be conducted more frequently.

After the medical staff completes the first assessment, an individualized care plan begins to develop. The plan strategizes how the staff can fulfill the needs of the nursing home resident. For example, certain occupants may need a nurse to help with daily bathing, while others need an aide to push their wheelchair to every meal. Some elements of a care plan may include:

  • Personal and healthcare services
  • Staff needed to provide these services
  • Frequency of services
  • Specialized diet
  • Equipment, including wheelchairs, feeding tubes, walkers, etc.
  • Health goals and how the facility can meet these goals

Including family members in the development of care plans maximizes the effectiveness of the plan. Asking questions, discussing treatment options, monitoring the plan after its implementation and talking with doctors and nurses can help ensure that a loved one is getting the care they deserve.