Organising a move to a nursing home: checklist

Your own home represents security, independence and routine. That’s why many older people want to remain in their own homes for as long as possible. However, as we get older, chronic illnesses often develop and physical limitations increase. In some cases, it is no longer possible for care and support to be organised within a familiar environment. This usually means moving into a nursing home.

Nursing homes support people who can no longer manage their day-to-day lives independently. Specialists provide medical care, personal care and day-to-day support, ensuring a safe environment. At the same time, they promote social contact and a daily structure that provides stability.

Moving into a nursing home has a profound impact – both on the person concerned and on those around them. On the one hand, the change means giving up old habits, but on the other hand, it also eases the burden. Relatives often bear a huge emotional toll. Feelings of guilt, doubt and uncertainty can accompany such a move, so it is all the more important to be well-prepared for this decision. Discuss the topic with everyone involved at an early stage, for example, and define the criteria and needs. 

If outpatient services or elderly care at home are no longer sufficient, care within a nursing home is often the right solution. The home’s nursing staff look after the person concerned around the clock, preventing loneliness and creating a stable environment. This is particularly valuable if a person’s physical or mental state has changed significantly. The following situations often indicate the need for admission to a nursing home:

• Deterioration of general health: as we get older, our physical and mental abilities gradually change. Everyday falls become more frequent and often lead to injuries. Age-related depression or constant exhaustion can also have a negative impact on well-being. Safety and hygiene are then difficult to maintain at home.
• Physical impairments: disorders such as Parkinson’s disease severely restrict mobility. Muscle stiffness increases, walking becomes unsteady and everyday activities can usually only be performed with help. In a nursing home, people suffering from Parkinson's disease receive therapeutic support and assistance with everyday life.
• Cognitive impairment: people with progressive dementia can no longer cope with day-to-day life, do not recognise familiar faces and often react aggressively. Such changes often overwhelm those around them and endanger the safety of those concerned. People with dementia can often be dealt with more successfully in a nursing home, where there are trained staff and established structures, than at home.
• Unbearable demands placed on relatives: caring for a loved one is extremely exhausting – both physically and mentally. Those providing round-the-clock care usually forego rest, relaxation, personal needs and social contact. Over time, this can lead to exhaustion, anxiety, sleep problems, low spirits and depression.

Talk openly about the current situation and the reasons for moving into a nursing home. Invite everyone providing care to a meeting and, if possible, involve the person in need of care. This will help clarify expectations and the next organisational steps.

Medical requirements for admission to a nursing home

Admission to a nursing home doesn’t happen immediately. Specialists carefully check in advance whether inpatient care is medically necessary and whether organisational arrangements can be made. This assessment considers the need for care, personal circumstances and existing support services. The requirements for nursing home care are met when in-home care and support have reached their limits. Physical limitations, psychological stress and social factors can further exacerbate the situation. 

Once the decision to be admitted to a nursing home has been made, the search for a suitable facility begins. In principle, you can choose whichever home you like. However, the options vary significantly in terms of price, amenities, care and nursing priorities. It is therefore a good idea to clarify which criteria are important with the person concerned before making a selection; this will lay a good foundation for on-site visits. The following points will help you to find a place in a nursing home:

• Location: the location of the nursing home has an impact on day-to-day life and emotional well-being. Is there good infrastructure? Can the person concerned visit the doctor or go shopping by themselves, for example? Proximity to familiar surroundings, family or friends is also important. This helps them adapt and provides security. Together, consider what frequency of visits to the nursing home is realistic and desirable. Ideally, the location will support these preferences.
• Amenities: make sure the environment is conducive to the person being cared for. Bright communal areas, a well-kept garden and peaceful places to retreat to provide an inviting setting. Accessible design makes everyday life easier and improves safety.
• Rooms: are there both single and double rooms? You should also check whether there is an easily accessible bathroom with shower and toilet and whether a telephone, TV or internet connection is included. Find out which emergency call system is in place and whether the person in need of care can take their own furniture.
• Meals: a varied, balanced diet is good for health. Enquire about specific dietary needs and opportunities to help plan menus. Is there a restaurant where people can eat together?
• Medical care: find out about in-house medical care and collaboration with external specialists. How is medication provided? Who will provide emergency care? For chronic or progressive illnesses, services such as dementia and palliative care in the nursing home play an important role.
• Care: find out how care is organised and whether it is appropriate for the health situation of the person being cared for. What day-to-day services does the care team provide? Do they have experience with specific medical conditions? A specialist dementia nursing home often has special care concepts and trained employees.
• Activities: a varied daily routine boosts mental well-being. Enquire about exercise options, creative groups, excursions and cultural events. Ideally, the activities should reflect the interests and abilities of the person being cared for. Also find out about visiting hours and the services offered. Can residents get a haircut or pedicure on site, for example?
• Costs: get an overview of all the expenses – from basic care to supplementary services. Pay attention to which services are included in the daily rate and what is billed separately. The cost of a nursing home in Switzerland varies depending on the facility, canton and care needs. 

A personal visit usually gives the best impression. Look around the nursing home at your leisure, talk to the management team and observe the daily routines. This usually provides a good assessment of the quality of the nursing home. Conversations with people who are familiar with the home may also provide valuable information. Also bear in mind that many homes have long waiting lists. That’s why it is important to plan ahead and include several care homes in your selection to increase your chances of finding a suitable place at the appropriate time.

Helpful information, address databases and further links can be found at heiminfo.ch.

Three parties are involved in financing nursing home places in Switzerland: basic insurance, public authorities and the person in need of care. Health insurance companies cover a fixed portion of recognised benefits, such as basic care and medication administration, regardless of the nursing home. The canton or local authority contributes to other care costs, and the person in need of care finances the remainder. This includes a share of the care costs, as well as the costs of accommodation and meals, along with personal expenses.

Social welfare assistance for admission to a nursing home

Not everyone in need of care can cover the costs of a nursing home place themselves. In such cases, public authorities provide financial assistance under certain conditions. This assistance takes the form of a helplessness allowance or supplementary benefits on top of OASI or DI. If neither income nor assets cover the care costs, social welfare assistance at a nursing home may also be available.

If someone is moving into a nursing home and there are questions about covering the costs, it is worth contacting the OASI/DI office or the responsible municipality at an early stage. They will tell you which benefits are available in your individual case. Pro Senectute will also be happy to provide detailed advice on financial matters.

When it comes to admission to a nursing home, there are a few things to do. This checklist will help you keep track of everything during the move:

• Cancel the telephone connection: check whether a landline is still required. If not, special notice of termination is sufficient, stating that you would like to cancel the telephone connection due to admission to a nursing home.
• End the tenancy: inform the landlord in writing in good time. Generally speaking, terminating a tenancy due to admission to a nursing home is sufficient reason. Keep a copy of the letter for your records.
• Check the contents insurance: find out whether the insurance cover no longer applies or whether it needs to be adjusted. It’s often possible to save on contributions if a person’s contents insurance is cancelled when they move into a nursing home.
• Re-register with the local authority: when moving into a new nursing home, de-register the person in need of care from their old place of residence and register them with the new local authority.
• Announce the change of address: inform relatives, friends, health insurance companies, banks, the post office, pension funds and other important bodies. Arrange for post to be forwarded if necessary.
• Sort out any aids: talk to the home about any aids required, such as a walker, wheelchair or nursing bed. Return any aids that are no longer needed via the health insurance company.
• Take furniture and personal belongings: ask if the person in question is allowed to take their own furniture. Personal items such as pictures, books or memorabilia create a familiar environment.
• Set up a lasting power of attorney: check whether a valid power of attorney exists and who is listed as authorised persons. The home needs this information so it can make legally sound decisions regarding medical and financial matters. Please submit a copy of the lasting power of attorney to the nursing home.
• Gather important documents: pack identification cards, insurance cards, living wills, lasting powers of attorney, care level notifications, medication plans and medical reports.
• Organise medical care: check with the GP whether care will continue or be transferred to the home. Notify other healthcare professionals about the admission to a nursing home.
• Nursing and delivery services: cancel outpatient care, meal services and other regular services that were previously used.

Once a suitable home has been selected, there will usually be an admission meeting with the nursing home’s management. This will cover care services, financing, support and personal wishes.

Admission to a home changes a lot for the person concerned, as well as for their family. Feelings such as sadness, insecurity or guilt often arise, so talk openly about the planned admission to a nursing home. Actively involve the person in need of care and visit various homes together at an early stage. Admission to a nursing home can often be made easier if wishes, needs and concerns are directly addressed.Leaving a previous home can be painful. Be patient if your loved one withdraws or becomes confused in the first few weeks. Adjusting to a nursing home takes time: keepsakes, familiar furniture or personal photos create familiarity and consolidate the new everyday routine in a nursing home.

Stay in touch at all times. Brief outings, coffee together or a friendly chat all contribute greatly to well-being. Use small gestures and regular visits to show how strong the connection remains despite the admission to a nursing home. This often creates a new dynamic in relationships – with less stress.

What can I do if someone doesn’t want to go into a nursing home?

People with dementia are often sensitive to change. Moving is particularly unsettling for them if it eliminates familiar routines. You should therefore carefully prepare for admission to a nursing home. Offer initial care experiences outside the home, through a daycare centre or hourly support from a trusted person, for example. When choosing a home, make sure that it specialises in adaptation to a dementia nursing home. This will make the transition smoother and your loved will become familiar with life in a nursing home more quickly.

Don’t forget about yourself, either. If you feel overwhelmed or guilty, talk openly to someone you trust or a professional. It is especially important to keep your strength up when caring for family members. When your mother or father moves into a nursing home, you don’t need to feel guilty – this step often eases the burden and allows you to enjoy new, memorable experiences together.

Moving into a nursing home isn’t always the ideal or only solution. It’s worth considering other residential and care models, especially when the need for care starts to arise or when independence in day-to-day life is very important. The main alternatives to a nursing home are:

• Spitex: various nurses offer support in a familiar environment. They provide medical and nursing care on an hourly basis, and also help with household tasks. Spitex is therefore suitable for people with mild to moderate care needs who live alone and want to remain at home.
• 24-hour care: if someone needs a lot of care but still wants to remain at home, 24-hour care is a good option. A live-in carer joins the household and provides assistance with all aspects of daily life.
• Care by dependants: family members provide day-to-day care and support. While this model requires a lot of commitment, it creates a familiar atmosphere. It is particularly suitable for people with stable health and a supportive social network. Respite services and counselling help prevent unbearable demands from being placed on relatives.
• Assisted living: this type of housing combines independent living with supportive services. Assistance is available if needed, with housework or organisational matters, for example. This model is aimed at people with mild support needs who value security but want to live independently. The difference between a nursing home and assisted living is the level and scope of care provided.
• Retirement home: retirement homes are a form of housing for older people with minimal care needs. They provide accommodation, meals and community activities without offering intensive medical care. The question often arises: what is the difference between a retirement home and a nursing home? While retirement homes focus on assisted living, nursing homes are geared towards comprehensive care needs.

Deciding between a nursing home and assisted living requires careful attention, patience and understanding. The better informed you are about the various options, the easier it is to make the right choice – in the interests of the person concerned and their well-being. Sometimes it only becomes clear whether admission to a nursing home is the right solution after consulting specialists or following a more in-depth discussion. Trust your gut instinct, observations and interaction with the person you are helping.