Long term care facilities are, by the nature of their services and structure, communities. While it is possible for people living in a retirement setting, receiving no services and requiring no interaction with fellow residents, to avoid all but voluntary contact, it is more likely that residents in long-term care facilities will have more daily contact with people other than family members than they have ever had in their previous lives.
Assisted living residents may have their own apartments but they are eating with others and living in large complexes as opposed to the private homes they may have inhabited in the past. In foster care and nursing facilities, quarters are even closer and many residents share a room with another resident.
There can be tense and uncomfortable situations for residents and their families related to lack of privacy and unavoidable contact and interaction in these settings. In nursing facilities, families will often have very little time or choice in arranging discharge from a hospital. They may assume that since the resident had a private room in the hospital that she will also have one in the nursing facility. If this is a critical issue for that resident’s recovery and well-being, and it can be, it is important to state this to the discharge planner in the hospital and make it the top priority when speaking to admissions coordinators at the nursing facility.
Many facilities have a number of private rooms but many others have few. If privacy is more important than the reputation of the facility for rehabilitation or other care, make that clear from the beginning to everyone involved in the arrangements. It should also be noted that skilled care reimbursed by insurance, including Medicare, does not offer payment to nursing facilities for private rooms. Facilities cannot allow families to pay extra for such privileges. Only residents paying privately for intermediate or custodial care can be charged for private rooms and facilities may be reluctant to offer those rooms to short-term residents whose stay is reimbursed at a flat rate.
While a private room may not be possible, facilities should be expected to attempt to match a new resident with an appropriate roommate. No person recovering from a hospital stay should have to endure noise or inappropriate behavior, and if this occurs, families should approach the social services designee or the administrator and ask for a transfer for the resident. If the resident in a nursing facility is sharing a room, the facility is required to ensure privacy by using curtains to create separation, asking visitors to leave when personal care is being offered, and creating quiet time and space for rest and sleep. If at all possible, prior to admission or actually choosing the facility, the family should ask to see the room and ask about the roommate’s routines and personality. In most situations new residents and families get along well with the roommates and their families and even establish new relationships. These all depend on courtesy and mutual respect for privacy and dignity along with some tolerance for the different expectations and routines of others. Such behaviors are not always easy to maintain in the middle of a crisis when families are already under stress. It is always best to request assistance from the staff in difficult interpersonal situations.