Nursing home admission: when, why, where?

The decision to institutionalize older patients puts stress on both them and their families. This option should be carefully considered and alternatives explored before a final decision is made. The physician must seek and treat reversible diseases, and try to optimize the patient's functional status. Once the decision to institutionalize is made, careful preparation and follow-up of both family and patient must occur in the pre-, peri-, and post-admission periods. In this way, the physician can ease an otherwise traumatic transition, and ensure that the move is appropriate, well planned, and properly executed.