What to Look for When Choosing a Nursing Home for Your Loved One with Alzheimer’s Disease

memories-1455326-639x479Placing your loved one in a nursing home is inevitably a tough decision that rouses many emotions about family obligations, concerns about finances and worries about doing the “right thing.” Ultimately, however, the decision comes down to this: Where will your loved one truly do best in the long run?

When it comes to Alzheimer’s, as symptoms advance, it’s often the case that the individual will do better in a nursing home specializing in Alzheimer’s care. Trained staff and specialists, a safe environment and appropriate activities, plus support for family members can make a significant difference in quality of life for everyone involved.

But how do you find the right Alzheimer’s Special Care Unit, particularly when it seems as if every nursing home promotes memory care services?

Massachusetts Requires Truth In Advertising about Dementia Care

Here in Massachusetts, the Alzheimer’s Association has worked hard to promote legislation ensuring that any nursing home that advertises dementia care actually does meet appropriate standards. A dementia care law passed in 2012 required all of the Commonwealth’s 414 nursing homes, whether they have a memory care unit or not, to complete staff training in dementia care by last November, since so many nursing home residents have some form of dementia.

But a July study by the Alzheimer’s Association of Massachusetts and New Hampshire found that almost 60 percent of Massachusetts nursing homes have skirted state rules about not making false claims regarding level of dementia care.

As a result, in August, the Department of Public Health issued new rules to tighten up advertising about dementia care. Massachusetts nursing homes can no longer promote dementia care or memory care unless they operate a dementia special care unit that complies with state regulations.

How to Evaluate an Alzheimers’ Special Care Unit for Your Loved One

Even with that consumer protection in place, you still need to know what to look for when selecting an Alzheimer’s Special Care Unit for your loved one. The Alzheimer’s Association-Massachusetts Chapter has created an excellent consumer guide, “What to Look for While Evaluating a Nursing Home for Someone with Alzheimer’s Disease.” Here are a few highlights:

Policy and Procedures

  • Does the Unit use Habilitation Therapy, a therapeutic approach to care for dementia patients developed by the Alzheimer’s Association-Massachusetts Chapter, in their program?
  • Is there an admissions policy that indicates that all the residents in the Unit must have a solid diagnosis of Alzheimer’s Disease (AD)? A mix of residents with AD and mental illness is a dangerous combination. Avoid facilities that have a “behavioral unit.”


  • Are the doors to the designated unit alarmed and on a delayed opening system?
  • Does the unit have adequate space for activities? Is there enough room for guests and residents to visit?
  • Check the flooring throughout the unit. If it’s vinyl, it should have no shine; if carpet, it should not have large patterns or dark borders. There should be no checkerboard patterns on the flooring.
  • There should not be an overhead paging system.
  • Is there a safe outside area with a walking path and appropriate fencing?
  • Are there features in the environment that help residents find their rooms, such as color-coded trim?
  • Does the Unit smell clean?

Staffing and Training

  • Does the Unit have a certificate from the Alzheimer’s Association indicating that all direct care staff have received a minimum of 12 hours training specifically on Alzheimer’s care, and the non-direct care staff, two hours of training?
  • Does the Unit maintain appropriate staffing ratios? Recommended: 1 staff to 5 residents for day and evening shifts; 1:9 for overnight.
  • Is there a full-time Unit Director responsible for running the Unit, advocating for residents, training staff and working with family?
  • Does the Unit have a specialist in therapeutic activities, a social worker, consulting support for working with agitated residents, clergy?
  • Can staff speak the language of your loved one?

The Guide includes many more detailed items for each of these categories, as well as what to look for regarding administration, activities, care plans and services.

In addition to these specifics, the Guide recommends getting a sense for the overall culture of the nursing home: Do the nursing assistants smile and treat the residents with kindness and compassion? Do they speak clearly without yelling? Are they respectful of the residents?

To order a copy of “What to Look for While Evaluating a Nursing Home for Someone with Alzheimer’s Disease,” please contact the Alzheimer’s Association, Massachusetts/New Hampshire Chapter, 480 Pleasant Street, Watertown, MA 02472; 617-868-6718 or 800-272-3900; www.alzmass.org.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.

Image Credit: Fritz Beck

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4 Responses to What to Look for When Choosing a Nursing Home for Your Loved One with Alzheimer’s Disease

  1. Leviticus says:

    Those are some great questions to ask before choosing somewhere for your loved one to live. I wouldn’t have thought to check the flooring patterns to see if they’d cause a problem. My grandpa has Alzheimer’s and my grandma won’t be able to care for him much longer, so we’re looking around for the perfect place for him. http://liveatlegacyplace.com/breese/

  2. Burt Silver says:

    Thanks for the information on choosing a nursing home. My grandmother is getting to the point that she cannot live on her own, and we want to find her the best care possible. Thanks for mentioning that the unit should have enough space for activities. We don’t want her to be cramped or uncomfortable.

  3. Frank Delaware says:

    Thank you for all this great information about choosing an assisted living home. It makes sense that you would want to see the training they went through. That way, you know your loved one will get the care that they need. http://www.altaridge.com/holladay-community/

  4. Kyle Winters says:

    There really is a lot about the environment that you have to take into consideration when choosing a nursing home for you loved one. In particular, I am glad that the article brings up the importance of having an outside area where they can walk and enjoy the outdoors. After all, our elderly loved ones deserve to get some fresh air and sunshine just like everyone else. http://www.vvrconline.org/ResidentialLiving.html

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