The decision to place your loved one in a nursing home is often difficult. We all want our family members to have the best care and retain a sense of dignity and independence as they age or face chronic medical challenges.
At the point where it becomes too difficult, expensive and stressful to provide that kind of quality support at home or in independent or assisted living, a skilled nursing facility is the necessary next step.
There are many excellent nursing homes that provide quality care. To find the right match for your loved one takes some advanced research and planning. All too often, a medical crisis requiring hospitalization precipitates a move to a nursing home, which may constrain your choices. It’s best to explore your options before a crisis hits, to fully understand what’s most desirable and possible.
Try to identify three good facilities in your area, to give you a sense of the range available. Choose facilities that are within a short drive from family, if possible. Nursing home residents do best with regular, frequent visits.
Here are some guidelines for choosing the right nursing home for your loved one:
1. See for Yourself
It’s always advisable to visit a care facility before making any kind of commitment. You can do your initial research via the Internet and conversations with knowledgeable friends and professional Geriatric Care Managers, but a site visit is the only way to be sure you’re choosing an appropriate setting. Schedule a visit, but plan on visiting unannounced, as well, during an evening or weekend when staffing will be at its lowest, to assess.
Among the things to look for:;
- What is the quality of staff interactions with residents? Are staff caring, kind and respectful?
- Are the residents clean and well-groomed?
- Does the nursing home look and smell clean?
- Is the facility well-maintained?
- How does the food taste? Would you want to eat it every day?
- Do residents in need of assistance receive it promptly, with kindness? Or are call lights left on for lengthy periods without being answered?
- Does the facility offer a variety of activities for varied interests? Are residents actively participating?
Important questions to ask:
- Is the facility Medicaid certified? Medicare certified?
- Are new residents being accepted? Is there a waiting list for admission? If so, how long is the wait?
- What is the resident-to-staff ratio? How many RNs and LPNs are on duty each shift?
- Does the facility conduct background checks on all staff?
- Is there an active family council? Residents council?
- What is the visiting policy?
- What is the discharge policy?
- Is transportation available for residents who need to see doctors outside the facility?
- For private pay residents, what is the monthly cost?
- What is the level of staff experience caring for people who have Alzheimer’s or dementia? Is there a special unit or services for those with memory loss?
2. Check for Safety
A licensed facility must have certain safety features in place. Here’s what to look for:
- Well-lit stairs and hallways
- Clearly marked exits
- Hallways equipped with handrails
- Grab-bars and call buttons in rooms and bathrooms
- Security and fire safety systems
- Emergency generator or other power source
- Clear and logical floor plan that facilitates emergency evacuation
3. Understand the Community Culture
You can learn a lot by careful observation. When you visit, make a point to watch for the following clues to the culture and values that guide the nursing home community:
- Do staff knock before opening the door to resident rooms? Is privacy respected when residents are dressing or being bathed?
- How do staff address residents? Is the conversation personal and on an adult level? Or do staff appear to “talk down” to residents?
- Are residents’ rooms decorated with personal objects and furniture, or does the setting appear uniform and institutional?
- Can residents make personal choices about daily routines, such as when to go to bed or when and where to eat meals?
- Are varied cultural, religious and language needs honored?
- Are residents’ rights clearly posted?
- Are there pleasant spaces, inside and outside the building, for personal family time?
You can find more guidelines for choosing the right nursing home for your loved one here:
- About.com Senior Living: How to Find the Right Nursing Home
- US News & World Report: TODAY Health: Finding the Right Nursing Home, Step by Step
President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric 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.