When you choose a nursing home, you’re choosing where someone you love-someone who is dependent and in need of care-will likely spend the rest of their life.
Plan ahead if possible; don’t let this be a last minute, rushed decision. Familiarize yourself with area nursing homes before they’re needed. Include your loved one in the process when they are still aware and competent and able to exercise judgment, and make this as much as possible their decision and not just yours.
In the beginning, you may not even be aware of your options, of what nursing homes are in your area. Eldercare Locator at 800-677-1116 is a good place to start. This is a program run by the Department of Health and Human Services that provides listings and information on nursing homes. Doctors and nurses can be good sources for nursing home recommendations. You also should talk to anyone you know with a family member in a local nursing home.
Do your homework to make sure any nursing home you’re considering is state licensed, and certified for Medicare and Medicaid.
Of course before making a decision, it’s crucial to visit the nursing home in person. Spend plenty of time there, ask a lot of questions, see everything there is to see.
Here are a few tips for what to look for:
1. Level of care and services
Nursing homes differ greatly in what level of care is available and what services they provide. Your loved one may need minimal daily assistance with certain activities, or may need full time medical care-make sure you choose a suitable facility. Some facilities are especially for people contending with specific disabilities, whether it be Alzheimer’s or blindness. Some are affiliated with a church and provide religious services. There may be physical therapy, social activities, recreational activities, etc. available.
You perhaps can’t expect a nursing home to have no odor at all, even if it’s just a noticeable antiseptic smell, but a strong unpleasant odor is a big red flag.
You can pick up a lot from just observing the residents. See if they are spoken to and treated with respect. Note if they seem content, or neglected or unhappy. Staff should have pleasant dispositions.
The facility should be well lit and pleasantly decorated. Make sure there is hot water in the bathrooms. Make sure there is plenty of drinking water available to avoid dehydration.
Check all areas for cleanliness, especially the kitchen and dining area. Remember safety issues, such as smoke alarms, emergency exits, and guardrails.
You need to crunch the numbers with a responsible party at the nursing home and make sure you understand what this will cost. Find out what’s in the base price and what will be charged extra. Determine what Medicare or your insurance will cover and what you will have to cover.
4. Medical staff
There should always be a doctor available. There should be sufficient nurses. The same team of nurses and assistants should work with the same resident. There should be a pharmacist or trained person on staff to monitor medical records and medications.
A very useful resource to use in guiding your decision process is this checklist provided by Medicare.
Karen Westerberg Reyes, “Choosing a Nursing Home.” AARP.
“Choosing a Nursing Home: A Caregiver’s Guide.” National Family Caregivers Association.
“How to Choose a Nursing Home.” Nursing Home Guide.