Choosing a Nursing Home Facility

Finding a nursing home

Finding the right nursing home is not easy, and you may be under pressure to move fast due to a recent hospitalization or deterioration in condition. The more information you have, the greater your chances of finding the right fit for you or a loved one. Here are some tips on narrowing down your options:

  • Start with referrals. Does your family physician or specialist have any recommendations? Or do you know any friends or family who have used different homes? Knowing someone with first-hand experience with a home can help you narrow your choices. However, remember your needs may differ: one size does not fit all.
  • Educate yourself. Online resources for nursing homes include ranking sites that utilize existing state data to rate nursing homes. Every state has what is called a long term care ombudsman, which can be a valuable resource about the current condition of a nursing home. Advocacy groups can also provide hints on searching for the right facility. See the resources section below for more information.
  • Consider your medical needs. Different nursing homes may have more expertise in different areas. Are they experienced in handling your condition of interest, such as for Alzheimer’s or a stroke? Or are you looking for more short term rehabilitation?
  • Factor in distance. In general, the more convenient the home, the easier it is for family and friends to visit.

Planning a visit

Once you’ve narrowed down your list of homes, it’s time to plan a visit. Visiting is key to understanding if a home is right for you. As with other senior housing options, it’s the people that make the place, both the residents and staff. In a nursing home, you’ll also need to make sure that the medical care is delivered appropriately and promptly.

What to look for in staff:

  • How is the staff turnover? What is the staffing level on weekdays, weekends and evenings?
  • Do they have time to speak with you or does it feel rushed?
  • How would they manage your health condition? How are medications and procedures arranged? And how do they handle emergencies or accidents such as falls?
  • Do they appear genuinely interested in you, and do you see them interacting warmly with current residents?

What to look for in current residents and their families:

  • Do the residents appear happy, engaged? Or excessively groggy and overmedicated? Do they seem clean and well groomed? Do they seem like people you’d enjoy getting to know? How do they respond to you? Try to observe social gatherings such as meals or other activities. If needed, are residents getting timely help to eat, and with getting to and from the gathering areas?
  • If you see a family visiting, you can ask them their impressions of the home and how their loved one has been treated. Ask if there is a family council and if you could attend.

What to look for in the facility:

  • Cleanliness. Does the facility appear clean? Do you smell urine or strong deodorizers that may be covering up the smell of urine?
  • Food. What kinds of meals are normally served? Does it look nutritious and appetizing? How are special diets handled? What kind of help is available with meals, and do they have to be eaten at the same time or in a common area?
  • Arrangement. Traditionally nursing homes have been run like a medical facility, including a centralized nursing station and set medication and mealtimes. Some nursing homes are now moving to a different model, with smaller communities and communal areas. If this type is available in your area, it may provide a more homely feel.
  • Activities. What quality of life activities are available for residents? Are outside activities also arranged as well, health permitting?
  • Experience with your condition. If a loved one has Alzheimer’s, for example, is there a special care unit or specialized staff and activities? How does staff handle behavioral problems like agitation, or wandering?

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