Tips for Choosing a Nursing Home

One of my many employment experiences was working as the Social Services Director of a nursing home. I know how difficult it is for anyone to actually place the seniors they love into a home and relinquish their minute to minute care to strangers. And you are right to be concerned. The quality of care varies greatly and you can't get too much information before you make your choice.

Before you do anything at all go to http://www.medicare.gov/publications/pubs/pdf/02174.pdf and download this publication. It is 68 pages and if it absolutely a must have as you begin your task of making this important choice. It is called a Guide to Choosing a Nursing Home. There are instructions at the end of the guide which will tell you how to get it in Spanish if you need it in that language. Reading this brochure will give you a sense of having some direction as to how to proceed.

Every city has a Council on Aging. Call them and ask if they have a list of local agencies with ratings. Ask to speak to the long term care Ombudsman. They are usually extremely nice and helpful.

Before you start visiting different homes make a list of your loved ones special needs - things like can they hear, are they picky eaters, can they see- things like that, so you can ask specifically how those needs will be addressed.

This is one time asking friends and family for recommendations is a good thing. Let people know you are trying to learn about the local nursing homes. Personal stories should be listened to. No matter how highly rated a home may be personal experiences from residents and family are more meaningful. Every nursing home is required to have a resident council. During that time the residents discuss their needs with administration. Attend this meeting. If they don't have such a meeting or are refusing to allow you to attend look somewhere else. You want a home that listens to its residents and cares about meeting their identified needs.

Visit the home at different times of the day. You want to see how each shift of staff is run. Talk to the staff and see if they are friendly and make you feel comfortable. Is the financial office helpful in trying to assist you to clearly understand the costs involved? Don't make any commitments until the finances are fully understood. And of you are not understanding ask questions - several times if necessary. Is the staff patient? If they are not patient with you they surely won't be patient with the residents.

Make sure the home and the administrator are licensed. Ask to see the licenses. Ask to see current fire inspection and food inspection results. Does the home look clean? Are the residents clean? Eat a meal or two in the dining room. Is the food good? Are special dietary accommodations being made for those who need it? Is the dining area inviting and the seating comfortable?

Here is something you won't find in any brochure but I have learned this from my personal experience. You want to know how long the administrator has had the job. New administrators usually make a lot of staff changes. This process disrupts the feeling of cohesion and order. Management may be chaotic for quite some time. People are learning their jobs and not working as a team. While this may be a good thing in the long run, it is usually very upsetting to the routine and care as these transitions are made. Ideally you want an administrator and a director of nursing who have been there for a while. The more stable to staff the more stable the care. Why did the last administrator leave? Is the home in financial trouble? Was there an incident that resulted in their removal? The staff won't tell you this but the patients and family members might.

And lastly if you do make a choice and it isn't working out don't be afraid to speak up and, if necessary, make a change. Visit often and watch how your loved one is being cared for. Attend care plan meetings and don't sit silently and listen. Tell them what you need and what they may be doing wrong. Advocate for your senior. It's unfortunate but true that those who have involved and present family get better care.