Sunday, April 21, 2024

How to Find the Right Nursing Home

wheelchair in nursing homeMaking the Long Term Care Decision

The decision to move a loved one into a long term care facility (LTC) may have to be made during stressful times. After a hospital stay elderly loved ones may be well enough to leave the hospital but not well enough to go home. Family members may need to quickly make some difficult decision. Depending on the illness, a nursing home may be their home for a very long time, therefore choose wisely. If you have chosen to move ahead with moving your loved one to a LTC nursing facility, how can you tell which facility is best?

Careful and thoughtful preparation ahead of such a situation will make the transition easier for the patient as well as the caregivers and family while providing comfort in knowing how such a situation is going to be handled. What environment would the loved one be most comfortable?

How to Find the Right Nursing Home

It is best to visit the nursing home you are considering before making a decision. You should call ahead and ask for a time to meet with staff. Be sure to ask if they have a drop-in policy, then follow up with some unannounced visits.

One of the best places to start comparing nursing homes is the nursing home compare website showing interesting vital statistics - such as how many dementia patients are heavily medicated - on Medicare approved nursing homes.  This site is a must see!

Nursing Home Checklist

  • Do residents look well cared for, happy, and alert?
  • Are residents engaged in activities?
  • What do the interactions between staff and residents look like? Is the staff friendly, caring and supportive? Do they call the residents by name?
  • Does the facility look / smell clean and well maintained? Is it bright and cheery or dull and drab?
  • Is it easy to move from one place to another?
  • What is the proximity of the dining room and other important areas? - consider mobility issues.
  • Are halls and bathroom facilities large enough to accommodate wheelchairs?
  • What safety / security precautions are in place? This can range from fire extinguishers and smoke detectors to patients escape precautions. Are emergency evacuations procedures clearly posted.

Questions to Ask Before Selecting a Nursing Home

So, if you have a chance to meet with someone from the facility, you may want to prepare a list of questions ahead of time so that you cover the bases that are most important to you. Here is a list of possible questions you may want some answers on before you make a long-term care decision:

  1. What is the daily and monthly rate for services – and is this fee all-inclusive or will there be other out-of-pocket expenses for things like activities or grooming care?
  2. Does the facility accept your long-term care insurance, Medicare and/or Medicaid? Depending on your situation, you may need to go further into questions related to fees and method of payments.
  3. What types of services and activities are provided on-site: Hair care, religious services, x-ray, labs, pharmacy, etc. and what will require additional fees or transportation for off-site services?
  4. How often and what method is used for bathing?
  5. How many personal items can be brought into the room?
  6. Does the room have its own bathroom or is this shared?
  7. What personal/hygiene items are provided for the residents – hygiene items like shampoo, etc. and personal items like medical equipment: canes, walkers, wheelchairs, etc.?
  8. What are the typical weekly/daily/monthly activities – how much time is scheduled and social?
  9. Do they eat meals together or alone in the room? What is the meal schedule and how much say does the resident have in menu planning?
  10. How often can residents get outdoors for walks, etc.? Are there ever any “field” trips or outings planned? Can family members take residents for holidays, etc. and what is the policy and procedure for that?
  11. Staffing - Does the staff have “permanent assignments” as opposed to being shifted around to different residents? Ratio of staff to patient? How many staff do you have? “Permanent assignment” allows the staff to get to know their residents and develop strong relationships. To find the standards for nursing home staffing in your state visit here.
  12. Are there specialists on hand for your family member’s particular needs (such as Parkinson’s disease or Alzheimer’s disease?).
  13. How does the staff make treatment/goal setting plans for residents and how is the family part of that process? (treatment philosophy)
  14. What are the visiting hours and other policies for family?

Clearly, this list may go on and you should think of other questions specific to your family member. It is important to chat with the nurses on the floor as well during your visit to see how friendly they are, etc.

Sometimes, the best information is gathered by chatting in a casual way with staff as it may open up comments, gripes, or other information you would not get by just asking the administrator a set of basic questions. If there are lots of complaints or negative attitudes about the “management” or the residents, this may be a clue that the facility is not a great place to work or live in.

Finally, what is your gut feeling? We can often gather information that is not necessarily logical by asking ourselves some basic questions like “would I want to live here?” If the answer is no, then it is not a great idea for your family member either. Maybe you can’t quite put your finger on it, but the social atmosphere is unfriendly or the physical surroundings are depressing. If you feel this kind of thing, trust it - and investigate more or move on to another facility.

After You Compare Nursing Homes - Next Steps

The next steps are moving forward with an agreement once you find a nursing home facility you like. You may need to get Powers of Attorney, certain papers in order, and have some family conversations.  Download this extensive guide to choosing a nursing home from Medicare.


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