How to Choose a Nursing Home Facility

One of life’s hardest decisions is deciding to place a loved one in a nursing home. Nursing homes often get a bad rap as being the hold over stop before a person dies, and in some sense there is a bit of truth to that. However, sometimes placing a loved one in a nursing home facility is the only way to ensure that they will receive the quality of care they deserve, especially when the aging process is compromised by severe illnesses and medical conditions. When it becomes a necessity to make this hard life decision and nursing home placement is the path chosen, it is important to research and thoroughly investigate the facility you choose.

Instructions

Difficulty: Moderately Easy

1. Decide what type of facility will most benefit your loved one. Do they need a long term care skilled facility, or minimal assistance in an assisted living facility?
2. Look at finances and medical coverage. It is important to know how you will pay for nursing home care and this may help you decide on the best facility within your financial means. However, that does not mean you should sacrifice quality of care, but some facilities do not except state-aid and are private, while other facilities work with the family member to ensure the best care and affordable payment.
3. Choose a location radius. You will need to decide how far you are willing and able to travel so that visiting your loved one will not be a problem or become an inconvenience.
4. Consult with loved one’s doctor. Doctors that specialize in geriatrics care may be affiliated with a nursing home facility, and this may help your search go smoother. But, be prepared for waiting lists at nursing homes. This means you may have to find alternative means of care until a room becomes available.
5. Visit several nursing home facilities. While there, you should thoroughly look around the facility and jot down notes about what you like and dislike.
6. Make sure you meet with the facility administrator, social worker, director of nursing, dietician, restorative/occupational therapist and recreational advisor. A good facility will be adequately staffed, and you should ask what the nursing staff to resident ratio is for all shifts.
7. Check for odor. Sure, there seems to be a distinct scent that permeates nursing home facilities, but overpowering odor is a sign that someone is not doing their job. In fact, when nursing home facilities are inspected yearly, there is a score given for odor. For the most part, unpleasant odors in nursing homes can be controlled through proper and prompt care being given to residents and quality housekeeping staff making sure the facility is clean.
8. Ask about restraint usage. Many nursing home facilities are pursuing restraint-free atmospheres, which mean that they use other means to deal with residents that may be combative or at risk for falling. A nursing home that utilizes restraints should also have a restraint protocol implemented. This means they must release restraint at certain intervals. While you are looking around, take note of how many residents are restrained and how often they were checked while you were there. You do not want to choose a facility that overly uses restraints because they can be abused and cause neglect to the residents.
9. Find out about monthly, bi-monthly or tri-monthly care plan meetings. These are meetings that are set up to discuss a resident’s total care. Generally, a member from all departments of the facility is present, including a family member. There will be discussion about the overall health and wellness of the resident, what improvements can be made and what the long term prognosis is. A quality facility will notify and include the family member for these meetings.
10. Inquire about end of life decisions. Some nursing home facilities require that residents have a signed DNR (Do Not Resuscitate) in their charts, and they are a specific end of life care facility, meaning they will not code a resident. Not all facilities are like this, but some are.
11. Ask to see information on the facilities most recent health inspection. It should be posted in the facility, but if you do not see it, you should ask about it.
12. Discuss activities the facility encourages the residents to be part of. There should be a full range of activities offered to the residents, including out of facility day trips for residents that can still get around.
13. Inspect the rooms. It is important that your loved one will feel safe and comfortable. Make sure the rooms are tidy and clean. Some nursing homes allow residents to move in furniture items from home, while others resemble a hospital room.
14. Talk about spiritual worship and religious accommodations. Maybe the facility only offers worship for a specific religion other than the one practiced by your loved one.
15. Question the dietary staff about the types of food served. You may be able to sample a meal.
16. Make sure the facility is affiliated with a hospital that will accept the type of medical coverage you have. This will help avoid unnecessary out-of-pocket expenses.
17. Monitor the security system that is used by the facility. Some nursing homes have safe security systems in place and use door alarm systems that help them monitor and prevent residents from wandering out of the facility. This is important for residents that have dementia or other condition that predispose them to wandering off.
18. Watch the staff. Make sure the staff interacts well with the residents. The staff should look and act professional at all times.
19. Check with the state health department to see if there have been any complaints made against the nursing home facility you are interested in.
20. Take some time to think about each nursing home facility you have visited and weigh the pros and cons about each facility. Then, narrow down your choice to the one facility you and your loved one will feel comfortable with.

Tips & Warnings

• Residents that are immobile or cannot get around without assistance and are left in one position for longer than an hour are more susceptible to skin breakdown (decubitus ulcers). This is a sign of nursing home neglect, though even the most vigilant care and repositioning does not always prevent skin breakdown. Ask the director of nursing how many residents have skin breakdown at the time of your visit. They should be able to answer this, and it will be a good indication as to the type of care given in the facility. Most facilities have repositioning protocols in place to lessen resident risk for skin breakdown.