June 12, 2014 Medical Conditions

Caring for Your Elders: How to Choose a Nursing Home

Caring for an aging loved one can be difficult in a lot of ways; aside from demands on your time and money, it can be an emotionally trying experience. The decision to put an elderly parent into a nursing home is not an easy one, so when the time is right, you want to be sure that you’re making the right decision.

If you have already decided that a nursing home would be the appropriate place for your family member, one of the first steps you can take to figure out the best placement is at Medicare.gov Nursing Home Compare. Here, you can search by location (as narrowly as a specific ZIP code or as broadly as by state) and then narrow your search to compare up to three homes at a time. The site will display how the facilities rank against one another with respect to inspection results, staffing, and other quality measures.

Your parent is entering nursing home care because he or she can no longer live safely on his or her own. As soon as that person moves into a nursing home, however, you’re entrusting strangers with his care. Here are some things to look for when you visit to make sure that the nursing home is treating its residents with respect and providing the best quality of care:

Check out the food: As people age, they lose sensory sensitivity, so it’s important that they are being served food that not only meets dietary requirements, but also that looks appealing and smells and tastes good. Certainly, restrictions like a low-salt diet or needing pureed foods can affect the overall quality, but good food is likely an indicator that residents’ sensitivities are taken into consideration.

Listen: Observe how staff treats residents. Are they addressed as “Mr.” or “Mrs.”? The current generation of elderly citizens is accustomed to being addressed with formality. Staffers should ask each resident how he or she prefers to be addressed, and stick with it. Don’t be alarmed if you hear residents moaning or yelling; it can be disconcerting, but it’s often the result of residents’ descending into dementia, which can be a natural part of aging.

Smell: Nothing substitutes for what you see, hear, and smell when you visit a nursing home. It is normal to experience some unpleasant smells in nursing homes. Be sure to visit more than once and at different times of the day and different days of the week.

Staffing: If you’ve ever been in a job where understaffing is an issue, you know that being overworked equals high levels of stress. Caring for elderly patients requires a lot of giving under the best of circumstances, and staff should be attentive to details of residents’ lives and understanding of their needs. Inquire about the staffing ratio, and observe how the staff interacts with residents. Ask about consistency in staffing assignments. Do caregivers work with the same residents each day? It is important for your loved one to develop relationships with the staff in order to feel safe and comfortable in their new home.

Resident engagement: Walk through the nursing home to see what the residents are actually doing. Loneliness and isolation can be big fears for people who are heading for nursing home care. It’s not a good sign if residents are alone in their rooms watching TV during the day. Instead, look for people who are sitting in common areas or participating in activities. Ask to see a calendar that lists activities or special events. If your loved one is bedridden or not independently mobile enough to participate in activities, inquire as to whether activities can be brought to his or her room.

Policies and practices: While some policies are government-regulated, nursing homes can have some of their own. Inquire about their policies with regard to the following:

  • Personal belongings
  • Special dietary needs or preferences (including religious or ethnic restrictions)
  • Room assignments
  • Reserving a bed if transferred to a hospital temporarily
  • Visiting hours
  • Emergency procedures
  • Self-care
  • Phone calls
  • Leaving the home with family members or friends
  • Theft, complaint procedures
  • Access to personal funds

You want a safe, engaging, and pleasant environment with caring staff and solid medical practices. Ask questions about how the nursing home handles preventive health and the care of chronic conditions. It is important to keep your relative’s health from declining.

Choosing the right nursing home takes research and perseverance. The most important thing is that the nursing home you choose for your spouse, parent, or other family member should be a place where she or he feels comfortable and cared for. As you visit prospective choices, carefully observe the environment and trust your instincts. If residents appear content and in relatively good health, it’s a good sign that your loved one will be comfortable there, as well.

Here is a checklist that can help guide your questions and your visits.


References: AARP, NYS Department of Health, Medicare.gov

Renee Golderman
About the Author

Renee joined CDPHP in 2007 as vice president of health care quality and has more than 25 years of health care experience. She leads the development, coordination, and communication of all health quality initiatives and is responsible for directing the CDPHP Medicare Stars initiatives. Prior to CDPHP, she was director of nursing at Seton Health for 12 years. Renee earned a Bachelor of Science in nursing from SUNY Buffalo and a Master of Science in health care management from RPI. She is board-certified in nursing administration by the American Nurses Credentialing Center and is a member of the New York Organization of Nurse Executives.

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