How to Choose a Nursing Home for Your Loved One
I am very often asked this question. The first thing I tell people is to choose a non-profit nursing home, if you find a suitable one. Non-profit nursing homes are not perfect. In fact, some non-profit nursing homes have seen some shocking neglect and abuse. However, some of the very best care can be found in good non-profit nursing homes. As a general rule, avoid a for-profit nursing home. The reason for this is that the profit motive very often leads some corporate decision-makers to under-staff and under-supply nursing home facilities. However, in many communities there is no suitable non-profit choice, and in any case, there are things you should look out for in any nursing home. Here is a list of things to consider:
1. - Choose a non-profit nursing home, if possible.
2. - Spend a lot of time making multiple visits to various nursing homes before you make a decision.
3. - Visit your final few choices on holidays, on Sundays, and in the afternoon and evening.
4. - Do not become fixated on fancy lobby furniture, art on the walls, or nice indoor plants. Those things are not good indicators of quality care.
5. - Understand that a guided tour of the facility is usually nothing more than a sales presentation. A guided tour is not a good way to judge a nursing home.
6. - Speak with the residents. Ask them what they think of the care they receive at the facility. Take their comments seriously. How is their grooming? Is everyone in a fog, or can some of the residents carry on a normal conversation? Talk to bedridden residents and residents in wheelchairs. If the facility will not let you speak to the residents, this can be a major warning sign.
7. - Eat a meal yourself to judge the food quality. Don't take the nursing home's word at face value. Visit during mealtimes, and observe whether and how much the residents are eating. Are bedridden residents adequately assisted with eating, or are trays of cold food simply left beside the resident without any assistance?
8. - Are pitchers of fresh water within easy reach of every resident's bedside?
9. - How does it smell? If rooms, hallways, and the residents themselves smell of urine, feces, or worse, this probably indicates that the residents are not being changed frequently enough. This is a very serious matter, and can easily become life-threatening, and even fatal.
10. - Are there enough certified nursing assistants (CNAs) on staff during all three shifts? Ask residents if the facility has enough staff in private.
11. - Every facility receiving Medicare funds must have the latest State Survey of the facility ready for you to review. Read the State Survey in detail, and look for potential problems. Also, review Medicare's own online comparison and rating of each nursing home here.
12. - Speak with family members of the residents. Ask them about any problems. Take their answers seriously.
13. - Meet the Director of Nursing, the Medical Director, and the Administrator. Is delivering the highest level of care possible their primary focus? Does the Medical Director visit with each resident frequently (daily or weekly)?
14. - Ask if the facility allows you to install a computer camera (a so-called "granny cam"), so that you can monitor your loved one's room when you are away. If the answer is "no," ask yourself why such cameras wouldn't be encouraged.