How to Choose a Nursing Home
Use personal visits and professional evaluations to help choose a quality nursing home facility
Before making a decision about nursing home placement, visit any facilities you are considering. You can learn a great deal about a nursing home by taking time to sit and observe how staff interacts with residents. Also, speak with residents and their family members to get a full understanding of life in the home. Gather information on both quality and payment issues.
It is very important to visit homes a second and third time during the weekend or evenings – times when many nursing homes reduce their staff and services. If at all possible, take the resident to visit potential nursing homes before a decision is made. This visit can give you insight into the resident’s wishes and may ease his or her fears.
Here’s what to look for on your visits:
Using your senses — sight, hearing, smell, touch:
- Do you notice a quick response to call lights?
- Are there residents calling out? If so, do staff respond quickly and kindly?
- Do the meals look appetizing? Are residents eating most of their food? Are staff patiently assisting residents who need it?
- Are there residents in physical restraints (formal or informal devices that hold residents in beds, chairs, and wheelchairs)? Why?
- Do resident rooms appear to reflect the individuality of their occupants?
- Are rooms, hallways, and meal tables clean?
- Is the environment noisy?
- Is there cheerful, respectful, pleasant, and warm interaction among staff and residents?
- Does the administrator seem to know the residents and enjoy being with them?
- Do staff and administration seem comfortable and peaceful with each other?
- Do residents look clean, well-groomed, well-fed, and free from bruises?
- Do many residents seem alert? happy? peaceful?
- Are residents seated comfortably?
- Is the home free from any unpleasant smells?
- Are residents engaged in meaningful and pleasant activities by themselves or with others?
Things you can ask of staff:
- Does each shift have enough help to be able to care for residents as they’d like?
- Do they enjoy their work? Are their ideas and information solicited and valued by supervisors?
- What activities are residents involved in?
- Are staff permanently assigned to residents?
- Are temporary staffing agencies used?
- How are the nursing assistants involved in the care planning process?
- How much training is given to staff?
- How often do residents who need it receive assistance with toileting?
- If residents are using disposable briefs, how often are they changed? Why are briefs used instead of toileting?
- What approaches does the facility use to prevent use of physical or chemical restraints?
- How does the staff assure family and resident participation in care planning meetings?
- What does the facility do to encourage employee retention and continuity?
- How long has the current administrator been at the facility?
- Has the facility undergone any recent changes in ownership or management?
- Does the facility provide transportation to community activities?
- What kind of therapy is available to residents?
- Can you give me an example of how individualized care is given to the residents?
- Is there a resident and/or a family council? Will the facility give you contact information for the leaders of these councils?
- What happens if someone has a complaint or problem? Are family/staff conferences available to work out a solution?
- Are residents involved in roommate selection?
- Who decides where residents sit for meals?
- Under what circumstances might a resident be transferred to another room or unit or discharged?
- Does the facility employ a professionally qualified social worker? (“Professionally-qualified” means with a bachelors or masters degree in social work.)
Things you can learn from talking with other residents and their families:
- Are residents treated with respect and kindness?
- Are residents helped with meals?
- Does the facility respect the resident’s wishes about their schedule (bedtime, baths, meals)?
- Is attention given to residents at night if awake? Is there anything for them to do?
- Does the resident have the same nursing assistant most days?
- Is there a family or resident council? If so, is the council led independently by families or residents or is it directed by staff members?
- Are staff responsive to resident requests? Do they assist the resident with toileting?
- Are snacks always available to residents? Fresh fruit?
- Do residents participate in care planning conferences? Are his or her opinions valued?
- Has the resident had missing possessions?
- Who handles resident or family member concerns? Is that person responsive?
- Does the resident get outside for fresh air or activities as much as s/he wants?
- What is best/worst thing about living in the home?