How to Find a Good Nursing Home

What type of activities does the facility offer?
What type of activities does the facility offer? | Source

Is a Nursing Home the Right Choice?

Every situation is unique. Be sure that a nursing home is the best option for you or your loved one. Speak to doctors, hospital staff and/or a social worker to determine the patient’s needs.

It may be possible that another type of facility such as assisted living, skilled nursing, a family member’s home or retirement community, may be a better option. The patient may even be able to remain in their own home with some assistance. A complete geriatric assessment may be beneficial.

Choosing the Best Nursing Home Facility

When a loved one reaches a point in life when they require more care, it can be very difficult to accept; for the patient as well as the family. Not being able to live independently can be a scary reality.

If the person who will be going into a nursing home is able to help with the decision making, give them the respect to voice their opinions. Let them be part of the process as much as possible.

Whether you are searching for a nursing home as a permanent residence or a short-term stay such as a few weeks for rehab, you want to choose a facility that is the best for you or your loved one. This decision can be quite difficult and stressful. This article will give you information and details about what you should consider to make an informed decision.

Patient's Health Insurance

Determine what type of medical insurance the patient has and what the policy covers. It is possible that a nursing home does not accept a specific insurance so knowing this information up front is important.

Nursing Home Location

Determine the ideal area to locate a nursing home. Choosing a nursing home that is close in proximity to family members and friends who are likely to visit is critical. Moving to a nursing home is a difficult transition for most. Having those closest to the patient able to visit and show support is a major influence in their well being.

Word-of-Mouth Nursing Home Recommendations

Although you should always do your own research when considering potential nursing homes, recommendations from people that you trust can be extremely helpful in narrowing down your search. If you know someone who is familiar with a particular facility that you are considering, speak to them about their experience.

Create a List of Potential Nursing Home Facilities

Search online and in local phone books for potential nursing homes. Begin creating a list of those facilities that you would like to learn more about. Jot down names, addresses and phone numbers.

Check Out the Help Wanted Ads

Typically, nursing homes with a high turnover rate have underlying problems meaning the employees often look elsewhere for work. They do not feel committed to the facility. Constant job openings such Director and nursing positions could be a warning sign.

Are the residents happy and content?
Are the residents happy and content? | Source

Prepare to Make Phone Calls to Admissions Departments

Make phone calls to nursing homes you are interested in prior to spending the time on an in-person visit. Here are some things you should consider discussing over the phone.

What Insurance Does the Nursing Home Accept?

Does the nursing facility accept Medicare AND most major insurances as well? It is better to choose a facility that accepts both because Medicare and private insurance companies have separate accrediting processes that lead to a higher level of overall accountability.

Typically, medical insurance will fall into three main categories: Medicare Part A, Medicaid and private insurance (that may be a supplement to Medicare coverage).

Availability

Depending on the time frame of your needs, be sure to ask if there are beds available immediately and/or if there is a waiting list.

What is Their Medication Policy

Many facilities will state that they use a “minimal drug policy” meaning medications are administered minimally as to not make the patient too tired where they cannot interact in daily activities. If a patient is given too much medication to a point where they are sleeping a lot and lethargic, it will make things easier for the staff but not necessarily the patient. Obtain information so that you understand their policy.

Is there a feeling of "home" for each resident?
Is there a feeling of "home" for each resident? | Source

It Is Your Right To Be Nosy!

Ask any question you wish! No question should be off limits. Also, on your tour, you should be able to see everything that goes on behind the scenes as well.

Once you feel comfortable with the initial details of at least a few nursing homes you have spoken with over the phone and it appears that the nursing home can meet the needs of the patient, it’s time to plan a visit.

Take a list with you of all the questions you wish to ask and the areas in the facility that you would like to visit.

Consider This: Although it is okay to schedule an appointment, just showing up without an appointment is a wise idea. This way, your visit is not expected and you will witness a "normal day" at the location. No matter what time during the day you visit, there should always be someone ready and willing to give you a tour.

First Impression

When arriving at the nursing home in person, take a look at the outside of the facility. Is the building structure well maintained? What about the parking lot? Are the flower beds neatly groomed? Visible signs of neglect before walking into the building can give you an idea that there may be other instabilities you will find inside as well.

When you walk inside the facility, what is your first impression? Does it smell clean? Does it feel comfortable and welcoming?

Availability of Recent Facility Inspection Reports

When you enter the facility and look around the lobby, you should find the most recent Federal government facility inspection report available for anyone to view. Regardless of the results, this is not something that should be hidden. If you have not seen this report either online or in person, feel free to ask.

Safety and Security

  • Are there smoke detectors and fire extinguishers easily located?
  • What precautionary measures are in place in case of an emergency?
  • Look around to see if exits and stairways are clearly marked.
  • Is there a special system in place for visitors to sign in?
  • Is there additional security for patients who may "wander" due to dementia, etc.?
  • Do they utilize other security equipment such as bed or chair alarms?

Spiritual Needs

Does the facility offer a place for worship? What religious services are available? Is there a Chapel? For many patients and their families, this information is extremely important.

Resident’s Personal Space

Moving to a nursing home can be extremely emotional for all involved. If it is important to the patient, find out if there are private rooms available?

  • Do the rooms look clean? Do the rooms smell clean?
  • Are they well lit?
  • If sharing a room, is there sufficient space?
  • Does each room have a its own bathroom?
  • Does each room have its own control over heat and air conditioning?
  • Can the resident rooms be personalized?
  • Does each room have an individual emergency response system in place?

Ask if residents are allowed to bring things from home such as a favorite recliner chair, pillows, blankets, framed pictures to hang on the wall and other items that will help with the transition.

Is there a dining room where residents can socialize and eat their meals together?
Is there a dining room where residents can socialize and eat their meals together? | Source

Meals

Ask about the food served to residents.

  • Is there a separate location such as a dining area where residents eat together and not alone?
  • Do the residents complain about the food?
  • Are there three meals a day?
  • Is there a variety of different foods served to meet the needs and likes of the residents?
  • Will staff be there to assist in feeding residents that need help?
  • Ask to see the kitchen.
  • Sample the food if you’d like.

Grooming and Amenities

  • Do residents appear to be clean and well groomed?
  • How often are showers available/given to the residents?
  • Are there special bathing devices such as handrails for safety?
  • Are laundry services available?
  • Is housekeeping done on a daily basis?
  • Are hair salon services available?

Exercise and Physical Therapy

Are physical therapists on staff? What type of exercise do the patients receive?

Is physical therapy available if needed?
Is physical therapy available if needed? | Source

Socializing and Daily Activities

  • Notice if the staff knows all the patients by name. Are they friendly, respectful and supportive of the residents?
  • Does the facility stress the importance of allowing residents to be as independent as possible?
  • Do the residents appear genuinely happy?
  • Are there appropriate areas for socializing?
  • What social activities are offered?
  • Are there outings offered that include transportation to off-site locations?
  • Are there areas available such as a meditation room or library?
  • What about outdoor space such as a walking path and garden area?
  • Is there a calendar of events? Ask for a copy.
  • What is the policy for allowing animals to visit?
  • What activities are offered to enhance the resident’s quality of life?

Reference
Website
U.S. Medicare Nursing Home Comparisons
www.medicare.gov/NursingHomeCompare
Find and Compare Senior Communities
www.find.nursinghomes.com
National Nursing Home Watch List (details facilities cited for violations by state)
www.memberofthefamily.net
Nursing Home Inspection Information
www.medicare.gov/Nursing/AboutInspections.asp
Elder Care Locator
www.eldercare.gov/Eldercare.NET

Final Thoughts

Choosing a nursing home is a difficult task and there really is a lot to consider when doing your research. There are great facilities all over the world where our loved ones are sure to be comfortable, safe and well taken care of. Whatever nursing home you choose, be sure it is one where your loved one's quality of life will be enhanced. By doing your homework in exploring potential nursing homes, you will be much more content with your decision.

Best wishes to you and your family,

This is Sharyn’s Slant

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Comments 33 comments

Sunnie Day 4 years ago

Sharon another excellent hub filled with great resources and sound advice. Thank you so much for sharing this information.

Sunnie


RTalloni profile image

RTalloni 4 years ago from the short journey

This is a good guideline for finding a nursing home when there is no other choice. There can never be too much research into such a facility and this information will help people take the responsibility seriously.


Melovy profile image

Melovy 4 years ago from UK

This is a really comprehensive hub. I hope I don't ever need it for my parents (or myself one day come to that) but if I do I will know where to come to. I had not thought about issues such as minimal medication policies, but that is definitely something to think about. Very useful, and voted up.


pringoooals profile image

pringoooals 4 years ago from Edinburgh

It is sad when children send their parents to the nursing home. But sometimes there is really no choice and this might be the best option. Really good advice when it comes to it. Voted op.


carol7777 profile image

carol7777 4 years ago from Arizona

Didn't have to go through this with parents. It is so tough and no matter how good the nursing home is..It never is good to have to be there. However, you did point out great things to look into. People just have to be aware of what they are up against. Thanks for taking time to write this hub on a topic most of us don't want to think about. Voted UP.


Glimmer Twin Fan profile image

Glimmer Twin Fan 4 years ago

I am at this point with my parents and were very lucky to find a wonderful facility. They are still in independent living, but one day my father will need more assistance. Great tips that make a very difficult time a little bit easier.


fpherj48 profile image

fpherj48 4 years ago from Beautiful Upstate New York

Sharyn, My fine talented lady....um..I just have a question and PLEASE tell me the truth. I can handle it.

Have any of my sons contacted you lately???

Great hub, girl! UP+++


Pamela99 profile image

Pamela99 4 years ago from United States

If you are in the position of looking for a nursing home, your list leaves no stone un-turned. This is a great list to take with you to visit the homes so you can really take everything into account before making a decision. Voted up and useful.


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi Sunnie ~ I couldn't believe how quick you commented earlier today. I love seeing you. Thank you so much for your compliments.

Sharyn


drbj profile image

drbj 4 years ago from south Florida

Excellent guidelines, Sharyn, but all too often the expression, 'good nursing home,' is an oxymoron. Sad but true.


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi RTalloni ~ I agree that much research should go into choosing a nursing home and people need to take the responsibility very seriously. I hope this information is helpful to many. Thank you so much for your feedback!

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi Yvonne ~ I know most people do not want "life" to come to making a decision about a nursing home. In some cases though, there really is no option. So I hope being armed with the proper questions and information will help many.

Regarding the "medication policy" - I've just learned more about that recently. I know for me, I would not want my loved one overly medicated to a point where there is no quality of life. I do believe that does happen, especially if the person is a "problem patient," maybe combative or whatever, and the staff over medicates them to keep them calm. It is something that I would specifically ask how it is handled and then monitor the situation as well.

I appreciate you stopping by, thank you so much!

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi pringoooals ~ I believe most people try to avoid the use of a nursing home if at all possible. But yes, sometimes there really is no choice. In my opinion, a nursing home is a better option than allowing an elderly person to remain in unsafe conditions such as living alone and having a difficult time getting around. Thanks so much for your feedback!

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi Carol ~ I agree, most of us do not want to think of this topic. It is a difficult and emotional process to go through and most people try to avoid it if possible. I hope that by pointing out things to look for and questions to ask, that those in need of this information will feel they did the best they could with their decision. I appreciate your feedback!

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi Glimmer ~ So glad to hear you found a wonderful place for your parents. I truly believe that if at all possible, moving to what would be considered "independent living" is a great option. It certainly helps with the transition as things continue to change as we age. Thank so much for your feedback!

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Dear Paula ~ your sons are wonderful men. I really enjoyed the lengthy phone conversations I had with them recently. There is no need to be concerned. I forwarded this hub to them. They have all the information they need to find you a comfortable nursing home. I'm not sure why or whatever, but they each said the same thing, something like "Ahh, well we know exactly where we are putting her." So that made me kinda feel confident that you will be well taken care of, you agree? But seriously, no worries, they sounded really compassionate on the phone.

Also, I wanted to mention to you that I think you should check out a hub that I found at the bottom of this one as recommended reading. It's called Nursing Home Hotties by DIYWeddingPlanner. I am confident you will enjoy it and even possibly do something like this in your future.

Thanks for the giggles this afternoon!!!

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi Pamela ~ Thank you so much for your compliments. I really do hope this helps those that must search for a good nursing home. I appreciate you stopping by!

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi Dr. BJ ~ I'm glad you appreciated these guidelines. I know you mentioned that "all too often the expression, 'good nursing home,' is an oxymoron. Sad but true." And I am sure that is true in some cases. But I have to say, although I've never worked at a nursing home, I have experience with patients that I have cared for in their homes who eventually needed 24 hour care and were transferred to a nursing home. And when I visit, I believe I am extremely picky because this is the person(s) that I took care of for so long and now someone else is responsible for them. And I want the best and will open my mouth if I don't like something. Yet in my experience, I have never run into anything that was so horrible, it needed to be reported. Usually if there is something you want to be changed, I have found the most nursing home staff are willing to oblige. I do think it's important for loved ones to visit often to check on things. It really helps the moral of the patient as well. Thank you always for your feedback.

Sharyn


BobbiRant profile image

BobbiRant 4 years ago from New York

If a nursing home is not a Culture change facility, it is not a good one, at least not for me anyway. I Have worked nursing homes and it seems that 97% of elderly surveyed said they would rather be dead than be in one. Sad but true. I have no nursing station in my living room at home either. They do not have to be 'horrible' to be crumby places to live. Little things can make life miserable, as we all know.Interesting article though.


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi Bobbi ~ I appreciate and respect your feedback. I believe that the statistic you quote depends on many factors. Some elderly people have so much going on with their health and their memory that they can't possibly even answer that question.

But let me say that most people do not like the thought of nursing homes for themselves or their loved ones. I don't. I have never worked in a nursing home yet I have worked many years in home health care. I do whatever it takes to make a client comfortable and able to remain in their own homes for as long as possible.

But what about people that have no one to help them. An elderly neighbor who cannot take care of themselves, has no family that is willing to help and is sadly living in unsafe conditions. A nursing home would be a better option where they can get daily care, meals, not be alone and much safer. There are elderly people that are miserable in their own home as well. I believe in some cases the quality of life can be enhanced by moving to a nursing home. And that's where doing research as I've detailed in this article becomes critical to the patients well being. Thank you again for your feedback.

Sharyn


fpherj48 profile image

fpherj48 4 years ago from Beautiful Upstate New York

Oh!......gulp! I KNEW it! They've been way too nice to me lately!!


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hey Paula ~ fyi, I did not sense any hidden agendas from your kids. They seem to know exactly what they were doing. Have a great day!


fpherj48 profile image

fpherj48 4 years ago from Beautiful Upstate New York

Your kindness has given me SUCH comfort........I just received an anonymous pkg. from UPS........it's luggage.


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Paula ~ that's what friends are for!!! Enjoy your luggage!


cclitgirl profile image

cclitgirl 4 years ago from Western NC

Well-researched, well-thought-out article! I know this can be an agonizing process for loved ones and you helped to make it a lot easier. :)


B. Leekley profile image

B. Leekley 4 years ago from Kalamazoo, Michigan, USA

That is all good advice. That is pretty much the steps that my siblings and I took for our mother. After a stroke left her paralyzed on her right side and unable to converse, I was her live-in assistant in her house for 11 years, with financial, respite, and redtape help from my siblings, until our mother's needs for nursing care got to be more than we could handle.

But we did not wait till then to research nursing homes and insurance coverage. We were familiar with Medicare, Medicaid, medigap insurance, and nursing homes rules and regulations, and with all the nursing homes for miles around, years before it was time to get on a waiting list. That's not possible for many families, but advance planning is prudent when possible.

The posh nursing homes in our county, where it's like living at the Ritz, were out of our league. Of those that were possibilities, our observation over and over was that the for-profit ones stank of urine, had heavily medicated patients, and were spoken ill of by whoever we found who had worked or had relations there. Luckily we got our mother into a nonprofit nursing home, owned and run by a charitable association, and it was just right for her and our needs -- less than two miles from her house, so I could bring her home for hours practically every day; well run by a competent and caring staff; building and procedures designed to let patients wander about and socialize; all the expected services that you mentioned, and so on. My mother thrived there. In spite of not being able to converse, she soon made friends, and in spite of being hemiplegic, she was able to do much on her own, such as wheel herself to the dining hall. I and/or one of my siblings attended a monthly meeting where administration, nurses, therapists, etc., etc. discussed her case. I liked visiting there. Just one example of their little touches was a giant glass case containing colorful birds. My mother and I loved to sit and watch them.

Up, Useful, Interesting, and shared.


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hi Cyndi ~ Thank you for the compliments. Searching for a nursing home can be an agonizing process and I do hope this helps others. I appreciate you stopping by.

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 4 years ago from Northeast Ohio USA Author

Hello B. Leekley ~ thank you for your awesome feedback. Wow, 11 years is a long time to be a caregiver for a family member. We do what we gotta do ;) Glad to hear you had family support. I was the main caregiver for my grandmother but I did have help when needed from my sisters. You and your family really took charge researching everything you needed to ahead of time.

Your observations of the places you checked out are interesting to say the least. It certainly should not be about how fancy a place is. It should be about all the little details and the compassion of all the workers.

I love your story about your mom. So many people think that going to a nursing home is a "death sentence." But that is not true. There are many places out there where the residents thrive because of all the little details and the dedicated, compassionate staff.

I am so glad to hear your positive story. The journey you describe for your mother's later years - I wish everyone could experience. Caring family that is involved every step of the way. Just wonderful.

I really appreciate your heartfelt feedback, thank you.

Sharyn


Rolly A Chabot profile image

Rolly A Chabot 3 years ago from Alberta Canada

Hi Sharyn's Slant... awesome hub here and one that needs to be passed on. We are an aging society and it makes me wonder what we will have when the time comes for me... Maybe I will become a Hobo...

Hugs from Canada


teaches12345 profile image

teaches12345 3 years ago

We had to make this decision for my dad and it is hard to decide which home is best. Your advise would have made it all much easier. Great share and so very helpful for those who are facing this decision with parents. Voted up.


Sharyn's Slant profile image

Sharyn's Slant 3 years ago from Northeast Ohio USA Author

Hi Roll~ thanks for the compliments. As far as becoming a hobo - well, I hope not :) But I do wonder about my future as a "senior" since I do not have children who might take care of me. I've done a lot for my nieces and nephews. Maybe they will be there for me if needed. Hugs back atcha from across the lake.

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 3 years ago from Northeast Ohio USA Author

Hi Diana ~ It sure is a difficult decision and one that many hope they never have to make. But it happens. Certain circumstances make finding a good nursing home the best option. I do hope this information helps many. Thank you so much for your feedback!

Sharyn


Sharyn's Slant profile image

Sharyn's Slant 21 months ago from Northeast Ohio USA Author

Wylie, thank you so much for your feedback, I appreciate you stopping by! I've heard of Home Instead, I believe it's a franchise (chain) here in Ohio as well. Thanks again!

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