9 Tips for Researching and Choosing a Nursing Home

Touring a Nursing Home/Terry Vine/Brand X Pictures /Getty Images.
  • Long term care
  • Healthcare facility
  • Skilled nursing facility
  • Custodial care
  • Dementia care centers

All of these names (and more) can refer to the same thing: a nursing home. To some, this is a dreaded place to be avoided at all costs. To others, it may have become a “necessary evil”. To still others, it is the place where a group of compassionate people are trusted and dedicated to caring for your loved one. Which response fits your perspective?

Your answer to that question might be based on your personal experience with nursing homes or the things you may have heard about them. It also may be influenced by your own desire and commitment to care for your family member in his own home.

Do you have a loved one struggling with a diagnosis of Alzheimer’s or another dementia that you hope to care for at home? It is a privilege and an honor to provide love and care to an individual with dementia. I’ve compiled a few suggestions and resources to support you in that goal.

However, even if you’re completely committed to caring for your loved one in his own home or in yours, I recommend doing some research about the different facility options in your community. If you experience an unexpected circumstance in your life, such as an illness, surgery, or unplanned trip, you will be thankful you’ve compiled a short list of options should you or your loved one need facility care, whether for just a few days or much longer.

So, what should you do to research facility care? Having been in both the position of a family member seeking care for a loved one and a professional in the non-profit nursing home industry for many years, here are 9 tips born out of experience:

  • Research Ahead of Time
    • Look into the different options when you do NOT need them, rather than when you’re facing a crisis. Some facilities have waiting lists that may make it wise to complete paperwork ahead of time. You'll be thankful you looked at your options before being in the middle of an immediate need.
  • Ask Others for Recommendations
    • Your best bet for finding quality facilities in your area is to ask around. Recommendations from others you know should carry a lot of weight in this process.
  • Licensed vs. Non-Licensed
    • Generally, there are benefits to licensed nursing homes. If a nursing home, it must meet certain standards and is inspected regularly. If licensed as a Medicaid facility, you don’t have to move out after your money runs out; you can just complete a Medicaid application. If licensed for Medicare, you can qualify for coverage of your stay for a limited time following a hospitalization in order to receive therapy services.
  • Sub-Acute Rehab, Long Term Care & the Transition Between
    • Find out what the nursing home you’re looking at offers. Some facilities only keep people who are receiving therapy following a hospitalization; this is sometimes called sub-acute rehab. Others provide long-term care (skilled care) as well as the therapy. You may also want to find out if the facility you’re interested in has a locked memory loss unit if you think it's possible your loved one would benefit from that.
  • Visit Facilities (By Appointment and Drop In)
    • Talk to staff, residents and visitors
    • Ask how long the Administrator and Director of Nursing have worked there
    • Do the residents appear clean, well-groomed and happy?
    • Is the facility, regardless of its age, clean and well-taken care of?
    • What are the options for food choices at meals?
    • In general, does the facility have unpleasant odors? Note that there are certainly going to be times when a resident has an accident and needs to be cleaned up. Typically, a strong foul smell is the result of a single incident that may be in process of getting cleaned up, whereas a lingering smell of urine throughout the facility is more likely to be an ongoing problem.
    • Ask what kind of activities are offered. A strong activity program should offer a variety of group and individual activities.
    • If your loved one has special needs, verify that they can be met.
    • Ask a couple of residents how they like the facility.
    • Note the general feeling you get when you are there. This is one of the vague, yet tell-tale signs of the quality of the facility. Does it feel warm and welcoming? Can you see that the staff and residents interact in a positive way?
  • Review Nursing Home Compare
    • This is a national resource that compiles data on each licensed nursing home, including its overall rating out of 5 stars, its recent survey reports, its life safety code report, its staffing and how well the facility performs in measures of quality.
  • Know Your Financial Options
    • Some facilities accept Medicaid; others will only work with Medicare and private pay (i.e., paying out of pocket). Some require you to have a certain amount of finances to pay for your stay for a specified amount of time, and others will let you enter and be on Medicaid right away.
  • Put Your Name On More than One List
    • Whether you need a facility now or are simply looking for the future, you may want to check out more than one place. It normally does not cost anything to be placed on a facility’s waiting list.
  • Arrange for Support at Home
    • If you don’t need facility care at this time and are simply planning ahead, look into home health care, home helpers, visiting physicians, and meals on wheels. These services can help you stay in your own home longer and improve your quality of life as well.

    Medicare.gov. Nursing Home Checklist. Accessed April 22, 2012. http://www.medicare.gov/Nursing/Checklist.pdf

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