A Check List For Evaluating Nursing Homes

A nursing home is a permanent option for seniors who are too sick or frail to live by themselves (or with family) at home, or a temporary option for those who need serious recovery. Either way, choosing to live in a nursing home or choosing one for your loved ones is a major, life-changing decision that cannot be rushed. With more than 16,000 nursing homes in the country, there are many things to consider when searching for the right one.

nursing home

Once you’ve targeted your search a bit more, visiting each nursing home is vital to finding the right one. Take this list of questions along with you on each visit – and personalize the questions to accommodate the specific needs of your loved one.  Try to ask similar questions of the director, residents, and nursing staff to get the most well-rounded picture of the facility possible. Also included are a few questions to ask yourself – included as a reality check. An additional, extremely helpful checklist can be downloaded at medicare.gov. We hope these resources will make a difficult process a bit more manageable.

Who Will Be Caring For Your Loved One?

Questions For The Director:

  • What is the turnover among nurses and nurse aides?
  • What is your method for retaining employees?
  • How frequently do you have nurses here from a temp agency?
  • What percentage of families hires private nurses as a supplement to staff nurses?
  • How would you handle my parent’s __________ (incontinence, problem maintaining weight, issues following a stroke, etc.)?

Questions For The Nursing Staff:

  • How many residents do you care for?
  • Is that a good number, or too many?
  • Do you feel like this is a good place to work?
  • Do you feel supported in your job?
  • Does this home have much staff turnover?
  • Does the home use many temp nurses?
  • Do any residents’ families ever hire private nurses from an outside agency?

Questions For The Residents:

  • How do you like the nurses and nurse aides who work here?
  • Do you have the same nurses regularly, or do they change a lot?
  • Do nurses help you to the bathroom, and do they get you there on time?

Questions For The Residents’ Family Members:

  • Tell me about your loved one’s medical concerns.
  • Does your loved one receive the assistance that he/she needs?

Questions For Yourself:

  • Are members of staff engaging with residents; are they busy talking and helping?
  • How do staff members talk to residents?  What tone of voice do they adopt?  Do they address residents politely, and by name?
  • Do you see blinking call lights, indicating that residents need help in their personal rooms?  How quickly do these lights go out, i.e. how quickly are needs addressed?
  • On weekends, do residents still get the help they need, although staffing might be lighter?

Have There Been Any Health Inspection Issues?

Questions For The Director:

  • Please show me your last survey inspection report.
  • May I also see previous ones?
  • How has the home solved issues that inspections identified?
  • What percentage of residents suffer moderate to severe pain?

Questions For Yourself:

  • Are there any obvious health code violations?
  • Would you be willing to live here?
  • Are there any issues that are deal breakers for you and your loved one?

How Are Resident Nutritional Needs Handled?

Questions For The Director:

  • Describe your resident nutrition program.
  • How do you detect when a resident is losing weight?
  • Are residents weighed regularly?
  • How do you ensure that residents eat?
  • How do you re-stimulate residents’ appetite if they have lost interest in food?

Questions For Residents’ Family Members:

  • Does your loved one require help eating?
  • Does he/she get that help?
  • Does he/she have a good appetite?
  • If not, what does the home do to stimulate his/her appetite?

Questions For Yourself:

  • If a resident needs help eating, does he/she get the necessary help during mealtimes?
  • Do you ever see trays going untouched, either in dining areas or in rooms?
  • Can you see fresh drinking water easily available, both in common spaces and in rooms?
  • Is this food I might consider eating?

How Are Resident Toileting Needs Handled?

Questions For The Director:

  • How do you handle residents with incontinence?
  • Do you have a regular toileting schedule?
  • If so, how often are they taken to the bathroom?
  • What percentage of residents is in diapers?
  • Are catheters ever used to assist residents with incontinence?

Questions For The Nursing Staff:

  • Are you comfortable handling my loved one’s toileting needs?
  • Will you help my loved one wake up in the middle of the night if necessary?

Questions For Residents’ Family Members:

  • Does your loved one receive help getting to the restroom?
  • Have you ever found your loved one in his/her own waste?

Questions For Yourself:

  • Is the schedule here something that could work with my loved one’s needs?

How Are Resident Stability Needs Handled?

Questions For The Director:

  • How often do residents fall here?
  • What do you do when they fall?
  • What is your plan to prevent falls?

Questions For Residents’ Family Members

  • Has your loved one ever fallen while here?
  • If so, what happened?
  • How did you feel about how it was handled?
  • Are you confident that it won’t happen again?

Questions For Yourself:

  • Does your loved one have stability issues and does it seem like they will be handled appropriately at this facility?

How Are Resident Medication Needs Handled?

Questions for The Director:

  • Is there a medication schedule?
  • What kind of training do the medical staff have?
  • Have there been any medication related problems?
  • Are there doctors and pharmacists in residence?
  • How often are medication needs re-evaluated?

Questions For The Nursing Staff:

  • Do you have a medication schedule?
  • Are you comfortable dispensing all manner of medications?
  • How do you keep track of your residents’ different medications

Questions For Residents’ Family Members:

  • Do you feel the medical staff handles prescriptions well?
  • Has your loved one experienced any medication-related problems?
  • Does your loved one ever seem overly drowsy or confused; in other words, do you ever think he/she might be receiving the wrong drugs or the wrong dosage?

Questions For Yourself:

  • Does this facility seem equipped to handle your loved one’s particular medication needs?

How Is The Quality Of Life At This Facility?

Questions For The Residents:

  • Do you have friends here?
  • Are you able to keep yourself busy?
  • Does the home arrange for you to do outside activities?
  • Are you happy living here?

Questions For The Residents’ Family Members:

  • Does your loved one engage in any activities?
  • Do you know if there are a variety of options for activities?
  • Do you know if residents go on excursions outside the home?
  • When you visit, is your loved on wearing his/her own clothing, or a hospital gown?

Questions For Yourself:

  • Do you see residents wearing hospital gowns or clothing?
  • Do you see residents out of their rooms doing things, or in bed watching TV?
  • Do residents seem unaware of their surroundings, or do they engage with each other and the staff?
  • Do you smell urine or strong cleaners to cover up smell—anything that might indicate systemic issues with incontinence?
  • Are there activities scheduled on the weekends?
  • How many activities are offered?  Anything beyond movies and bingo night?
  • How creative is the home as far as activities?  Are there excursions to museums, or sports events?  Are there any classes or outdoor events offered in-house?  Do volunteers ever visit to do performances or teach workshops?
  • Do younger people and kids interact with residents?

Sources:

www.medicare.gov

www.aarp.org

 

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