What to Look for in a Nursing Home

What to look for in a nursing homeAfter careful consideration, your family has reached the decision that a skilled nursing facility is the best care option for your aging parent. Now that you’ve made that decision, you have another important decision to make: how to find the best nursing home to suit your parent’s needs.

“When a loved one requires long-term care in a skilled nursing facility, choosing the facility that best fits their needs can sometimes feel like an overwhelming task,” says Rebecca Abenante, healthy aging coordinator for the David and Joan Powell Center for Healthy Aging at the Atlantic Health System’s Geriatric Assessment Center in Morristown, N.J. “In addition to the emotional stressors that often come along with these kinds of caregiving decisions, there’s a lot to learn about quality of care, safety and financial considerations.”

Abenante offers the following steps that will allow families to make an informed decision in choosing the best facility for their loved one.

Put together a list of facilities to visit. Abenante recommends using Medicare’s Nursing Home Compare Tool to help in this step, since it allows you to compare quality of care and staffing information for all Medicare and Medicaid-participating skilled nursing facilities throughout the country.

Prepare for your visits. Abenante advises that, before you visit, you make a list of your loved one’s needs and personal preferences. This will help you develop key questions. “For example, if Mom is at high-risk for wandering, do they have a secure area to help keep her safe? If spiritual support is important to Dad, do they offer religious services on-site?” she suggests. Print your list ahead of time to help guide your visit and take notes. (This Nursing Home Checklist from SeniorAdvisor.com can serve as a starting point.)

Also, while most facilities can accommodate walk-in tours during business hours, Abenante recommends you make an appointment to discuss the admission process and financial information.

Visit your top choices. An onsite visit is the best way to observe the surroundings and to get answers to your questions. “Sometimes it’s helpful to bring another person (not the prospective patient) along to the tour to have a second set of eyes and ears,” Abenante adds. “You may want to schedule your tour during a meal to observe not only presentation and service, but also how appetizing the food is. Sometimes facilities will invite you to sample a meal yourself.”

Other questions for which to seek out answers, Abenante suggests: Is the staff attentive? Do they address residents respectfully? Do the residents appear well cared for and engaged in activities? Does the facility and its décor seem well maintained?

“Keep in mind that what you might consider ‘outdated’ furniture may appeal to an older generation,” Abenante adds. “Ultimately, the quality of care in the facility is more important than the beautiful chandelier in the lobby.”

Ask questions about the staff. Abenante advises families to ask about the various professionals who will be involved in your loved one’s care. “What are their roles and responsibilities, and who would you go to if you have care concerns?” she says. “How often are physicians and/or nurse practitioners in the facility to see patients?”

Also ask about staff turnover, since high turnover rates tend to result in consistency of care issues. Another question that Abenante recommends: “Are they able to provide patient satisfaction information and do they offer avenues for feedback, such as resident or family councils?

Understand the costs. “Most long-term care in nursing homes is paid for with private funds,” Abenante says. “However, if your loved one has long-term care insurance, this can help with the out-of-pocket cost.”

Other sources of payment may include the VA’s Aid and Attendance pension benefit (available to eligible veterans and spouses of veterans) and, in the case of those seniors who have limited financial resources, Medicaid.

“Be sure to ask the facility what’s included in the daily rate and what would be extra, such as cable TV or beauty parlor services,” Abenante advises. “Don’t be afraid to ask questions about finances—you’re certainly not the first to do so.” Based on your questions, the administrative staff should be able to give you some guidance as to your options.

Compare your choices. Using your online and in-person research, do a comparison of the facilities you visited. “Some families find that making a chart or pros/cons list is helpful when considering their options,” Abenante says. “Think about your loved one and imagine their day-to-day in each setting, considering both their needs and personal preferences. Keeping in mind that no facility is perfect, which facility feels like they would be good partners in caring for your loved one?” In some cases, you may need to go back to one or two of your final choices for more information or to confirm your impressions.

“While moving to long-term care can be a difficult transition for any senior (and their family), doing your research can help you find the right facility to care for your loved one,” Abenante concludes.

CHIME IN: What steps did you go through to find a nursing home for your loved one?

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