5 Tips for Choosing a Nursing Home: An Insider View

One of the most painful times for some families comes when their loved one can no longer thrive with in-home care and is in need of the skilled care that a nursing home can provide. Difficult as this time can be, emotion must be put aside so that necessary research can be conducted to find the best care facility possible.

The internet can be useful for starting these searches and there are a couple of quite different ways to go about it. The Medicare site Nursing Home Compare is probably the logical first choice though, in my opinion, it should simply be one tool because, like all current tools, it is imperfect.

Certain categories are self-rated by the nursing homes involved, which sets up questionable results. Also, since states vary in how they do inspections, standards that may seem high in one location may not rate so well in another, so even those categories are not unbiased. Still, Nursing Home Compare is a tool, so I’d suggest that you use it as a launching pad. Just keep an open mind.

Another choice to consider while you’re online is the business rating site Yelp. This site has become quite popular with consumers, and it also can be used as a tool for your nursing home search. Again, be aware that these ratings can be skewed, especially because consumers of any kind are more likely to complain than to compliment. Again, it doesn’t hurt to check out the site, but don’t accept the ratings as solid truth.

What is the best method of selecting a nursing home? It boils down to time consuming, intensive, personal inspection of each possible facility.

Tips from a licensed nursing home administrator

Susan Hodges, author of “A Breach of Trust,” is an advocate for seniors and their families navigating the world of geriatric care and assisted living. A retired long-term care administrator and licensed nursing facility administrator, Hodges previously maintained nursing homes in both Stamford, Texas, and Fort Worth, Texas. Hodges and The Candid Caregiver communicated by email about the best ways to go about selecting a nursing home. Below is an outline of Hodges’ thoughts:

  1. Cleanliness: When you visit, cleanliness will be one of the very first things that you notice. If the residency does not appear to be taken care of, this could indicate the residents are being neglected as well.

  2. Appearance of residents: Are the people who live there dressed and groomed or do they look as though no one cares if they are reasonably neat and clean? Are their rooms tidy and clean? Is their clothing fresh and clean or dirty and foul? Did you notice an overall stench at the home?

  3. Pain management: As you walk through the home pay attention to the conversations between residents or between residents and caregivers. Note if you hear anyone say he/she is hurting, as it is pertinent that nursing home residents are receiving prompt and accurate care.

  4. Medication: While it is important for nursing home residents to receive proper medication and treatment, it is equally important that they are not being overmedicated. See if the facility has an antipsychotic medication policy for residents who suffer from schizophrenia and bipolar disorder, as these are just a few of the issues faced in nursing homes today. These medications should not be used to subdue patients, however. They are only used when medically necessary.

  5. Nutrition: To determine if your loved one will receive nutritious food and beverages, request a meal during your visit (at your expense). Also take a look at residents’ plates after they have been served, observing their expressions as they eat and notice if they did not finish their meal. If you did not enjoy your meal, think of the residents who dine at the facility every day, as they do not have access to alternative options. Also, ask if snacks are served between meal times and if residents have choices in times to eat and foods that they prefer.

Bottom line: Does this nursing home seem like a place where life happens or is it a place where people simply wait to die? If you tour a few homes, you should pick up on the differences fairly quickly.

The Candid Caregiver
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The Candid Caregiver

The Candid Caregiver (TCC) is a safe place for all caregivers, of any condition area or caregiving level, to go for candid yet professional guidance. Questions will be answered, tough topics will be discussed, and the caregivers will ultimately have a place where they, themselves, feel cared for. No topics are off the table. Ask your questions and share your stories on social media using the hashtag #TheCandidCaregiver. TCC's lead caregiver and author is Carol Bradley Bursack, a veteran family caregiver with more than two decades of experience.