Placing a loved one in a nursing home is one of the most difficult decisions a family member ever faces. When it becomes necessary, however, prospective residents and their families should gather the best information possible to make the best choices for care. There are many resources that can help. Mennonite Manor has compiled guide for getting started with your search.

#1 Explore Your Alternatives

Once it has been determined that nursing home care is necessary, decide which qualities of a nursing home are most critical for meeting the needs and expectations of your loved one. Research the weaknesses and strengths of each nursing home in your area. As you begin your evaluation, visit several nursing homes. While there, ask current residents, resident’s families, and staff about the day-to-day routine. Some quality issues are subject to personal preferences while others are critical to a resident’s health and well being. Also, discuss your alternatives with your loved one’s physician and a clergy member. They can give you opinions regarding various facilities.

Consider these issues when evaluating your choices:

• Quality
• Bed availability
• Provision of services
• Location
• Affordability
• Multiple visits

It is very important to visit as many nursing homes as possible. A great deal can be learned by observing how staff interacts with residents and families. Speak with the residents to get a full understanding of life in the home. Gather information on both quality and payment issues.

If possible, take your loved one to visit potential choices before a decision is made. A visit can give you insight into your loved one’s wishes and may ease their fears.

Conducting your visit:

• Use your senses – sight, hearing, smell and touch.
• Is there cheerful, respectful, pleasant and warm interaction among staff and residents?
• Does the administrator know the residents and enjoy being with them?
• Do staff and administration seem comfortable and peaceful with one another?
• Do the rooms reflect the individuality of the resident?
• Are rooms, hallways, common areas and dining areas clean?
• Do residents look clean, well groomed, well fed and free from bruises?
• Do residents seem alert? Happy? Peaceful?
• Are residents seated comfortably?
• Is the home free from unpleasant smells?
• Do you notice a quick response to call lights?
• Are there residents calling out and if so, do they get an appropriate response from staff?
• Do the meals look appetizing?
• Are the residents eating most of their food?
• Is staff patiently feeding residents who need assistance?
• Are there any residents in physical restraints (form or informal devices that tie residents to beds, chairs, or wheelchairs?
• Are residents engaged in meaningful and pleasant activities by themselves or with others?

Things to ask of staff:

• Does each shift have adequate help to care for the residents appropriately?
• Does staff enjoy their work
• Are staff ideas and information solicited and valued by supervisors
• What activities are provided?
• Is staff permanently assigned to residents?
• How are nursing assistants involved in the care planning process?
• How much training does staff receive?
• How often are residents who need assistance with toileting or need assistance with disposable briefs changed?
• What approaches does the facility use to prevent use of physical or chemical restraints?
• How does staff assure family and resident participation in care planning meetings?
• What does the facility do to encourage employee retention and continuity?
• What are the qualifications and experience of the administrator?
• Has the facility undergone any recent changes?
• Is a copy of the most recent State survey available for review?
• Does the facility provide transportation to doctors, dentists, community activities, etc.?
• What kind of therapy is available?
• How is individualized care given to residents?
• Is there a resident or family council?
• Are council members available for questions?
• How are complaints or problems address?
• Are family/staff conferences available to resolve issues?
• Are residents involved in roommate selection?
• Who determines residents assigned seating for meals?
• Under what circumstances might a resident be transferred to another room, or unit or be discharged?
• Can the family/resident refuse a transfer?
• Is a professionally qualified social worker on staff?

Things you can learn from talking with resident and their families:

• Does the facility respect the resident’s wishes regarding their schedule (bedtime, baths, meals, etc.)?
• Are residents given attention if they are awake late at night?
• Do residents have the same nursing assistant most days?
• Is staff responsive to resident requests?
• Are snacks available to residents (fresh fruit, cookies, etc.)?
• Do residents participate in care planning conferences?
• Are residents missing possessions?
• Who addresses resident or family member concerns? Is that person responsive?
• Are residents taken outside for fresh air or activities as much as he/she wants?
• What is the best thing about the facility?
• What is the worst thing about the facility?

Online Research-Nursing Home Compare
Provided by the Federal Government through the Center for Medicare and Medicaid Services ‘Nursing Home Compare’ website: http://www.medicare.gov/NHCompare/home.asp
This site contains facility inspection information, staffing information and quality measure information.