How can I find a good nursing home for my loved one?

A good way to find a good nursing home in your area is to personally visit the nursing homes in your area. When you walk into a nursing home, what do your five senses tell you? What do you see? Is the facility clean? Are the residents needs being tended to? How does the facility smell? What do you hear? Does it sound pleasant? Many nursing homes have an admissions clerk who is more than happy to set up an appointment with you to give you a tour of the facility. This is a good time to ask questions such as services they offer (physical therapy, frequency of physician visits, nursing care, etc.). Be sure to ask about their nurses aid to resident ratio. This ratio is dictated by Medicare and is usually around 10-15:1, that is 1 nurses aid is responsible for the care of 10-15 residents at any given time. This is important to the care of your family member.

www.medicare.gov is an excellent website to view ratings and state reviews on local nursing homes. You may ask your tour guide how they did on their last state review (did they receive any negative "tags" that they were required to correct) as this is public information. Mainly, try to find a place that has staff that you are comfortable with and that your family member is comfortable with. After all, they are the one who will be living there.

If you are searching for a good nursing home for a loved one with some form of dementia such as Alzheimer's, then it's important that you ask about staff dementia training. Does the facility just give the minimum required dementia training, or do they go above and beyond to ensure the safety and comfort of elders with dementia. Is the training on-going and not just a once-a-year course? Watch to see how staff interact with elders with dementia. Are they treated with respect and kindness?  What are their policies if your loved one begins to lose weight, or refuses medications, or wanders away from the facility? How are the residents protected from one another during sleep hours?  These are all questions you should ask in order to compare one facility to another. Also, be sure to visit more than one time and at a different time of the day to see how the atmosphere changes. 

Finding a "good" nursing home can be difficult. I have been in many, and while some are better than others, I have never been in an "excellent" nursing home.

The first order of business is to visit the home. Ask to speak with the director, but ask to speak with the staff. Get a feel for personalities. Make sure to take a tour and use your senses. Look to see if things are in order. Is there any clutter? Are the walls chipped with paint? Is the wallpaper old and stained? This could be a sign that there are not enough funds to work on the appearance. I, personally, would not want to put a loved one in a place that looks drab. Most importantly is the smell. Does it smell like urine or feces? If it does, turn around and walk out the door. I would not even work in a place that smelled. Make sure that smells from the kitchen or fresheners are not being used to mask the smell. If patients are being tended to as needed, then the place should smell refreshed. Any unusual odors could be a sign that the patients are being left in their diapers longer than needed or that beds and linens are not being changed as they should be. This could result in bladder infections and skin breakdown, which is never a good thing in an already comprised individual.

I would then ask to see or read the latest Department of Health's Survey results. Legally, this should be posted for all to see, but if not, it should be made available upon request. This is a public document, not private (at least in Ohio). Any home not willing to share this is not a home worth putting our loved ones in.

Lastly, I would ask permission to talk with the residents, which could require approval from their family members. If not, ask around the community and see what others have to say. The more information a person has the better.