October 6, 2000
Choosing A Nursing Home-Part II
By: Gail R Mitchell
The more you research, the more you will be able to
make a better, more informed decision.
Considerations to look for when choosing a nursing
- Location- is the home a reasonable distance from
your home? By being close, visiting will be easier. Do
you have accessible transportation to the home?
- What are the visiting hours? How do they fit into
- What kinds of activities are provided for the
residents? What types of activity rooms are available for
- Are there safe areas and gardens for walking and
- What is the physical layout of the facility like?
- Is it attractive?
- Is it well organized?
- Is it designed for the privacy needs of the
- What are the ratios of patients to staff?
- Is the staff welcoming and responsive?
- Is the level of hygiene maintained - the cleanliness
of rooms and hallways.
- What is the quality of food like?
- Are the foods nutritious, and
geared towards the patient's individual needs?
- Is assistance available if the patient needs
to be fed?
- Are snacks and proper foods available in
- Can residents choose their own menu?
- Is the kitchen clean?
- Are dishes, pots and pans clean?
- Are there bugs?
- What are the resident's rooms like?
- How are they furnished?
- Are they warm and comforting?
- Can you bring in your own bed and
- Is there storage for the patient's belongings?
- Can personal items be brought in to create
an environment that is comfortable for them?
- Are these personal items safe? How is the
theft of personal possessions handled?
- Does the room have an emergency system to
call for help? Are they working properly?
- Does each room have it's own bathroom and
is it clean?
- Does it have the proper hand rails, grab bars
and accessories your loved one will need?
- If patients share rooms with another
resident, how are problems handled?
- How accessible are bathrooms outside the
patient's own room?
- Is there a phone in the patient's room or nearby for
personal use? Can those with wheelchairs reach the phone?
- Is there a television and radio in the room if the patient
is bedridden? What if the patient prefers to just watch TV or
listen to the radio on their own in the comfort of their room?
- Are personal services available i.e., hair cutting, washing
- How are ingoing and outgoing personal mail services
delivered? Are postage services for mailing available?
- Who is responsible for shopping for the personal needs
of the resident?
- Are pets allowed and how is this handled if they are?
- How is cash handled for the resident's incidental needs?
- Are all entrances, exits, rooms, and hallways and elevators
wheelchair accessible, and walker accessible and does the
width meets the needs of the patient's means for getting
- Is smoking regulated?
- Are exits marked and not blocked?
- Are the floors slippery?
- Are heating and cooling systems adequate and
working properly? Does the resident have individual control
of the heating and cooling systems in their room?
- Are floors, sidewalks and ramps smooth to prevent
tripping and falling?
- How frequent are linens changed?
- How are resident's personal laundry needs handled?
- How does the facility involve the family?
- Is there professional support one on one or are there
- How are the resident's spiritual and religious needs met?
- Are there periodic meetings scheduled between the
care team and the family members? How often are they?
- How are family members informed of their loved
one's status and how often?
- If your loved one has Alzheimer's observe and check
out the following:
- (In terms of Alzheimer's patients,
the need for placement will require that special
needs be met daily by the facility. Many homes
now have separate Alzheimer's units with
specialized care. Some may even offer therapeutic
programs for the family members as well).
- You will want to check out how the staff
interacts with these patients.
- How knowledgeable and trained are the
physicians with Alzheimer's, the current
medical technology etc?
- Is the staff trained with the specific dietary,
activities and other problems and needs arising
with the patient?
- What safety precautions are taken in case
they wander off and hurt themselves? How are
- Is there confusion and lots of noise in the
unit, possibly indicating a lack of control and
supervision on the part of the staff?
- How are medications and physical restraints
used in behavioral management? (Remember
there are laws governing these restraints. The
family must give permission and certain forms
are illegal. No one can be restrained 24 hours
- Speak with other residents and their families
if possible, to view things at the nursing home from
- Observe other residents?
- Do they have bruises on their faces, arms
- Are they dressed properly?
- Are they occupied, or are they wandering
aimlessly in the halls or left sitting all alone?
- Are there odors in the hallways and communal
- Are smoke detectors and fire extinguishers working
- Are calls for assitance promptly answered both day
- Is there a physician available for emergencies at
- Where and what is the nearest hospital?
- Will the home take the patient
to the hospital from the facility if needed?
- Will the hospital be able to provide the care
that your loved one might need?
- Visit all facilities unannounced. Try to do
this when there aren't visiting hours.
- Is there a family council that meets to handle
- What types of admission plans are available?
Single rooms? Shared rooms?
- Is there a waiting list?
- Do a complete background check on the facility:
i.e., ownership, management, financial stability, and
staff qualifications. You can check with the Chamber of
Commerce, the Better Business Bureau and your state's
department of health.
- Use the services of an ombudsman. (An
ombudsman is an advocate for the residents). They
can find out about past complaints and lawsuits
against the nursing home.
- Make sure the facility has complied with all state
licensing and accreditation requirements.
- Is there an admissions fee in addition to the
regular monthly charges?
- Get a copy of the last inspection report for the
- Get written copies of all oral agreements or promises.
- Request a copy of the resident's bill of rights.
Under the Federal law, all nursing homes must have a
written description of the rights of the residents and it
must be made available to the resident or family member
who requests it.
- Does the facility accept benefits from Medicare,
Medicaid and the Veterans Administration?
- What are all the financial costs involved?
- Is the fee daily or monthly
and how much is it? How are extra needs met?
- What payment options are available?
- What is and what is not included in the
- What services are available for extra charges?
- What is the policy regarding daily or
monthly rate increases? When was the last one
done? What was the last increase?
- How much notice is given regarding an
increase and how are they informed?
- Under what conditions are refunds
made available to the resident? How much
notice is needed?
- How long does the home hold a room
if a resident needs hospitalization?
Before signing any agreements, have an attorney
review the contract, the small printed matter and
the rules and regulations of the facility.
With proper research and preparedness, you can be
reassured that you will find the proper home that
meets the need of your loved one and their family.
It is important to stay involved and oversee that the
home is maintaining the quality of life for the patient.
Many times it is important for the patient to see familiar
faces as they can become disoriented when the transition
is made into a home. Close monitoring on your part will
assure your loved one receiving the best care.
We look forward to the opportunity
of serving you. We welcome your
comments, suggestions, and questions.
Please feel free to contact us at:
- How often are the families informed of
the status of the resident?
- Will our loved one need their own aid or nurse
24 hrs within the facility in addition to the home's staff?
- Meet with the administrator to ask important
questions you may have.
- What grounds are cause for the contract to be
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