Practical Tips on Choosing a Nursing Home

by Barbara Edelstein, LSW, Director of Admissions, McGaw Care Center/Frank B. Foster Pavilion, Evanston, Illinois

At some time we all may need to make the decision to place a loved one in health care center or nursing home. With some guidelines, a difficult and emotional decision can be made a little easier.

The need to make a nursing home placement can occur for several different reasons. It may occur when there is a physical or cognitive decline in functioning, a sudden onset of illness, or after a hospitalization. Often a family member is caring for a loved one and the family member is no longer able to provide the additional care now required.

To ease the burden of guilt and feelings of failure, know what to look for when choosing the right nursing home for your loved one.

Location appears to be the number one criteria when choosing a nursing home.

Family and friends need to be close by to encourage frequent visits. The nursing home needs to be close to the hospital and the physician to provide continuity of care. Also, it should be close to the individual's home and neighborhood.

Environment should be as homelike as possible.

A personalized environment enhances the resident's individuality and promotes independence. Good lighting, handrails, and wide uncluttered hallways are most desirable. Observe how clean the nursing home is. Is there an odor? Is there a dining room or dining area? Where can residents entertain guests?

Atmosphere is a crucial factor.

Do the people seem friendly, courteous and respectful of one another? Does the staff interact with residents and do they know their names? Take a look at the residents; are they dressed for the day? Try to get a feel for the mood on the floor.

Services offered may vary from one nursing home to another. Be familiar with your loved one's physical needs, and be sure the nursing home can meet those individual needs. Be sure to ask about the ratio of staff to patients. Someone who has suffered a stroke will need physical therapy, occupational therapy, and speech therapy. If your loved one has some confusion or memory loss, a special memory loss community might be best.

After a hospitalization, skilled nursing needs, such as a feeding tube, injections, or intravenous fluids may be required. Inquire as to how one reaches the staff; what is the call system like? In addition to nursing staff, inquire if there are other supports available, such as social workers, chaplains, volunteers, doctors of different disciplines, and activity therapists.

Licensing and costs of care are also determining factors in placing a family member in a nursing home. Be sure to know the difference between Medicare, a federally funded program offering short-term skilled nursing coverage, and Medicaid, a state-funded financial assistance program with asset limitations. The nursing home may or may not offer Medicare and/or Medicaid. Find out what is included in the cost of care and what is an extra charge. If there are any concerns that the assets may be exhausted in a private-pay facility after a few years, it may be wiser to look at a Medicaid facility. It is often easier to get into a better Medicaid facility if one can pay privately for a year or two. Help in choosing a nursing home can be obtained from your local senior center, your physician, a private care manager, and a hospital discharge planner. After you have identified some nursing homes to visit, call and make an appointment with the person handling admissions. With the help of families, a nursing home can offer the continuing support needed to maintain a sense of purpose and security. Trust your instincts. If it looks good, if it feels good, it should be a good fit. For more information, please fill in the Information Request Form.