The decision to move a loved one into a nursing home or assisted living community can be one of the most difficult and stressful that a family can make. The most important factors when considering a facility are the security, safety, and well-being of the residents. It is your right and responsibility to ask the pertinent questions of those who you will be entrusting the care of your loved one.
It can be difficult to trust a nursing home with the care of your elderly loved one. To ensure that your loved one receives quality care in a comfortable and safe environment, ask administrators and nursing directors the follow questions when considering a nursing home:
- What is the staff-to-resident ratio? Is the staff overworked?
Staff members who frequently work overtime or double shifts will be less likely to provide quality care to residents. Similarly, if nurses are responsible for the care of too many residents due to a lack of staff, the quality of care suffers. You can find facilities’ staff ratio ratings on the Medicare website.
- What is there a pattern of staff turnover?
When staff members care for the same residents over an extended period of time, they can more easily identify residents’ needs and become more familiar with the kind of care their residents require. Because residents benefit from stable and consistent staffing, ask about staff turnover.
- How many hours a day do staff members spend with residents?
To ensure that your loved one is not isolated or neglected, ask about the number of hours a day the staff spends with residents. Are residents often left alone for hours at a time; how often do staff members check on them? If your loved one is bedbound, ask how nurses prevent pressure sores.
- Are there any previous cases of elder abuse or neglect by nursing staff?
Be sure to ask whether any current or former staff members have been accused or found guilty of elder abuse.
- How do staff members interact with residents?
While touring a nursing home, observe interactions between nurses and residents. Do the staff members treat residents with respect and dignity? For example, as Maryglenn Boal, a former nursing home administrator notes, the nursing staff should refer to residents by their names as opposed to “grandma” or “grandpa.”
- Is the nursing home certified to accept Medicare or Medicaid?
If you are not planning to pay out of pocket for your loved one’s care or are concerned about running out of funds, ask whether the facility is Medicare-certified or Medicaid-certified.
- Does the facility have specialized services, resources, or equipment?
It is important to determine whether the nursing home has the means to care for your loved one’s specific health needs. Ask about preventative care, physical rehabilitation, special care for residents with dementia, counseling, etc. If the facility has a physical therapy center, inspect the condition of the equipment and ensure that the facility has the right equipment to meet your loved one’s needs.
- What are the conditions of the facility?
When touring a nursing home, take note of the conditions of the facility. Inspect rooms, common spaces, etc. to ensure that your loved one will be comfortable in his or her new environment. Take note of strong odors (good or bad) as they may indicate a problem.
- Do residents at the facility contract infections easily?
As infections such as methicillin-resistant Staphylococcus aureus (MRSA) are still common in nursing homes, inquire about infection-control/prevention practices. For example, employees should wash their hands regularly and get a Flu vaccine annually.
- Are staff members fostering an environment for the residents and catering to their likes and needs?
As common spaces are intended to be enjoyed by the residents, you should also look to see what is playing on the TV and the radio. Is the staff allowing residents to watch and listen to programs and stations suited to their likes? If not, this might be a sign that staff members are disregarding residents’ preferences.
- What is the daily schedule like?
Social activities encourage residents to be physically and mentally active and to engage with those around them, so ask whether the facility offers structured activities and/or planned outings. Also ask whether residents have the freedom to construct their own schedules. If your loved one is in a wheelchair, or his or her mobility is compromised in another way, make sure the facility either offers activities catered to less mobile residents or has a plan to include them in activities.
- Do the residents look well cared for?
While touring a nursing home, take note of residents’ appearances (remember that bruising does not necessarily indicate abuse). If you can, ask residents about their experiences. Do they like the nursing staff? Do they enjoy their daily schedules? Do they like the food?
When choosing a nursing home, ask administrators, nursing staff, and residents as many questions as possible. Aside from the more obvious inquiries related to financial feasibility, living conditions, and reported cases of elder abuse and neglect, be sure to inquiring into staff ratios and turnover can expose faults in the culture and framework of the nursing home.
Asking residents about their lives at the nursing home is extremely valuable as only they can offer a perspective based on personal experience. Asking about the quality of the food, planned activities, relationships with nurses, etc. will give you a better understanding of how the residents feel about the quality of their care. Asking questions during the process of choosing a nursing home allows you to serve as an advocate for your loved one and ensure that his or her needs are met. This also communicates to the staff that you will be attentive to how your loved one is treated in their facility.