When one makes the decision to entrust unfamiliar people with caring for their elderly relative or loved one, they have some challenges to consider. This is a difficult time not only for the emotional pull of letting their loved one go, but also considering the reality of their vulnerable state. Finding your loved one good quality care is paramount. At the most basic level, you need to know they are safe.
It’s important to remember that nursing homes in the U.S. are essentially businesses. Rather than making their patients’ safety and well-being the number 1 priority, some would instead prefer to sacrifice them in the name of profit. The reality is, in fact, that choosing the right nursing home means avoiding the nursing home abuse epidemic that’s taken hold across America.
With that in mind, there’s a lot to think about. These 8 tips cover basic steps for finding a safe, earnest, and top-tier nursing home for a family member in need of long-term care.
1.) Look Close to Home
For starters, it’s best to choose from nursing home options that are conveniently located for as many family and friends as possible. That way, there is always someone on hand to visit – especially in cases of emergency. This is important both because spending time at the home will improve the resident’s wellbeing, and also as it will allow family members to deal with quality of care problems quickly if they arise.
2.) Ensure the Facility Is Certified and Covered by Medicare or Medicaid
The Centers for Medicare and Medicaid Services (CMS) requires inspection of any home that receives federal funding. Bear in mind that only homes which pass CMS safety inspections are certified. Even if they are, it’s worth checking how recently the home received certification and the state of things beforehand.
Then, in financial terms, the nursing home should of course be affordable. Medicaid or Medicare can partially cover the cost of care for someone on low income or someone with special needs, respectively. However, not all nursing facilities approve these payments. Check current rules about programs and benefits on the Medicare or Medicaid websites; these also provide helpful resources to assist your search such as guides and recent inspection reports.
3.) Examine the Facility’s Physical State
When you visit potential homes, take stock of your surroundings. Is the space clean and well-lit? Does it seem to offer a welcoming and supportive environment? Does it cater for special needs, such as physical disabilities? Are the rooms comfortable and private? What treatment and bathing facilities are available?
Sometimes, your first impression can speak volumes. But keep a watchful eye on the details. For example, be especially careful to look out for subtle safety or health hazards, such as frayed carpets and other settings that may cause a fall; strong odors, which could indicate a hygiene problem; or strange sounds.
4.) Take Meal Arrangements Seriously
A healthy environment will, of course, ensure that residents maintain a healthy diet. Take a look at how meals are prepared, supervised, and presented to patients: Is the food nutritious, while also appealing in both appearance and taste? Are meals served in a clean environment? Be sure to make a trip to the cafeteria a priority when you first visit a facility and then on an ongoing basis once your loved one lives there. Joining them for lunch will not only boost their spirits, but it will give you a good idea if they are eating enough and whether the food is palatable.
5.) Ask about Enrichment Programs and Activities
A good nursing home will have strong connections with the community – for example, schools or places of worship – to encourage a life outside its 4 walls. Residents need opportunities to be kept occupied throughout the day, where they are room-bound or not.
Don’t be alarmed to notice patients roaming freely in and out of the facility, as this is a good sign they are keeping active. But make sure staff are attentive and patient-focused at all times.
“Are they gossiping with each other or are they making time to sit and talk with the patients?” says Debra Stang, a former nursing home social worker and expert on elder needs. “That’s something that I would always look for. Any time you come in and you’ve got three nurse’s aides giggling over a book and a bunch of residents sitting around in wheelchairs looking bored – that’s not a good environment.”
First and foremost, consider any hobbies and interests that are important to your loved one. Ensure the nursing home you choose caters for those as much as possible.
6.) Look for Signs in Current Residents
Getting a good idea of quality of care can be as simple as observing those who currently reside in your prospective choice. Do residents look content and well cared for? Even more, do you see any hint of the opposite – such as bruising?
Bruising is not always a sign of abuse; rather, skin can become mottled with age. But, says Stang, “A finger-shaped bruise around the upper arm is a very suspicious injury.” Look for hand print-shaped marks or bruises in areas unlikely to be touched by a fall. These are obvious signs that nursing staff are mistreating their patients – which leads us to the next point.
7.) Pay Close Attention to Nursing Staff
Adequate staffing of nurses and aides is perhaps the most critical requirement of all. There are many ways a nursing home’s recruitment habits can affect standards of care, such as:
- The ratio of staff to patients; a bad one indicates shortage of care
- Whether employees are screened for criminal history and drug use
- Whether staff undergo rigorous training and regular updates on standardized practices
- Staff turnover rate; high turnover indicates overworked or dissatisfied staff
- Whether management relies heavily on temporary workers, which can inhibit residents from building trusting relationships with regular members of staff
First, try to catch a glimpse of interactions between staff and residents – and again, look for subtleties. Respectful caregivers will knock before entering a room, address their patients by name (or how they prefer be addressed), and converse in a warm and polite demeanor, for example. If possible, take note of how staff react to problems such as falls or dementia-induced behavior. They should always act with care, patience, and the highest standards of safety.
Second, see how staff members interact with each other. According to Marion Somers, elder-care advocate and former nursing home administrator, “If the staff is rude to each other, they’re going to be rude to your parent.”
8.) Don’t Be Afraid to Ask Tough Questions
At the end of the day, word-of-mouth recommendations are unparalleled. Friends, social workers, neighbors, and religious groups may have invaluable insight on reputable homes.
But when you’re faced with your own investigation, it’s imperative to ask nursing home staff as many questions as possible – and not to be afraid to dig deep. If anything seems amiss, you have the right to voice your concerns.
Keep in mind, too, that settling on a nursing home does not mean the questions should end. Go through the admissions contract with a fine-tooth comb, question the director about anything you don’t understand, and have someone you trust check it over. Then, once your loved one moves in, monitor their treatment. Look out for unexplained physical issues such as bedsores or bruises. Or if your loved one is incontinent, ask how their daily personal care needs are met.
If you suspect your elderly relative is suffering from poor or unlawful treatment, your first point of contact is the unit manager for your patient’s floor. Any problems that aren’t resolved this way should be taken up the line of command. If necessary, you may file a complaint with a state agency. Yet another reasonable way to move forward is through legal action. After all, dealing with nursing home abuse isn’t only about stopping the horrific mistreatment happening right now – it’s about helping to stop future cases, for good.