Selecting the Right Nursing Home Visiting the nursing
home is a very important step in selecting the right one for
you or your loved one. A visit gives you an opportunity to talk
with nursing home staff and, more importantly, with the people
who live and receive care at the nursing home.
When you visit the nursing home, you will probably be given
a formal tour. This is a useful introduction to the home,
but it is important that you are not overly influenced by
a guided tour. Use this time to evaluate the overall atmosphere
of the home. It may be helpful to take notes during the tour,
or use a checklist of items that are important to you. A good
checklist for this purpose is available by clicking here,
or you can call us and we will mail one to you.
When the tour is over, tell the nursing home staff you may
want to return, but don't want another formal tour. Your second
visit should be unannounced and scheduled at night or on a
weekend. This should give you a complete picture of the amount
of staffing, services and activities available to residents.
When you return, make sure to check with nursing home staff
before entering resident care areas. Respect resident privacy
when walking around.
The Nursing Home Visit Near the end of your visit,
ask to see a copy of the nursing home's most recent inspection.
An inspection is a written report that says how well the nursing
home meets Federal health and safety requirements. This report
is like a snapshot. It simply reflects that moment in time and
shows what deficiencies were found at the time of the inspection.
Deficiencies are rated on scope and severity. Scope tells
you how often a certain problem occurs or how many residents
were affected. Severity tells you how seriously the problem
impacts the health and safety of residents.
Nursing homes are inspected about every nine to fifteen
months and inspections are supposed to be "unannounced" so
that the facility is reviewed in a manner most similar to
its normal operating condition. Nursing homes that do not
meet State and Federal requirements are subject to fines and
other penalties if their deficiencies are not corrected. By
law the nursing home inspection report must be posted in an
area that is convenient for residents and their visitors to
see. Please click here to see resources available to you and
your family to compare nursing homes (link to protectelders.org/resources/nhcompare).
Quality of Life The law requires that residents receive
the necessary care, treatment and services that will enable
them to reach and maintain their highest practicable level of
physical, mental, and social well-being. In the last decade,
different laws and regulations have been passed to raise the
quality of life and standards of care for nursing home residents.
When considering a nursing home, it is important to remember
that people who are admitted into nursing homes do not leave
their personalities at the door. They keep life-long preferences
and habits. They still have the basic human need for respect,
encouragement, and friendship.
To maintain a good quality of life, nursing home residents:
- Need to keep as much control over the events in their
daily lives as possible. People can become very depressed
when others make these basic decisions or life-long patterns
are changed.
- Should have the freedom and privacy to attend to their
personal needs, to participate in their care planning, and
to examine their medical records.
- May only be restrained to treat medical or psychiatric
symptoms if using them is reflected in the resident 's comprehensive
assessment and care plan, and prescribed by a physician.
Benefits from using restraints should outweigh the risks
of harm to the resident that may include incontinence, decreased
ability to walk, or pressure sores.
When you visit a nursing home, keep these questions in mind
(click here for the Coalition's checklist):
- Does there appear to be enough staff to attend to the
residents' needs? Does the interaction between residents
and the staff seem warm and friendly?
- Do residents seem clean and well groomed? Are residents
dressed in appropriate clothing?
- Does the facility look and smell clean?
- Most residents must share their room. Is the room large
enough? Is there a bathroom? Do residents have a reasonable
choice of roommates? How are differences between roommates
resolved?
- Even though space in nursing homes is limited, having
a few cherished items can be very comforting. How does the
home help protect residents' property and personal items?
- Does the nursing home provide a variety of activities
that residents like and allow residents to choose the activities
they want to attend? Are there activities for bed-bound
patients?
- Are family members encouraged to visit, and are they encouraged
to bring special ethnic or religious foods on special or
holy days? What are the visiting hours? Can family visit
outside the scheduled visiting hours?
Quality of Care
By law, nursing homes must make a thorough assessment of
every new resident within two weeks of admission.
The assessment covers important issues like the resident's
mobility, skin condition, nutritional and medical status,
rehabilitation needs, and daily habits.
Based upon the assessment, the home also must complete a
resident care plan that helps each resident reach or keep
his or her highest level of well-being. Good care plans are
put together by a variety of health care providers as well
as the resident and family. Be sure to attend the care-planning
meeting to participate in the development of the care plan.
Care plans may change as a resident's needs change.
Unless you have a medical or social work background, it
might be difficult to assess the quality of health care the
nursing home provides to its residents. However, that does
not mean you cannot trust your senses: does the home look
and smell clean, is it pleasantly lit, do residents seem relaxed,
and do staff seem to respond quickly to call lights for help?
Other ways to evaluate the home are:
- Check the most recent State inspection report. If the
home was cited for deficient practices in any quality of
care areas, ask staff how they were corrected.
- Learn if the home has written policies to prevent resident
abuse and neglect.
- Does there seem to be enough staff to care for the number
of residents.
- Find out how long the current staff have been working
at the home.
- If the resident has special needs (dementia, permanent
kidney disease, ventilator dependency), make sure the home
has experience in working with people who have the same
condition.
- If you have a trusted doctor, ask if he/she will be visiting
you in the nursing home. Also, ask how often the nursing
home's Medical Director visits the home. You need to be
confident that the home's Medical Director can take care
of resident needs, because he or she might be called in
emergencies.
