Ohio State University Extension

Senior Series

For more information, visit the Ohio Department of Aging web site at: http://www.state.oh.us/age/
and Ohio State University Extension's "Aging in Ohio" web site at: http://www.ag.ohio-state.edu/~seniors/

Taking a Difficult Step: Finding a Nursing Home

SS-203-02

Author: Christine A. Price, Ph.D., OSU Extension State Specialist, Gerontology, The Ohio State University

There are a variety of reasons why individuals must enter a nursing home. For some, it is a brief stay; just enough time to recover from an illness or get appropriate therapies to assist them in their recovery. For others in need of extended long-term care (LTC), entering a nursing home can mean staying indefinitely.

There is nothing simple or easy about locating a nursing home or skilled care facility. Often, this decision requires the assistance of a family member or friend. In these cases, it is a big responsibility for the family to be sure their loved one will be cared for by professionals who respond to emotional, social, and psychological needs as well as physical and medical limitations. If you have the responsibility of assisting a friend or loved one with locating a nursing home, the following is a list of important topics to consider and suggested questions that may help you with your search.

Getting Started

• Talk to as many people as you canthe local or state long-term care ombudsman program, nursing home advocacy groups, hospital discharge planner or social workers, the state or local office on aging, your physician, and any others who have knowledge about the nursing homes in your area.
• Involve your loved one in making the decisionthis is important to assist him or her to adapt to this significant life transition.
• Look for a nursing home that is Medicare and/or Medicaid certified.
• Create a short list of nursing homes you want to visit and visit them.
• Read the inspection reports of the nursing homes you are interested in.
• Look for signs of quality care (cleanliness, dignity, activity, good food, helpfulness, and a home-like environment).
• Avoid signs that indicate poor quality care (i.e., strong and persistent odors, physical restraints, lack of privacy, disrespect, unanswered calls for help, loneliness, boredom and inactivity, and lack of assistance with eating).
• Look for facilities that are located where family and friends are able to visit frequently.

Things to Look For

General Physical Characteristics

• Does the facility have adequate lighting?
• Are the rooms a comfortable temperature and well ventilated?
• Is the furniture attractive, comfortable, and safe for residents to use?

Attitudes and Atmosphere

• Is the general atmosphere of the facility warm, pleasant, and cheerful?
• Do staff members take time to visit and show affection?
• Are residents encouraged to wear their own clothes, decorate their rooms, and keep a few prized possessions?

Safety Issues

• Are there grab bars in the toilet and bathing areas as well as on both sides of the hallways?
• Are smoke detectors, automatic sprinkler systems, and emergency lights in good working order?
• How does the facility monitor confused residents who may wander?

Food Services

• Are the meals provided by the facility planned by a trained dietician?
• Sample a meal. Is the food tasty and served at proper temperature?
• Do residents who need assistance get that assistance whether in the dining area or their own room?

Social Services and Resident Activities

• Is there a trained, qualified social worker or activities director on staff?
• Does the facility provide varied recreational, cultural, and intellectual programs for residents?
• Are activities provided to residents who are relatively inactive or confined to their rooms?
• Does the facility have a safe outdoor area where residents can get fresh air and sunshine?

Residents' Rooms

• Does each room have a window, a reading light, a comfortable chair, a phone, a closet, and drawers for personal belongings?
• How does the facility handle matters of resident privacy?
• Do residents have any input into the assignment of roommates?

Transportation

• Does the facility provide transportation to residents for recreational and medical purposes?
• Is the facility on or near a bus route for the convenience of residents and visitors?

Financial Considerations

• Is the facility certified to participate in the Medicare and/or Medicaid programs?
• Are many of the services needed included in the basic charge? What is not included?
• Does the contract between the facility and the resident clearly state: Costs? Date of admission? Services to be provided? Discharge and transfer conditions?

When the Decision Has Been Made (Contract Issues)

• Make sure you understand the contract before you sign it.
• Be sure you understand what the facility defines as a "responsible party" before you sign on as one.
• If you have any questions, do not hesitate to seek legal advice.

Family Involvement

• Speak up when you have concerns as well as when you have compliments.
• Participate in family council meetings if they exist.
• Attend quarterly care-plan conferences and advocate for individualized care.
• Follow up on the agreed upon care-plan and request a meeting if it appears the care-plan is not being followed.
• Get to know the staff members who care for your loved one.
• Help the staff to know your loved one better by sharing details about his or her personal history, likes and dislikes, and preferred routines.
• Make contact with your community's long-term care ombudsman and become familiar with the laws and regulations that apply to nursing homes.
• Document any problems you might observe to assist with any investigation (date, time, persons involved).
• For additional information about moving to a nursing home and making nursing home visits, please see the following Senior Series fact sheets:

#SS-187-01 "Moving Your Loved One to a Nursing Home: What You Can Do"

#SS-188-01 "Tips When Visiting a Nursing Home"

#SS-189-01 "Gift Ideas for Nursing Home Visits"

Additional Resources

Choosing Good Care: A Family Guide to Finding a Nursing Home. (2000). American Association of Retired Persons (AARP). (Publication D17064)

Solving Nursing Home Problems: A Guide for Families (2000). American Association of Retired Persons (AARP). (Publication D17065)

Lieberman, T. & Consumer Reports Books (Eds.) (2000). Consumer Reports complete guide to health services for seniors: What your family needs to know about finding and financing, Medicare, assisted living, nursing homes, home care, adult day care. Crown Publishing.

Martin, L.M. (1999). The nursing home decision: Easing the transition for everyone. Wiley, John & Sons, Incorporated.

Silin, P.S. (2001). Nursing homes: The family's journey. Johns Hopkins University Press.

See also: The Administration on Aging: National Aging Information Center (NAIC) web site on Nursing Homes at http://www.aoa.gov/NAIC/Notes/nursinghomes.html

Sources

A Consumer Guide to Choosing a Nursing Home. (1999). National Coalition for Nursing Home Reform at www.nccnhr.org.

Choosing Good Care: A Family Guide to Finding a Nursing Home. (2000). American Association of Retired Persons. (Publication D17064)

Nursing Home Life: A Guide for Residents and Families (1991). American Association of Retired Persons. (Publication D13063)

There is nothing simple or easy about locating a nursing home or skilled care facility. Often, this decision requires the assistance of a family member or friend.

Click here for PDF version of this Fact Sheet.