Speak to all sorts of staff members – and residents – to get the real scoop.
Questions to ask
Obviously, you can't just rely on facility tours or promotional brochures to make this crucial decision. First, get your ducks in a row. When you're ready to visit in person, turn to administrators, staff members and residents for answers to pivotal questions.
Consider Before You Visit:
Is the location realistic? Lengthy drives, not to mention flights, will affect visits and add barriers to relationships with friends and family members, including spouses still living at home.
Many families face a tough conundrum. Sometimes it's a matter of choosing between top-ranked but distant facilities versus more accessible locations for loved ones to visit regularly and monitor care.
Ask Administrators and Nursing Directors:
What are the staffing ratios? Bolster your question with research.
What is your staff turnover? Stable staffing is a good sign. In addition, consistent assignment – when the same caregivers are assigned to the same residents on a daily basis – is critically important. That way, staff members really get to know residents, anticipate their needs and can recognize and address problems early.
Which services do you offer? If you're undergoing rehab to recover from a hip fracture, you'll need a higher level of care than some nursing homes can offer. With medical conditions like chronic obstructive pulmonary disease, or COPD, residents may need help managing supplemental oxygen.
Do you provide special care for people with dementia? Memory care means much more than just a locked unit to prevent residents from wandering. Staffing ratios should be no more than five residents per caregiver, including nurses and aides, around the clock. Caregivers should have special training in dementia care, and the awareness and sensitivity to best address these needs.
What kind of food do you serve? Residents rely entirely on nursing homes to meet their nutritional needs. Healthy, tasty food improves everyone's quality of life.
How do you satisfy cultural and individual food preferences? People in nursing homes still want to enjoy meals that evoke family traditions and tastes they've developed over their lives.
Do you accommodate special diets? Residents come in with their own dietary preferences and restrictions. Some also may have medical orders for soft or puréed diets, for example.
Can residents eat when they want? Some people prefer to eat outside routine schedules.
After the formal tour, explain that you'd like a chance to speak with several residents. Drop in at the activities room or a lounge, introduce yourself, say you're considering a move there and ask what it's like for them.
Are you happy here? "Do you enjoy living here?" "What do you like best about living here?" and "If you could change one thing, what would that be?" are positive ways to frame your questions and make residents more likely to respond.
Do you have freedom of choice? Does the facility offer resident-centered care? Are you able to get up when you want? Do you go to bed at the time you want?
When you ask for help, how long do you have to wait? If you always have to wait beyond five minutes for help, you're likely to try doing things on your own, which could set you up for falls.
Ask Activity Directors:
What about activities? How do you keep residents engaged? Ask to see monthly activity calendars. Offerings should be varied and appealing.
Does the facility have a resident or family council? These self-determined groups can provide a strong voice for quality care.
Is reliable transportation available? Sometimes nursing homes only provide transportation for certain medical appointments – and they don't provide transportation for social purposes. Is there staff to help residents get to a granddaughter's play?
Can residents easily spend time outdoors? Attractive courtyards are sometimes the first thing visitors notice. But how often can residents, particularly those with mobility issues, actually go outdoors? Does staff encourage and help them to do so?