Social & Community

Research is Key When Choosing a Nursing Home

When families are faced with the reality that a loved one needs long-term care in a nursing home, finding the best facility that offers quality, resident-centered care can seem like a difficult — even overwhelming — challenge. But if you’re in doubt about how to choose the right facility for the older adult in your life, research is the key to helping you feel more in control of this important decision.

“There are many ways families can investigate available options,” says UAB geriatrician and Certified Nursing Home Medical Director Clare Hays, MD. “Then, they can have confidence they’ve done their best in selecting the most appropriate facility for their loved one.”

Look to Organizations That Can Help

As you begin your search, it may be helpful to check with organizations that can guide you in choosing a facility — and provide key information about nursing homes in your area. The local Area Agency on Aging and Office of Senior Citizens Activities have information on many long-term care options.

“The Web site Medicare.gov contains some helpful advice on selecting a facility,” says Dr. Hays. “There is a downloadable ‘Guide to Choosing a Nursing Home’ as well as ‘Nursing Home Compare,’ which provides quality indicators for facilities nationwide.” She adds that the National Citizens Coalition for Nursing Home Reform (www.nccnhr.org) is another good source for information.

Visit Several Facilities

“One of the most important things families can do is to visit many different nursing homes before making a decision,” Dr. Hays emphasizes. “Be sure to spend a good deal of time evaluating the atmosphere. Is it cold and institutional, or warm and homey?” She explains that although nursing homes in our country are tied to the medical ‘hospital’ model, this really isn’t the best type of environment for residents.

“The best nursing homes should remind you more of a home than a hospital, and activities should be varied, with food, music, art, plants, animals, and outings.” She adds that residents should also be involved in planning activities. “A good nursing home might look more like a kindergarten classroom than a hotel,” says Dr. Hays. She stresses that families should ask — and observe — if residents are encouraged to bring their own personal belongings. “Also, ask if pets and children are welcome to visit.”

Dr. Hays underscores the importance of finding out whether the nursing home is more resident-driven or task-driven. For example, she says families should find out if the nursing home puts all patients on the same schedule based on the needs of the nursing home — or if they’ll work with patients to accommodate a schedule that’s best for them.

“Ideally, you want to find a nursing home that offers individualized care, and this can sometimes be difficult to find,” says Dr. Hays.

Talk to the Caregivers — and Patients

“When families are researching a nursing home facility, it’s very important for them to talk to the Certified Nursing Assistants (CNAs),” explains Dr. Hays. “These are the people providing most of the day-to-day care in a nursing home, and you want to have a comfort level that they’re compassionate and competent.” Also, Dr. Hays says families should ask the nursing home about CNA turnover rates. “Consistency of CNAs on a unit is a positive thing. It’s important for a CNA to get to know a patient and become familiar with his or her care.”

Dr. Hays point out that, in addition to talking to nursing home staff, it’s also very important for families to observe — and speak with — the residents. “Do they look bored or lonely? If so, this can be an indicator that the facility isn’t resident-centered,” explains Dr. Hays. “Don’t be afraid to talk to the residents and ask them if they enjoy living there. Your goal is to find a place that offers meaningful activities for the residents that help them feel engaged.”