Shopping for a Nursing Home – Part 1

December 17, 2015

Always ask questions: it’s the best way to ensure you are making the best decision.

For most of us, the process of shopping for a nursing home is something completely foreign. It is something we’ve never done, never given any real thought to, and it can be intimidating, even a little scary. With this five part series, we’d like to help take some of the uncertainty out of the process and give you the tools and background you need to make the right decision for you and for your loved one.

First, know that you have a choice in the decision. Even if your loved one has no assets or long term care insurance, or the hospital has already arranged for a home to accept the patient upon release, you still have choices. And if you find yourself in a facility that is not meeting your needs as well as they should, you have the option of going elsewhere.

Second, you need to know what you’re looking for. In most instances, people are looking for either a nursing home or a rehabilitation center. A nursing home, or skilled nursing facility as most are known today, is a long term solution to providing for someone in need of regular medical care who cannot receive it at home. Typically those who move in to a nursing home as a long term care solution are there for the foreseeable future.

A rehabilitation center is a short term solution where the person checking in expects to be there for a loosely defined period of time, which could be days, weeks or months. But regardless of the time period, the intention of all involved is to assist the resident in returning to full independence and reaching the point where they can be safely discharged from the facility to their own home, or that of a family member.

In most cases, the facilities you’ll be considering in either of these situations will be the same. Certain residents will be there on a permanent basis and others for a brief period of rehabilitation. Most Centers Health Care facilities are in this category. In fact, usually about 30% of the residents of any given Centers facility at any point in time are short term residents who are there for a period of rehabilitation. In any case, the vast majority of facilities such as ours do not accept out-patient rehabilitation patients, so regardless of your particular situation, you or your loved one will be calling the facility home at least for a while. Most long term residents receive some level of physical, occupational, or other therapies from the same staff and using the same equipment, so an evaluation of the therapy department is important for everyone.

But before you get to looking at the various departments, think about your very first impression upon entering. Hopefully the lobby was warm and friendly. After all, this is the home of dozens, possibly hundreds of people, so you should expect some activity. Does it make you feel welcome? Were you greeted with genuine warmth by the receptionist? Was the area well lit, and most of all, did it have a bad smell? A fresh smelling, warm lobby with pleasant staffers and perhaps a resident or two enjoying the day will tell you a lot about the rest of the facility before you go any further.

When you tour the facility, ask to see the entire facility. Don’t accept a response such as “all the floors are the same” or “if you’ve seen one room you’ve seen them all”. If it’s a six story facility, visit all six floors, and if placement is imminent, ask to see the room your loved will most likely be moving in to. Look for cleanliness, organization, and staffing. It’s difficult to tell from a casual walk-through whether or not the staff is sufficient, but you can look for clues. Are the nurses and nurse’s aides busy (they should be), or are they so busy as to appear frazzled or over-worked? Listen for call bells. Every bed in every room has a buzzer for the resident to call for help when necessary. Are you hearing call bells ringing that aren’t answered promptly? Pay special attention to how the staff and residents interact. Compassionate staffers are on friendly terms with their residents and you should see that in action.

If your loved one is moving into a skilled nursing facility, there are obvious medical issues, so make it a point to meet the director of nursing. Ask if he or she can take a walk with you while you chat. Note how the staff reacts when the director is in the area. Does he/she know the patients and seem to have a positive relationship with the staff? These are critical indicators as to what kind of healthcare you can expect. Good relationships indicate passionate, compassionate people, which is a far cry from a staff that simply measures and distributes medications.

Often times there is a designated person who handles facility tours. But you shouldn’t feel that as though you can only tour the facility with the social worker. Or designated person. Even if you’ve been on the social worker’s tour, you can still ask to walk around with the director of nursing, or other department heads, assuming they have the time in their schedules to allow them to break away from their regular responsibilities. If you like what you’ve seen, then it’s worth looking at four key areas that will determine if the facility is right for you: rehabilitation, accommodations, dining and activities. If you’d like to download our Choosing the Right Facility checklist, click here.

Join us next week for Part 2 of Shopping for a Nursing Home, where we’ll discuss what to look for at a rehabilitation facility.

Heart. Health. Home.

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