Nursing Home Checklist

Print our checklist of what to look for when choosing a nursing home.

By John Mitchell
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Do your homework to find the perfect place for your loved one.
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Searching for the right nursing home for Mom or Dad? Use this guide to pick the a home that will take good care of your loved one's needs.

Pick a Location That Works For You
If you want to be involved in your loved ones' care and they live in Florida but you're in DC, find them a home near DC. You'll drive yourself nuts flying back and forth otherwise and you'll do them no good. If they're at the point where they need to be in a nursing home, then you don't need to worry so much about keeping them near friends and familiar surroundings. They're not going out anymore, and they need you now, nearby and available to pop in and check up on them. If your brother lives in Florida and can be the family rep, that's fine, but make sure someone from the family is close.

Visit and Assess the Homes You're Interested In
This is the most important step because nothing else tells you as much about a place. Take a tour, and keep your eyes open. Smell the place; if it smells bad, that's a bad sign. Urine is not a mark of a well-run home. Talk to some residents if you can. They'll all have complaints, but some you can see through. They tend to think the staff are stealing from them, but if you can see through the lies your children tell, you should be able to see through some of the confusion of these people. Ask about staffing -- the more, the better.

Look at the condition of the people. You want most of them to appear to be in the same shape as your loved one. If everybody else is playing shuffleboard and your loved one needs to be hooked up to an IV all day, he or she might not fit in this home's target audience.

Look at what the residents are doing. Are there supervised activities going on in the activity room, or just a few people knitting and working on a jigsaw puzzle? Is there a posted list of activities that looks full and interesting? Maybe you just missed the macramé class. Are there residents just parked in the hallway or in front of a TV in their wheelchairs? Are residents restrained in chairs? Sometimes restraints are needed to keep someone from tipping over, but their use should be minimal and not degrading.

é Look at what the staff are doing. Are there three nurses standing around talking while the residents are being ignored? Are the desks staffed? Are they friendly? Imagine you were visiting and needed to talk to a nurse; could you find one?

Inspect the public bathrooms and other common areas. It's like a restaurant -- if the places you can see don't look well-maintained, what are the odds the places you can't see are well-maintained?

Try to join in a meal or at least watch while one is going on. Does the food look like something Mom would want to eat? Maybe it doesn't matter, but if they're serving mystery meat and your loved one is Julia Child, it might not be the best match.

Because the jargon is meaningless, ask the administrators to explain everything clearly. What does it mean when they say X,Y and Z?

Do Your Homework
Check medicare.gov/NHcompare. This great government site will give you detailed information on the facilities, their staffing, the status of the residents and their health, results of the home's inspections...tons of good stuff. Play around a little on the site to see what it can tell you. Put in your zip code and look at homes within 10 miles. You want a place that falls in the middle of facilities in your area. Better is fine, but average is good enough if it's a place you got a good feeling about and it's convenient. (You could use this step to figure out which ones to visit, but your list will be longer.) For-profit places tend to have lower staffing because staff are expensive, but plenty of them do a good job. On the other side of the coin, a nonprofit home being run by nuns doesn't make it a better choice for your loved one -- unless he or she loves nuns.

Stay Involved
Before you make a decision you can do your research and make an informed decision, but you need to keep popping in and checking out the home to make sure your loved one is doing well. If you see something that concerns you, talk to the administrators and let them know you live nearby and aren't interested in just warehousing your loved one. It sounds crass, but if they know you only come by on Sunday after church, that may be the only time your loved one gets washed up and dressed nicely. Like the way colleges spruce up a little more and offer better choices at the dining halls around Parents' Weekend. If the home knows you'll be stopping by randomly, Mom might just get a little more attention.

Be aware of your loved one's changing condition. What started out as a great place for her when she was recovering from her surgery might not be the right place six months later. Some places have a range of care options and can slide residents to another room in their skilled care wing if the resident deteriorates; others might tell you it's time to look for another place. But you need to think about it yourself too. And listen to your loved one. If your son went away to college and told you after the first semester that he hated it there, you wouldn't tell him to suck it up for another three and a half years. You'd talk to him about it and try to figure out if transferring would be a better choice.

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