Finding a really good nursing home is, for many people, very difficult and emotionally-draining.
You want to make the best decision for your loved one, and there are many competing priorities that sometimes make the choice difficult. Here, I have tried to point of some aspects of the decision that you may not yet have considered. In addition to what I've written here, there are links to sites that I have found helpful. Also, be sure to visit the "Find Local Help" to find local people and organizations who would like to be of help, and to find local nursing homes.
The importance of a Nursing Home's Location
The first step is to compile a list of nursing homes that are in the area. You will want to choose a nursing home that is a short and easy drive from a caring relative or friend (like you!), to make visiting easier. Proximity is very important. Once someone is in a nursing home, most of their contact with the outside world is very limited. This means that being close to, for example, an old neighborhood, is only important if people from the neighborhood will visit. If you are a long distance away from where the loved one lives now, consider choosing a nursing home near where you (or another devoted friend or family member) lives, even if it means a move for the nursing home patient. Regular visits from someone in the community are key to ensuring good care and also a key factor in reducing isolation and depression.
How to Get a List of Nursing Homes
You can get a list of local nursing homes from the director at a senior center, a doctor, or from the U.S. federal government's Nursing Home Compare database (keep in mind that only Medicare and Medicaid-approved nursing homes are listed - that is most, but not all, nursing homes).
What to Look for When You Visit A Nursing Home
Be sure to visit the nursing home at several different times throughout the day.
You will want to sample the food, and view the rooms.
Ask to meet with the director of recreational services and see one of the activities. Show up in the early morning, and the late afternoon.
Does the facility pass the smell test? You should not smell a dirty diaper smell unless an accident just happened coincidentally near you (which is why more than one visit is advised). It is NOT normal for a nursing home to always have "that smell." You wouldn't accept that in a day care situation, and it's not acceptable in a nursing home.
Observe the staff. Do they seem friendly, and warm to the residents, or are they disinterested? Remember, what you are witnessing is "best behavior."
Attend a family support group meeting (usually held in the evening). If there isn't one, this isn't a good sign; ask why.
If You Can't Visit the Nursing Home Personally
Sometimes, you are not able to personally make the visits yourself. Maybe you are ill, live a far distance away, or have other pressing commitments. In this case, if you can afford a couple hundred dollars, I recommend highly that you hire a geriatric care manager. He or she is a specialist in helping individuals and families arrange for long term care, whether home-based or facility-based. He/she can act as your local eyes and ears, and can be a great ally in finding the best nursing home for your loved one. A geriatric care manager may also know of care resources you weren't aware of.
If you cannot afford to hire a private geriatric care manager, your loved one's doctor's office or the director of the local senior center of council on aging can be very helpful.
