How To Choose A Nursing Home For a Loved One

When faced with the difficult choice of  how to choose a nursing home to place a loved one in, you want to ensure the care meets the needs of both your loved one and the family.  This can often be an agonizing choice as everyone’s preference would be to avoid a skilled nursing facility.  But if the choice is inevitable, here are some factors to consider.

By far, the most important consideration is the quality of care and attentiveness given by the staff.  Visit the facility and see for yourself if the staff seems alert, caring, and attentive.  Ask what the ratio is of staff to residents.  The more workers there are should translate into more attention.  Arrange to speak with the admissions director, a social worker, and, if possible, the head administrator.  Do they seem warm, interested in your concerns, and patient? 

Observe the hallways and rooms.  Do they appear clean and tidy?  Do they have an institutional smell?  Is there a fair amount of natural light that enters?  Ask other residents’ families, if you can, about quality of food, social activities, laundry services, and coordination with family members about care concerns.  If you don’t know other families, ask the nursing home for references.

Some facilities specialize in the care of Alzheimer’s patients, or those with severe dementia.  If wandering is a problem, the facility should have a secured wing.  Connecticut has some excellent choices for dementia patients.  Other facilities may be equipped to handle ventilators.  At least one home in Connecticut has an internal psychiatric wing.

Proximity to a child or other relative is often a very important criteria, because if it is not a long drive, it will be easier to visit, and the more visits, the more you will be able to monitor the care.  It is human nature that the more you check on care, the more the staff will try to please you.  We often advise clients that if two facilities are fairly similar, always choose the one nearest in travel time.  Mom or dad will appreciate your visits.

Often the need for a nursing home comes on suddenly, and there are limited choices because of bed availability.  But if the choice can be made without severe time pressure, you will have a greater chance of admission to the place of choice if you can pay privately for a few months before assets are used up and Medicaid is a necessity.

Price is usually not one of the factors, because once the high cost of care depletes the assets that are not protected, Medicaid (or Title 19) will usually take over as the payor.  There are a few nursing homes that do not take Medicaid, so in that situation, price may be a consideration, because the assets available to pay for care will last longer if the daily rate is less.

Other sources of information are an experienced elder law attorney, or hospital discharge planners, who regularly deal with many skilled nursing facilities.  CareScout of Wellesley, Massachusetts was founded in 1997 and provides reviews and also ratings of nursing homes.  You can find their website at carescout.com.  Medicare also provides information which can be found at Medicare.gov/NHCompare/