It’s not easy deciding which nursing home (or assisted-care facility) would best suit an aging loved one. Unfortunately, often times the person in question is no help at all. Many of us have been forced to undergo this difficult transition, however, and are willing to share their insights about weathering the process. Also, for those who find choosing a nursing home too daunting, there are professional services that can help, such as Aidin, Assisted Transition, SilverLiving, and HealthAdvocate.

Here, then, are eight things you should consider when taking on this daunting experience – from people who’ve been there, and come out the other side.

Understand your needs

Geriatric Care Manager Angil Tarach-Ritchey, RN, says a basic understanding of what you need can drastically reduce the number of places to consider: “For example, does your loved one have memory loss? If so you’ll want to decrease your choices to only those with memory-loss units and programs. Do they like to socialize and take part in activities? If they like such things, you’ll want to find a place with appropriate programs.”

Talk with your community

Ritchey advises to ask around for referrals. “Ask the staff at your loved one’s doctor’s office,” she said. “Ask social workers at your local hospital or home-care agency where they would choose for their parents. Ask friends, co-workers, people at church or other organization you belong to. Attend a local caregiver support group and ask the family members to recommend a place.”

RN Lucy Boyd suggests that when you visit a facility, “Privately ask a few of the patients, ‘Would my aunt like to live here?’ Their responses may be very enlightening.”

Check with the regulators

Martin Rosen, co-founder of Health Advocate, suggests inquiring about the agency that oversees eldercare in your state: “Different states assign different agencies to oversee assisted living, typically Licenses and Inspections or the Department of Health. Check with the appropriate agency for information on the facility. When was the agency’s last survey? Can you see a copy?”

Ask about costs

Rosen asks, “ Will your state’s public programs cover the bill – does your loved one qualify? Find out what’s included in your monthly fee: they can add up quickly, especially if services are a la carte. For example, make sure the basic fee covers essentials like three meals a day.”

Ask probing questions

Peter Mangiola, RN, MSN, suggests a few productive questions to ask about the key medical and safety issues that nursing homes are responsible for. These may be depressing to think about, but your elderly loved one has fragile health already, and needs to be in a protected and sanitary environment:

  • How does the facility rank for their patients’ falling rate?
  • Where do they rank with nosocomial (hospital-acquired) infections?
  • What does the institution do to prevent the spread of staph infections?
  • What’s their policy toward preventing patient-to-patient infections?
  • What’s their record of maintaining patients’ ideal weight?

What about when staffing’s tight?

Denise M. Brown. founder of CareGiving, asks, “How does the facility handle staffing shortages? Some facilities will use an agency. I’m not a big fan of this because the agency staff will be unfamiliar with resident needs. Some facilities will have administrative staff (those who are nurses) take a shift. Be sure to understand how shortages are handled – they will occur.”

Do your homework before the legwork

Ritchey counsels, “You should have no more than 3-5 facilities to check out after considering your needs, as well as costs, ratings and referrals. If you hear a facility is great from more than one person, put it at the top of your list.”

Make a surprise visit

Rosen suggests, “Visit the facility unannounced: The best way to make a decision is to see the it for yourself. Are they receptive to unannounced visits? If they welcome you, ask for a tour, take notes, and meet the staff.” Keep visiting once you’ve made your choice. Wendy Harris of Assisted Transition says, “Nothing is as important as continued advocacy from a loved one. Drop-in visits at varying times of day and night, and active questions about care plans, let the staff know that you care.”

There’s no point in feeling overwhelmed: you only have to take this one step at a time. And now you know some of the important steps.

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