A nursing home (also known as a skilled nursing facility) is for older retirees who can no longer cope with the tasks of daily living. It is staffed by trained nurses and carers who are experienced in looking after the elderly.
The services provided by a nursing home are comprehensive and, besides nursing care, include: 24-hour supervision and assistance with everyday tasks, as well as all meals and recreational activities.
Some people enter a skilled nursing facility as a half-way step on their way home from a hospital stay. They are there for just a week or two until they recover fully from whatever surgical procedure they underwent.
These facilities are also used to give respite to family carers who are devoting their time to look after an aged parent. The parent spends a week or too in a safe, professional environment which the person caring for her in her own home enjoys a holiday.
However, most residents in a nursing home live there permanently because they have physical or mental infirmities that require constant care and supervision. This is the case with my mother.
Choosing a nursing home can be very stressful for any retiree as it was for my mother who, sadly, was both physically and mentally impaired.
As a skilled nursing facility is likely to be you last permanent home on this planet, you need to plan ahead and consider all your long-term actions first. This was not possible for my mother. She had always stated her opposition to entering a nursing home.
She had a fall, one of many, and ended up in hospital. Up to then she had refused to consider entering a nursing home. But her doctor would not discharge her back to her own home, so she had no choice.
Fortunately, myself and my siblings had done a lot of research during the previous years… as we knew from her failing physical health and her increasingly obvious dementia that going to a nursing home was inevitable.
We had already researched the local nursing homes and knew which one we wanted for Mum. As luck would have it, there was a vacancy.
This article is based on our experiences looking for a suitable home for our Mum.
Deciding on your best option
Becoming enfeebled is not a sudden thing. It’s happens gradually as we get older. We become less able to take care of ourselves or our homes.
It was heart-breaking to witness my mother’s slow 5-year transition from a vibrant, very sociable, highly energetic lady into a bent old woman who shuffled about.
Entering a nursing home only becomes necessary at the last stage of this process of enfeeblement. At the earlier stages you have several options. These include:
- daily assistance from a carer who comes in several times a week or each day to help you do your daily tasks
- having a live-in carer, often a retired nurse, who can help with getting in and out of bed, washing, dressing etc, as well as cooking, cleaning and keeping the home tidy
- independent living communities in which you live in an apartment complex with on-site facilities such as banks, gyms, fitness programs, a beauty salon and barber’s shop, a communal dining room, and even a doctor who makes regular round
- assisted living communities for older people who need more support than they can get living independently but who don’t need complex medical care on a daily basis… they usually offer meals, housekeeping, and planned activities, but not medical services.
Before choosing a nursing home, take time to consider whether any of these options might be more suitable for the time being.
My mother went through the first two of these stages for several years before her incapacities made it impossible for her to remain at home.
Steps in choosing a nursing home
When you are making the decision yourself, you need to have the support of your family and close friends in making your decision.
Bring them in on the option-weighing process to help you with making your final decision. Our whole family made the choice on behalf of our mother.
Consider your needs in the final years of your life – nursing care, physical therapy, special care needs, religious needs, physical decline, dementia care and so on – when weighing up your options.
Once you have finally decided that you wish to or must enter a nursing home, here are the three basic steps to follow:
Do an in-depth search on Google and made a list of all the nursing homes in our area. We asked for recommendations from other older persons you knew and trust.
Research the quality of the nursing homes you are considering:
- check their websites for the facilities they offer
- check the inspection reports made by the regulatory agency for nursing homes, which you can find on the nursing homes’ own websites or on the website of the regulatory agency.
- type the name of individual nursing homes into Google and search for comments from residents or other persons.
Next list the homes in order of preference, ie create a short-list.
Visit the nursing homes on the short list.
If you are checking out the homes yourself, looking for a place to spend your last years, I’d suggest bringing along a family member or close friend.
Or have someone you trust undertake the visit on your behalf.
Visiting provides a chance to see the residents, staff and setting of the home.
- Before your visit, consider and decide on what is important to you – nursing care, meals, therapy, a religious dimension, location near family and friends etc
- Call ahead to ensure you’ll be received
- Ask questions and make sure you get clear answers.
- Ask staff to explain anything you don’t understand
- Ask who you should call if you have further questions
- Get a copy of their standard contract so later you can peruse it carefully.
Bring along the checklist that you’ll find below to help you.
Pay a second, surprise visit to the facility without calling ahead. On this visit try to arrive during late morning or midday, so you can see the residents when they are on their daily routines or mealtimes.
I hope you find these pointers useful.
Myself and my siblings undertook all these investigations on our mother’s behalf and, as my mother’s attorney, I made the final decision taking into account what I knew of her wishes.
I can tell you now it’s quite a job and fairly time consuming. Yet it must be done properly if the retiree is to be happy in his or her final home.
Here’s a checklist I devised to help you when visiting a nursing home.
Nursing Home Checklist
Name of Nursing Home: ____________________________________________________________
Date of first visit: ____________________________________________________________
Who visited: ____________________________________________________________
Date of second visit: ____________________________________________________________
Who visited: ____________________________________________________________
Is the nursing home registered with the appropriate regulatory body?
Have you checked inspection reports?
Is a brochure available?
Has the home the level of care needed?
Is a bed available?
Is there a waiting list?
Can the nursing home provide care for those with special needs, eg dementia, disability, residents who wander?
Is the nursing home located close enough for friends and family to visit?
Is the nursing home clean and well-kept?
Have you checked corners and carpets for ingrained dirt?
Are noise levels in common areas are comfortable?
Is the temperature in the nursing home comfortable?
What are the arrangements for visits by family and friends?
Are there areas where residents can meet visitors privately?
Are care plan meetings held with residents and family members at times that are convenient, whenever possible?
Are residents allowed to make choices about their daily routines?
Does each resident have storage space?
Are there smoke detectors in the rooms and hallways?
Are there are policies and procedures to protect residents’ possessions?
Is the nursing home free of bad odours?
Does the nursing home accept residents who smoke?
Are smoking regulations in place and are these acceptable?
What is the management structure of the home?
Does the home provide therapy services?
Are chiropody services provided?
What medical arrangements are in place?
Under what circumstances does the facility call the family or doctor?
How are medical emergencies handled?
Does the nursing home have a policy on self-medication?
What are the arrangements for ensuring that assessed health needs are reviewed and met?
Is the relationship between staff and residents warm, polite and respectful
Do all staff wear name badges?
Are staff actively engaging with residents?
Does the nursing home do background checks on all staff?
Are staff numbers adequate?
What is the staff to residents ratio?
What is the qualified nurses to residents ratio?
What is the ratio of carers to residents?
Does the home provide staff with training and continuing professional learning?
Menus and Food
Do residents have a choice of food at each meal?
Are special diets provided?
Are menus available for you to look at?
Do staff help residents eat and drink at meals if needed?
Is the dining room attractive, cheerful and comfortable?
Is there a variety of social, cultural and educational activities?
Are residents free to choose to participate?
Does the nursing home offer the religious or cultural support you need?
Are arrangements made to accommodate religious worship?
Does the staff offer individual activities, to residents who are confined to bed?
Does the nursing home have outdoor areas residents can use?
Do staff help residents to go outside?
Are outside trips planned?
What is done for holidays and birthdays?
Is there a residents committee?
What is and what is not included in the weekly or monthly rate?
Is a deposit required?
Are payment plans available?
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