2. Let your senses be your guide! For instance, overall,
the smell of the facility should not be unpleasant. The noise level should
be comfortable. The hallways, rooms and nurses stations should be
organized and relatively clear of clutter. Is it too warm or too cold?
Does the staff greet you with a smile? Is there cheerful, respectful,
pleasant interaction between the staff, the residents, and administration.
Does the nursing home have a "homey" atmosphere or is it cold
and business like? Does the food look and taste appetizing? Are the
residents wearing appropriate clothing, jewelry, makeup, and are the men
clean shaven? Are residents involved in activities and using the common
rooms such as the lounge? Observe the facial expressions and body language
of the residents. Do they appear relaxed and how do they respond when
approached? Visit during different times of day and visit unannounced;
however, for your safety as well as the safety of the residents, you
should not tour the facility unattended.
3. Inspection Reports. Although inspection reports are
not necessarily a true reflection of the quality of care that a facility
provides, you might ask to see the most recent one. The administrator
should be more than willing to share it with you or show you where it is
posted within the facility. If it is not made available to you, the most
recent inspection report is available on the Internet. Are you unsure what
to look for in these inspection reports? Click
Here
4. Talk with residents and their families and your
physician! If you know someone in the facility, or a family member, ask
them to share with you how they feel about the overall care and about the
facility administration. If possible, talk with a few of the residents to
get an average view of how they feel about the important things like the
hands on care, the food, and the overall atmosphere. If time allows,
attend a family counsel meeting where you can talk with a number of family
members who meet to support each other. Don't forget to ask your physician
frank questions about nursing homes in the area, and which facilities
she/he might favor.
5. The staff!! The importance of quality staff can't be
overestimated. Spend time talking with some of the nurses and nursing
assistants throughout the facility. Do they speak warmly of the residents
and their co-workers? Do they smile when approached by a resident? When a
call bell rings, do they try to respond quickly? Do the nursing assistants
and nurses seem to work well together? Ask how long they have worked
there. It's not a good sign if a large percentage of the assistants are
new employees. Does the facility have an active volunteer contingent? A
strong volunteer program can add much to the overall feeling of community.
6. The facility tour! Take your time and consider
touring the facility at different times. Does the admissions coordinator
take time to answer your questions and address your worries and concerns?
The following is a list of questions you may want to ask the admissions
director or other staff members while touring the facility:
- Resident rooms should reflect the individuality of
their occupants. What types of things are the residents permitted to
bring from home? How much storage is available for the resident's
personal belongings?
- How quickly are call lights answered? Does the
facility have a policy on answering call lights? Are all staff
members, including management, required to answer call lights?
- Are there rooms that residents and their families can
use for private visits?
- What is the policy on physical restraints? What
alternatives to physical restraints are used to ensure a resident's
safety?
- What kinds of activities are residents involved in?
What kinds of activities are there for residents with dementia? Does
the facility have a wheelchair accessible van for community
activities?
- How many residents are assigned to each nursing
assistant? Is there permanent assignment of staff to residents? Does
the nursing facility try to accommodate individual schedules and
preferences? Is the patient's privacy protected when dressing and
bathing?
- Are the nursing assistants involved in the care plan
meeting? They should attend and contribute ideas as they have the most
contact with your family member.
- What is the facility policy for missing clothing and
other possessions?
- What kinds of therapies are provided and who pays for
these services?
- Who should you talk to when you have a concern or
complaint? How are my concerns resolved? Are there family council and
resident's council meetings?
- What is your daily rate and what is included in that
fee? How often do your private pay rates increase? Are there charges
for extra care, special diets, and ancillary supplies?
- Does the nursing home accept Medicare and Medicaid?
- What is the policy on roommates and room changes?
What happens if your family member does not get along with his or her
roommate?
- Does the facility have a policy regarding smoking?
Are there designated areas for smokers?
- How is the outside environment? Are there places to
walk or sit outside? Is there a secured place outside for residents
with dementia to enjoy?
- Do residents participate in patient care conferences?
If the resident is not able to participate, are conferences held at a
time that family members can attend. Is adequate time allotted to
allow all of your concerns to be addressed?
- Does the dietician work with the resident and/or
family members regarding food likes and dislikes? Is there a second
choice available at meals? Can you have meals with your family member?
Are snacks provided? Is there a place to store snacks and food brought
from home?
- How are outside doctor's appointments handled? Does
the facility provided transportation to these appointments?
Choosing a nursing home for a loved one is not an easy
process. Spend some time touring different facilities, talking to the
staff, and becoming informed. It is extremely important to gather as much
information about a nursing home as possible before making a decision.
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