Tips on selecting a nursing home
Can there be a more difficult job than finding a nursing home for
a parent or spouse? No one wants to live in a nursing home.
They serve as institutions of last resort when it's impossible to
provide the necessary care in any other setting.
Many individuals struggle with making health-care decisions on
behalf of their aging loved ones. Long-term-care resources such as
home care, adult day centres, adult homes and assisted living
facilities may provide alternatives for those who do not require
24-hour skilled care, allowing them to remain in the community and
maintain optimal levels of independent functioning.
However, once the determination has been made that placement in a
nursing home is appropriate, there are a few simple steps to assist
in the process of selecting the home that is right for you.
Begin by researching the available nursing homes in your
geographic area. The Commission for Social Care Inspection (CSCI)
has a web site where you can search the comprehensive directory of care homes and other services, like home care, to find your local services.
Get their reports about care homes, care services and
council services free of charge from their website.
Follow the links below to find an inspection report.
Once selected, comparisons can be made in relation to quality,
staffing ratios, survey reports and fire safety deficiencies.
Visiting each nursing home will also assist you in your
selection. Formal visits or tours can be scheduled through the
Department of Social Services, or you could just stop by and take a
look around (though staff may not be available to assist you without
an appointment). Visit with residents, families and staff as you
look around, and observe the activities.
Here are a few rules of thumb that can help you:
1. Location, location, location. No single factor is more important
to quality of care and quality of life of a nursing home resident
than visits by family members.
The quality of care is often better if the facility staff knows that
someone who cares is watching and involved. Visits can be the high
point of the day or week for the nursing home resident. So, make it
as easy as possible for the family members and friends to visit.
2. Ask the facility to provide the names of family members of
residents so you can ask them about the care provided in the
facility and the staff's responsiveness when the resident or
relatives raise concerns.
3. Talk to the nursing home manager or nursing staff about how
care plans are developed for residents and how they respond to
concerns expressed by family members. Make sure you are comfortable
with the response. It is better that you meet with and ask questions
of the people responsible for care and not just the person marketing
the facility.
4. Tour the nursing home. Try not to be impressed by a fancy
lobby or depressed by an older, more rundown facility.
It is also advisable to try and get a tour of the facility that is
not prearranged. While this is not always possible, it does give you
the opportunity of seeing an unrehearsed atmosphere.
Other things to be considered when selecting a nursing home
include, but are not limited to:
- What matters most is the quality of care and the
interactions between staff and residents. See what you pick up
about how well residents are attended to and whether they are
treated with respect.
- Bed availability - Is there a bed available now, or
will you be placed on a waiting list?
- Staffing - Are there a sufficient number of certified
nurses' aides and nurses available?
- Activities -Monthly calendars can be reviewed
to see the variety and frequency of programs offered at each
nursing home. Further discussion with activities staff should be
initiated for specific questions or comments.
- Policies - What policies and rules are in
place that residents and sponsors must follow? This may include
smoking, visiting hours, etc.
- Services and fees - What's included in the monthly
charge? Are all the services required available at this home?
How does one nursing home compare to the other?
- Preventative care programs -Are programs
available such as immunizations for flu and pneumonia? Is there
routine monitoring of blood pressure, weight, etc.?
- Resident and sponsor involvement - Does the home
promote involvement through group forums, including residents
and family councils? How often do these groups meet? What occurs
at these meetings?
- Resident information - Interdisciplinary reviews are
scheduled quarterly to review and update any care plan changes.
Does the facility promote sponsor and/or resident involvement at
these meetings quarterly? Biannually?
- Hospice - Some (but not all) nursing homes
participate with Hospices for terminal care needs.
- Nutritional services - Investigate the quality of the
food service. Eating is both a necessity and a pleasure that
continues even when we're unable to enjoy much else. Can the facility comply with special
diets and dietary restrictions?
- Treatment availability/options - All nursing homes
provide custodial care, but some offer additional treatment
options including peritoneal dialysis, central line care,
intravenous medications, wound vacs, etc.
