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Published December 28, 2013, 10:00 PM

Minding our Elders: How to evaluate a nursing home for your loved one

DEAR CAROL: I’m moving my mother from another state to a nursing home near where I live. I’d like her closer to me, and I also feel we have access to better nursing homes in my community.

By: Carol Bradley Bursack, INFORUM

DEAR CAROL: I’m moving my mother from another state to a nursing home near where I live. I’d like her closer to me, and I also feel we have access to better nursing homes in my community. Her mind is quite good, but she’s 83 and has several health issues. Since she’s been in assisted living for a few years, she doesn’t have a problem with the plan, but I want to select the home carefully. I know another move won’t be good for her. How do I rate homes so we can decide? – Lyle

DEAR LYLE: You can begin by visiting the Medicare nursing home compare site at Medicare.gov/nursing

homecompare. Type in the ZIP code or location of the nursing homes you are considering and see how they rank for health inspections, staffing and quality measures. Keep in mind that this is just one step in the process.

Once you’ve looked at the ratings, visit the nursing homes that you are considering. Observe how the staff treat one another and how they interact with residents. What is the general mood? Is it as positive as possible given the difficult situations involved? Do they have a variety of activities for people with different interests? Would they accommodate your mom’s special interests, if any? Watching interaction between staff and residents is, in my opinion, one of the best ways to determine how well people are cared for.

People with dementia are incredibly vulnerable, so how these elders are treated is also a good test. If the facility has a memory wing, ask to take a tour. Is there a caring atmosphere even if some of the people seem completely unresponsive? In nearly every dementia unit, there will be people in earlier stages of the disease who can interact with others, so if all of the residents act sluggish, you may have cause for concern. Conversely, if you see caregivers touching their care receivers and looking them in the eye when talking with them, you’ve likely found a good care home.

Talk with the administration. How do they respond when you tell them that you want to visit often? While I strongly support the idea of respecting the staff for their professionalism, I also feel that family members should be able to stop in at any time. There are those who differ with me, but if I found a nursing home that was skittish about drop-in visits from families, I’d be leery. This doesn’t mean that you are out to catch the staff being neglectful. It simply means that you want to be part of the care team.

Beautiful facilities are wonderful, but in the end it’s the staff that matters. If you find a facility that you like but their Medicare Compare rating has a lower ranking, ask an administrator about it. Maybe they had two deaths on the day of an inspection and some smaller issue was neglected. Give them a chance to explain. If you feel you are getting an honest answer to your question, that’s a positive sign.

Realize that the best nursing homes often have waiting lists, so start soon. Also, since your mom is still cognitively sound, it would be nice to send her pictures, brochures and notes on a couple of possibilities so that she will be part of the process.


Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.

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