Fact: Today, there are many options to help older adults stay in their homes, ranging from help with shopping and laundry to caregiving and visiting home health services. If home care options are no longer possible, other options, such as assisted living, may be a better fit if the primary need is custodial care rather than skilled medical care. Even if you’re considering hospice care, that can often be done at home.

Fact: Many cultures have strong beliefs that it is a family’s duty to care for elders. However, in today’s world of smaller families living farther apart and people living longer with more chronic illness, it simply may not be possible. Considering a nursing home for an elderly family member doesn’t mean you don’t care about them. If you cannot provide the necessary care, it is the responsible decision to find a place where your loved one’s needs will be met.

Fact: While it is key to research homes thoroughly and visit your family member frequently, it is not true that all nursing homes provide poor care. There are more and more safeguards in place, and a facility’s staffing information and any previous violations are available to the public, which can aid your decision-making.

Fact: Sometimes an illness or injury progresses to the point where you’ll need both ongoing medical and custodial care through to the end of your life. However, many people encounter a nursing home for the first time after a sudden hospitalization, such as from a fall or stroke. After rehabilitative care, you may be able to either return home or choose a more appropriate housing option.

When should you consider a nursing home?

Whether you and your family are facing a quick decision about a nursing home due to a recent event, or have been coping with a worsening progressive disease such as Alzheimer’s or Parkinson’s, considering a nursing home is not an easy decision. Emotions such as guilt, sadness, frustration, and anger are normal. But by working through your housing, financial, and medical options, you and your family make can make an informed decision.

Whether you’re looking for yourself or an older family member, here are some questions to ask when considering a nursing home:

Have you had a recent medical assessment? If you’re considering a nursing home as the next step after hospitalization, this has likely been done. However, if you’re considering a move from your home or another facility, a more formal assessment by a medical team can help clarify your needs and see if other housing options may be a possibility.

Can your needs be met safely in a different housing situation? If you need 24-hour supervision, or are in danger of wandering off or forgetting about a hot stove, for example, a skilled nursing facility may be the best option. If your needs are solely custodial, though, an assisted living facility may be a better fit.

Can your primary caregiver meet your needs? Caregivers are often juggling the needs of work, their own family responsibilities, and their own health. It’s not possible for one person to be awake and responsive 24 hours a day. Sometimes other family members can help fill in the gap, or day programs, home care services, and respite care can provide the necessary caregiver support. However, there may come a point where medical needs become too great and home care services are insufficient or become too expensive.

Would the need for a nursing home be temporary or permanent? Sometimes, a temporary situation may be covered through home care, or family members might be able to rotate care on a short-term basis. However, if the level of care is expected to be permanent, this may be too expensive or coverage might not be enough.

Nursing home vs. other types of senior housing

Nursing homes provide some of the highest levels of care, both medical and custodial. If you’re not sure that you or your loved one needs that level of care for the long term, learn more about other types of senior housing, including home care, to see what will best fit your needs.

Handling the emotions of moving to a nursing home

Moving can be a stressful experience, even at the best of times. Moving to a nursing home can bring with it a whole host of additional, difficult emotions.

If you’re the one moving

You’re leaving behind a familiar place with lots of memories. If the nursing home move was due to a hospitalization, the transition may have been abrupt and you may not have had time to even process what has happened. Add to that your increased medical needs and decreased mobility, and moving to a nursing home can become a very stressful time. You may even feel angry and abandoned by your family members, even if you realize they can no longer provide the level of care you need. These are perfectly normal emotions.

Accept your feelings. Everyone needs time to adjust and come to terms with their feelings. Trying to sweep anger and grief under the rug—or refusing to acknowledge the difficulties of the transition—will only intensify these feelings.

Remember that you’re not alone in this. Many of us over the age of 65 will require some type of long-term care services. And there’s nothing to be ashamed about in admitting you need more help than you used to.

Be patient with yourself. Losses are a normal part of aging and losing your independence is not a sign of weakness. Allow yourself to feel sad or frustrated about changes in your housing situation without beating yourself up or labeling yourself a failure.

Be open to new possibilities. By keeping your mind open to new ways to make life easier, you’ll be able to cope with your change in situation better. Sometimes, new experiences and situations can lead to you developing new friendships or finding new interests that you’ve never considered before.

Affordable Online Therapy

Get professional help from BetterHelp’s network of licensed therapists.

HelpGuide is reader supported. We may receive a commission if you sign up for BetterHelp through the provided link. Learn more.

Need urgent help? Click here.

If it’s your family member who’s moving

You may feel guilty for being unable to care for them, or sad that your loved one has to go through this forced transition. Any relief that you feel about your loved one now getting the care they need may be tempered with guilt that you’re somehow letting them down. You and other family members may have been arguing about whether a nursing home is necessary or over details such as where it should be located or who should be the point of contact.

Allow your loved one to take the lead. As much as possible, the person making the move should be the one making decisions about which nursing home is most suitable. Whenever possible, they should come along on visits to different nursing homes, and make the choices about what to bring from home and how to personalize their room. If the older adult is unable to do so, family members should try to think about what their wishes might have been. A familiar blanket, a treasured picture, or a favorite piece of music, for example, may provide comfort even if the senior is unable to verbalize it.

Help your loved one cope with their loss of independence. Encourage them to maintain relationships with friends and family, and to keep an open mind about new interests.

After the move, keep in regular contact.Regular visits by family and friends help to ease your loved one’s transition. Even if you live far away, frequent calls, letters, and emails can make a big difference. Keep your loved one in the loop about family events as much as possible.

Stay involved

Regular contact not only reassures your loved one, but allows you to serve as an advocate for their needs. Even if you’ve chosen the finest facility, you want to make sure your loved one’s care continues to be of the highest standard, so visit at irregular hours to make spot checks, and get to know the staff. The more engaged they feel you are, the more attentive they are likely to be towards your family member. If the nursing home has a family council—a group of relatives and friends who meet on a regular basis to discuss concerns and issues—consider joining.

Tips on choosing a nursing home

Choosing the right nursing home is not easy, and you may be under pressure to move quickly due to a recent hospitalization or deterioration in your health. The more information you have, the greater your chances of finding the right fit.

Start with referrals. Does your family physician or specialist have any recommendations? Or do you know any friends who have used different homes? Knowing someone with first-hand experience of a nursing home can help you narrow your choices. However, remember your needs may differ; one size does not fit all.

Educate yourself. Online resources for nursing homes include ranking sites that utilize existing state data to rate nursing homes. In the U.S., for example, every state has what is called a long-term care ombudsman, which can be a valuable resource about the current condition of a nursing home. Advocacy groups for specific illnesses can also provide hints on finding the right facility.

Consider your medical needs. Different nursing homes may have more expertise in different areas. Are they experienced in handling your specific health condition?

Factor in distance. In general, the more conveniently located, the easier the nursing home is for family and friends to visit.

Planning a visit to a nursing home

Visiting is key to understanding if a home is right for you. As with other senior housing options, it’s the people that make the place, both the residents and staff. In a nursing home, you’ll also need to make sure that the medical care is delivered appropriately and promptly.

What to look for in a nursing home staff:

What to look for in current residents and their families:

What to look for in the nursing home facility:

How to Choose a Nursing Home

A nursing home, also known as a skilled nursing facility, provides a wide range of health and personal care services.

These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, are also available.

Some people stay at a nursing home for a short time after being in the hospital. After they recover, they go home. However, most nursing home residents live there permanently because they have ongoing physical or mental conditions that require constant care and supervision.

If you need to go to a nursing home after a hospital stay, the hospital staff can help you find one that will provide the kind of care that’s best for you. If you are looking for a nursing home, ask your doctor’s office for recommendations. Once you know what choices you have, it’s a good idea to:

Consider what you want. What is important to you—nursing care, meals, physical therapy, a religious connection, hospice care, or special care units for dementia patients? Do you want a place close to family and friends so they can easily visit?

Talk to friends and family. Talk with friends, relatives, social workers, and religious groups to find out what places they suggest. Check with healthcare providers about which nursing homes they feel provide good care.

Call different nursing homes. Get in touch with each place on your list. Ask questions about how many people live there and what it costs. Find out about waiting lists.

Visit the facility. Make plans to meet with the director and the nursing director. The Medicare Nursing Home Checklist (PDF, 178K) has some good ideas to consider when visiting. For example, look for:

Ask questions during your visit. Don’t be afraid to ask questions. For example, ask the staff to explain any strong odors. Bad smells might indicate a problem; good ones might hide a problem. You might want to find out how long the director and heads of nursing, food, and social services departments have worked at the nursing home. If key members of the staff change often, that could mean there’s something wrong.

Visit the facility again. Make a second visit without calling ahead. Try another day of the week or time of day so you will meet other staff members and see different activities. Stop by at mealtime. Is the dining room attractive and clean? Does the food look tempting?

Carefully read your contract. Once you select a nursing home, carefully read the contract. Question the director or assistant director about anything you don’t understand. Ask a good friend or family member to read over the contract before you sign it.

The Centers for Medicare and Medicaid Services requires each State to inspect any nursing home that gets money from the government. Homes that don’t pass inspection are not certified. Ask to see the current inspection report and certification of any nursing home you are considering.

For more information about nursing homes and tips for choosing, visit the Medicare website.

To read about paying for nursing home stays, see Paying for Care.

Learn about residential facilities, assisted living, and other long-term care options.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

How to Choose a Nursing Home: 8 Practical Tips

Health visitor and a senior woman during home visit. A nurse talking to an elderly woman.

In 2016, there were more than 15,600 nursing homes in the country. That number has increased over the years as more Americans start needing more sophisticated levels of care.

If your loved one needs to move into a nursing home, finding the best home for their needs can feel challenging at best. There are so many options to choose from, you need to know how to choose a nursing home that will work for them.

Though the process can take time, there are a few things you can do to make the search easier. Here are a few tips to keep in mind when searching for the best care facility for your loved one.

1. Think About What Your Loved One Needs

The most important thing to keep in mind when figuring out how to pick a nursing home is what your loved one needs from the facility. Think about the types of care and attention that will truly help your loved one.

Are you looking for a nursing home that specializes in a specific type of care like dementia or Alzheimer’s? If so, you’ll need to make sure the nursing home is able to treat those conditions.

When calling different facilities, be clear about your loved one’s needs and medical issues. This way, you’ll be able to weed out homes that can’t provide adequate care immediately. You can also read about urgent care in Grovetown, GA incase you’ve got family members in that area.

2. Read up on Reviews

Once you have a few homes you’re interested in, do a little research. Read up on each facility’s online reviews and don’t hesitate to check their reputation with the Better Business Bureau.

If most of the reviews are positive, ask the facility for references and see what families of previous residents have to say. If they were happy with the services the nursing home provided, you’ll likely have the same experience.

However, if the online reviews are mostly negative or the references mention the same issues, keep looking. The key to finding a nursing home your loved one will love is making sure they’re trustworthy.

3. Tour the Nursing Home in Person

The best way to figure out if a nursing home is the right fit for your loved one is to visit it. Whenever possible, try to tour the facility in person.

This will give you an opportunity to see where your loved one would live and interact with the staff before you commit to a period of care.

While at the facility, try to get a feel for the way residents get treated by both medical staff and caregivers. If you have any concerns or feel that the nursing home isn’t operating with their clients’ interests in mind, keep looking.

4. Get a Comprehensive List of Activities

When you’re trying to find a nursing home for your loved one, you need to remember that they’ll be living on-site the entire time. This means they may not have access to the activities and amenities they normally enjoy.

Ask each nursing home for a comprehensive list of activities and amenities they offer.

If that list has several that your loved one will enjoy participating in, the nursing home may be a great fit. However, if the activities aren’t in line with your loved one’s interests, keep looking.

The last thing you want to do is choose a nursing home that they won’t be able to enjoy living in.

5. Pay Attention to the Cleanliness of the Facility

During every visit you make to nursing homes, pay careful attention to the cleanliness of the facility. Don’t get distracted by nice décor or interesting artwork—look deeper.

Check the surfaces in the common area for dust. Look at the wear and tear in the most-used areas of the building and make sure the residents get bathed regularly. Unfortunately, some facilities may not provide the level of care your loved one deserves.

If you notice that the facility looks dirty or smells off, keep looking.

6. Make Sure You Can Afford It

Medicare plans often cover a portion of the fee, but you may need to be able to come up with the rest.

Review your loved one’s finances and make sure the facilities you’re considering are able to work with their Medicare plan. If they can’t or you’re not able to cover the cost on your own, keep looking.

7. Pay Attention to the Location

When you first start making a list of what to look for in a nursing home, you likely focus on the quality of the facility. While this is important, you also need to choose a home that’s in a convenient location for you and your family.

Remember, the best way to make sure your loved one is receiving the care they need is to visit them often. This helps you hold the nursing home accountable.

If the location is too remote or not convenient for you and your family, you may want to keep looking. Choosing a facility that’s too far away can leave you feeling like you abandoned your loved one. Pick a location that works for both your loved one and the rest of your family.

8. Consider In-Home Care

If you’re not comfortable choosing a nursing home, you don’t have to. You can always choose to provide in-home care for your loved one.

There are many services to choose from and the best way to pick the right care provider is to schedule an in-home visit. While they’re there, you can learn more about their services and make sure their personality meshes with your loved one’s.

Now You Know How to Choose a Nursing Home

Now that you know how to choose a nursing home, you’re ready to start your search. Just remember to put your loved one’s needs first and be willing to keep looking.

Finding the best home for your loved one can take time. If you’re patient and willing to put in the work of researching different facilities in your area, you’ll be able to find the perfect fit in no time.

Looking for more tips to help you manage your loved one’s changing needs? Check out our latest posts.

Caregiver Guide: Choosing a Nursing Home

Understanding the Problem

When the needs of an older person can no longer be met in the home setting, finding an alternate living arrangement can be challenging.

The inability to care for oneself is a primary consideration for families when seeking alternate living situations. The primary caregiver and family members often begin to search for assistance when an older person:

Finding suitable alternative living arrangements is becoming more complex as there are a number of community resources that provide various levels of care. The resources vary from community to community and, with the exception of nursing homes, standard definitions based on services provided are generally lacking. Additionally, terminology and regulation vary from state to state. Funding sources for the different care facilities vary also.

Nursing homes are residential care facilities that provide a range of services. Both federal and state regulations require that a doctor or their designee will routinely visit an individual living in a nursing home, assess the resident’s health status and monitor the plan of care. Licensed nursing staff are in the facility 24 hours a day. Some nursing homes provide secure units specifically for persons with dementia. There are several types of nursing home care that you might want to consider, depending on the person’s needs:

Alternatives to Nursing Home Care

Assisted living facilities

Assisted living facilities are residential facilities that provide individual rooms, three daily meals, and activities for older people who can no longer live alone but do not require 24-hour nursing supervision.

These facilities are sometimes referred to as congregate care or congregate living facilities and have grown in number recently. Assisted living facilities provide 24-hour on-site support and assistance, including help with medicines and personal hygiene. Many assisted living facilities offer a secured Alzheimer’s unit.

These facilities are prohibited from providing skilled nursing services and are regulated under a different set of state regulations than the ones governing a nursing home. If skilled nursing services are required, these services can be provided by a separate home health agency as directed by a doctor or other healthcare provider. There is no healthcare provider involvement in the plan of care for an individual residing in an assisted living facility and neither state nor federal law requires them to visit. The older person should still be taken from the facility to visit his or her primary care provider as needed.

Board and care homes

Board and care homes are generally smaller, more home-like residences for people who can no longer live independently.

These facilities provide room, board, and assistance with some activities including managing medicines and help with personal hygiene. Fees and services vary from one site to another. The size of the residence determines whether or not it is regulated by a state agency and this differs from state to state.

Continuing care retirement communities

Continuing care retirement communities (CCRCs) usually have all levels of living arrangements, ranging from independent living to nursing home care.

The financial requirements for a person to enter a CCRC will vary according to whether health care is included in the total cost or charged only if used. In general, CCRCs are reluctant to accept people directly into the assisted living or nursing home facilities.

Adjusting to moving to a nursing home

It is very important to include the older person as much as possible in deciding whether to go to a nursing home or other care setting.

If the older person is mentally alert, they should be involved in the process every step of the way.

Moving from one’s home to a nursing home is a big life change. It will take time to adjust to the move and become comfortable. Both the primary caregiver and the older person placed in the facility will require patience during the adjustment period. Consider the first month in the nursing home as a trial period to help ease the transition for the older person. During the adjustment phase, visiting frequently for short time periods can be more helpful than staying for hours at a time.

You can play an important role in assuring that the older person receives good care by being involved during this transition. You can be involved during this transition by visiting often, speaking with the staff, and participating in both the care planning sessions and nursing home’s family council. (A family council is an organization of family members who meet to make suggestions for how to have a positive influence on the quality of residents’ care, treatment, and quality of life.) If there is no family council, consider starting one.

Talk with the activities director and see if you can help in some of the activities and outings for the residents.

Paying for nursing homes

Paying for nursing home care is a major concern for most people. If people enter a nursing home directly from a hospital, Medicare will often pay, but only for a limited time. When people enter from their own home, they usually pay for the nursing home stay themselves. After personal resources are spent, many nursing home residents become eligible for Medicaid. Medicaid is regulated by both federal and state laws and provides funding that will pay most nursing home costs for people with limited income and assets. Eligibility for Medicaid varies by state and is provided only to persons in Medicaid-certified facilities.

A Medicaid-certified nursing home must continue to provide care for a resident whose personal funds have been spent while residing there. A nursing home that does not participate in the Medicaid program can discharge the resident. Some nursing homes try to avoid admitting residents who are currently or will soon become Medicaid recipients as they can charge private paying residents a higher fee than they would receive under the Medicaid program.

If the older person will be relying on Medicaid from the beginning, find out if the nursing homes you are considering accept Medicaid residents. To learn more about eligibility for Medicaid in your state, gather information from such reliable sources as the Center for Medicare and Medicaid Services and your county Family and Child Services Department.

The local Area Agency on Aging will have useful information also, and the American Association of Retired Persons (AARP) has a wealth of information about nursing homes, Medicare, and Medicaid. If the older adult is in the hospital at the time of consideration for nursing home placement, the hospital social worker is another valuable resource.

Medicare, which pays for a number of healthcare services including hospitalization and limited nursing home stays for episodic illness, will not pay for long-term care in a nursing home.

If the older person has long-term care insurance, this can, under certain circumstances, be used to pay nursing home expenses. If you are considering purchasing long-term care insurance for the older person’s possible future use, be sure to check the costs carefully, read the small print, and review the background and track record of the company involved. It is currently recommended that people consider purchasing long-term care insurance around the age of fifty. Premiums for long-term care insurance increase as one gets older, and the cost varies depending on the number of chronic conditions present and the type of coverage desired.

Your goals are to:

When to Get Professional Help

Talking to a healthcare provider

Your home health nurse, social worker, and/or other healthcare provider can help you and your family with the decision about nursing home placement. Many counties have a council of aging or an Area Agency on Aging that can also be helpful.

You should request help if:

You are having difficulty providing care

Begin the discussion before the situation becomes a crisis. Many people wait too long and then wish they had acted sooner. You can learn about services that can keep the older person at home as well the kinds of nursing homes available in your community. Getting information early will enable you to make the best use of help that is available and help provide the best possible care for the older person.

A frank discussion with a geriatrics healthcare provider can help you decide on the appropriate type of care best suited for your loved one.

You think placement in a nursing home is necessary

If you have already decided that a nursing home is necessary, professionals can help you decide which home best fits the older person’s needs. Hospital social workers usually have experience with several nursing homes in an area and can make recommendations. Family doctors are often knowledgeable, as are geriatric doctors, geriatric nurse practitioners, and geriatric social workers.

Your regional Area Agency on Aging can tell you how to obtain copies of evaluations of nursing homes by licensing agencies. (The National Association of Area Agencies of Aging has more information.) The federal government’s Medicare website provides additional information, including recent evaluations of all nursing homes in your area.

Know answers to the following questions before requesting help

What You Can Do to Help

Gather information

Start gathering information early

It is wise to begin the search for a suitable nursing home well in advance of seeking admission. Often, the best homes have no space available and long waiting lists.

Determine what the older person and the family want and need

Different kinds of nursing homes provide different types of services and care, but all must provide certain basic services. Some people might want a safe and comfortable place to live among pleasant companions. Others might want a home that emphasizes special foods or foreign languages, or similarity in religious faith. The older person might need specialized medical attention. Location can be an important factor if you, your family, or friends want to visit often.

Ask people you know if they know of any good nursing homes

Friends and acquaintances who have had family members in a nursing home are good sources of information. Healthcare providers, social service agencies, and some religious organizations are also potential sources of information.

Call nursing homes

Call the nursing homes on your list and ask key questions. By calling nursing homes and asking some key questions, you will be able to select those that are most likely to meet the older person’s needs. Some suggested questions to ask include the following:

Visit nursing homes

It is essential to visit the nursing home before the person you care for becomes a resident there. When you go, take with you a copy of the Nursing Home Checklist found at the end of this section.

Tour the facility with the director of nursing

You can ask the director of nursing to show you around. This person has overall responsibility for the day-to-day nursing care provided. Ask about the philosophy of care at the facility and whether there are problems maintaining that care philosophy. Ask how many nurses’ aides there are compared to residents (“aide-to-resident ratio”). Ask what the nursing staff turnover rate is. Observe how the director greets residents and staff and notice how they react and respond.

Observe staff at work

Personnel should be courteous, helpful, and honest. They should treat residents and their requests with respect. Staff members should respond quickly to calls for assistance with courtesy and respect. Warm, professional relationships between staff and residents are essential for quality care.

Visit more than once

Visit at different times of the day and make at least one unscheduled visit. Try to make one visit at night to see how many staff members are available.

Talk with the residents

Ask them what they like and what changes they would suggest. What do they like about the staff? Are interesting activities scheduled on a regular basis? Residents can give you valuable insights.

Talk with aides and observe them with residents

Aides provide most of the hands-on care. Try to get a sense of how they feel and act toward the residents. Sometimes observing what they do can tell you more than talking with them.

Ask to see the inspection report

This report will let you know the kind of care that is provided. The report will also show any violations, including physical abuse, that have occurred at the nursing home.

Trust your instinctive feelings

If the grounds are beautiful, but the staff seems unhappy and unkind to the residents, do not place the older person there. You want the person you care for in a facility where they will feel respected and comfortable.

Compare Nursing Homes

Compare the quality of the nursing homes you are considering

Use the five-star quality rating system produced by the Center for Medicare and Medicaid. Information on health inspections, nursing home staffing, and quality measures can be found at Nursing Home Compare at Medicare.gov.

Talk to your local long-term care ombudsman

Federal law requires each state Agency on Aging to have an Office of Long-term Care Ombudsman. Ombudsmen visit nursing homes on a regular basis and they often have knowledge of what occurs in facilities in their communities. In addition, they investigate complaints about nursing homes and work to resolve the problems. If they are unable to resolve problems, ombudsmen refer complaints to the state Health Department for action.

More than 500 local ombudsman programs now exist nationwide. The Administration on Aging provides information on the ombudsman program and provides a link to state ombudsman programs. Ombudsmen cannot tell you which nursing home you should use, but they will provide current information about nursing homes in your area. Ask the local ombudsman about the following:

Keep in mind that ombudsmen are government employees. They cannot state bluntly that a particular nursing home is unacceptable. Listen for subtle hints, such as, “Are you sure you would like Springmill?” “I think you should take a look at the Pine Barrens.” “Be sure to include Green Acres in your list.”

Plan how you will pay the nursing home bills

Be sure that you understand in advance how much the nursing home will charge. Then review the older person’s financial resources. If they will need financial help from Medicaid, call your local county’s Department of Children and Family Services office to get a Medicaid application for long-term care. Information to help you understand and begin the application process is also available through the Centers for Medicare & Medicaid Services. Be sure that the nursing homes you are considering are Medicaid-certified.

Carrying Out Your Plan

Problems you might have carrying out your plan

Once you decide that nursing home care is needed, you might experience painful emotions. You might feel anxious, angry, guilty, depressed, or frightened by making such a big decision for someone. You might also feel grief for the loss of the older person’s former self. The older person might say things that bring up these feelings. They might feel abandoned. There can be tension and disagreement among family members. Although such reactions are natural and to be expected, they are painful when they occur. These problems need to be managed directly and openly by talking about them with the older person and other family members, close friends, medical professionals, and/or clergy.

Even when you have excellent plans, there are obstacles or problems that may prevent you from carrying out your plans. You or the older person may have some beliefs that might get in the way of carrying out your plan. Here are some ways to challenge those beliefs.

Think carefully about what is bothering you about this decision. The guilt could be about no longer being able to provide the care, or worry that the nursing home is not good enough or that it is not the most expensive. You might feel guilty that you can’t visit often enough. Talk about these feelings with someone you trust who can provide an objective view or balanced perspective. Remember that you provided the best care you possibly could prior to the nursing home placement and that you are now in the role of an advocate who can visit and observe the care in the nursing home.

“Some people do die in nursing homes, but it is also a place to live. This home will be able to provide for your needs now that I am no longer capable of providing 24-hour care. I’ve visited the home and talked to the staff and some of the people staying there. I hope you will keep an open mind in the first few weeks, looking for things to like about the facility. If you are not happy there, we will make some other arrangements. If this nursing home isn’t what you need, we will find one that is.”

“Tell me exactly what the staff did that was nasty and I will talk to them about it.” Visit the home unannounced at various times of the day. If you come upon a care situation with the older adult, listen and observe what is occurring prior to speaking. Talk with the director of nursing about your concerns

“Tell me what you liked and didn’t like; I’ll talk with the dietitian about your preferences.” Participate in the nursing home care planning conferences for the older person. Bring in a favorite meal to share with the older person (call ahead to alert the staff). If the older person is capable of traveling by car, consider going out for a meal together.

Think of other problems you might have carrying out your plan

What other problems could get in the way of doing the things suggested in this section? For example, will the older person cooperate? Will other people help? How will you explain your needs to other people? Do you have the time and energy to carry out this plan?

Checking on Progress

Once the older person is in a nursing home, you must monitor the care. If there are problems, you need to work with the older person and the nursing home staff to resolve them. Get to know the staff members who care for the older person most frequently and remain in contact with them. Ask questions and expect full answers. Compliment them when they do a good job. Be kind and courteous even when you may feel like responding negatively. Occasionally take a special treat to the nursing staff who provide care for the older person.

State and federal laws ensure that nursing home residents have certain rights. These rights include, but are not limited to, the right to privacy, confidentiality and respect, freedom from restraints, freedom to express grievances without retaliation, and freedom to have visitors. The nursing home “Bill of Rights” is often posted at the entrance to nursing homes.

What to do if your plan isn’t working

If you have explained your concerns to the nursing home staff and you and the older person are still dissatisfied, you can call your state long-term care ombudsman. The number for the regional ombudsman in your area is usually posted in the public areas of the nursing home. You can obtain the number for the ombudsman by calling your county or state office of aging. You can also call The National Consumer Voice for Quality Long-Term Care (202.332.2275).

If you decide to look for a new nursing home, repeat the steps listed earlier. Be sure that the new location will meet the older person’s needs better than the present one. Do not move just to get away from a problem only to discover that the new location is no better or has worse problems.

Nursing Home Checklist

Here are some questions to guide you in making a decision about a nursing home. Bring this checklist with you when you visit a nursing home. Write down what you learn at each facility. Once you are back home after visiting several facilities, review your notes as you make your decision.

Medicare also provides a helpful guideon how to choose a nursing home.

• ← How to choose a mattress
• How to choose a pet →