Choosing the Right Nursing Home

Don’t wait until there’s a crisis before finding a nursing home for a loved one no longer able to look after themselves. That’s the advice of John Wilson, president of the Unionville Home Society, a seniors’ complex near Toronto. Families, he says, must be more open in talking about these decisions ahead of time. The worst situation, he says, is when a crisis develops a fall, a broken hip, for instance and arrangements have to be rushed.

But having a loved one admitted to a nursing home or long term care facility (virtually the same) is a decision most of us would rather avoid. It arouses feelings of guilt and inadequacy. It shouldn’t.

So when it’s no longer practical or even safe for mom, dad or your spouse to live independently, how do you go about the unenviable task of choosing the best place? And what can you do to make sure their lives are as full and pleasant as possible?

Likely the people at the assessment agency or the social worker at the hospital will give you a list of nursing homes in your area and ask you to check each out, picking three in your order of preference.

First of all, however, be aware that the horror stories of years gone by hardly ever apy now. Nursing home standards have improved immeasurably, and both private and charity or government nursing homes must meet rigid criteria.

Second, put aside those feelings of guilt. You could give up your job, stay home with mom, or ruin yourself paying someone to look after her and in the end she might be worse off than she would be in a good long term care facility where there are medical facilities, social services and the kind of professional care you could never hope to match.

And don’t limit yourself to homes on the list: Ask friends, anyone you can think of, for their experiences or recommendations, and broaden the list accordingly.

Don’t attach too much importance to scenic views, attractive gardens or imposing entranceways it’s the warmth and care inside the nursing home that matters.

As far as location is concerned, it’s a big plus if the home is close enough for family and friends to visit perhaps by public transit.

Starting the search

In her book, How to Care for Aging Parents (Workman Publishing Co. Inc., New York), Virginia Morris suggests you make an informal visit during normal visiting hours, and walk the corridors on your own to get an idea how residents are treated. If you like what you see, make arrangements for a formal tour during which, in addition to the lounge and dining room and chapel, you should also ask to see typical bedrooms and bathrooms and any special units, perhaps for residents with dementia.

Judge, as best you can, the coziness factor how friendly does it feel, how much opportunity is there for social interchange? At the same time, will mom or dad also have a chance for privacy, preferably surrounded by a few items, perhaps a favorite chair, from their former life? Is the staff friendly, welcoming your questions, or are they edgy and defensive? In short, do they seem to like their jobs?

Does the place smell clean without an overbearing aroma of air cleaners or cleaning agents?

What activities are in place religious services, events that involving family members, outside trips? Check the activity calendar and find out how many actually take part in the events. Is there a service club that visits? Is the home accredited by the Canadian Council on Health Services? What are the smoking and alcohol policies? Is nursing available around the clock?

If possible, arrange to have a meal in the dining room so you can judge the food quality yourself.

Moving day is bound to be traumatic, so try to bring your loved one for a visit ahead of time so they can be introduced to the staff, other residents and the facilities. Morris suggests friends and family be urged to offer support and encouragement, and if appropriate, hold a small party a few days beforehand at which guests bring gifts, such as framed photos of favorite past occasions or a grandchild’s drawing, that will play a part in their new life.

Keep promises

Do your best to visit regularly (and never promise to visit and then fail to turn up), and instead of just sitting and making small talk, play cards, take them out to lunch, rub their back, look through old photo albums whatever pleases them.

Take children along if possible and watch the smiles light up on other residents’ faces too.

Check their clothing, and the care they’re receiving. Get friendly with the staff and other residents, and be prepared, if necessary, to talk to staff or supervisors about concerns you may have about the quality or lack thereof of care.

A final suggestion: You can cover many of these bases including visits, building rapport with the staff, etc. by becoming a volunteer at the nursing home. Most facilities are desperate for help, and providing you’re not perceived as being there to make a nuisance of yourself, you’ll be well rewarded in terms of the staff’s gratitude and your peace of mind.