1 June 2010TAKING CARE OF OLDER PEOPLE: SELECTING NURSING HOME WITH CHECKLIST
The physical plant. Is the home clean, well lit, relatively odor-free, laid out with a disabled person’s needs in mind? Do residents’ rooms contain personal belongings? What is the policy on bringing in such belongings? Is there enough room for privacy and an attractive place to sit outside?
You want a place that looks cheerful and is appropriate for people who have problems in walking or seeing or hearing well, where the environment minimizes excess disabilities. You also want an administration that is sensitive to a crucial human need – not to be parted from all the treasured possessions that are so essential to maintaining our sense of self.
The residents. Are they clean and well groomed? Are they kept occupied, or are most lying in bed or sitting and staring at the wall? Do not expect a camp atmosphere, but expect some residents to be happy and engaged. Approach some of these people, tell them who you are, and ask how they feel about the home. Expect complaints, but also expect to learn a good deal about whether this is a humane place.
The staff. Are they neatly dressed and well groomed? Are they on the floor helping residents? Do they appear to be caring, respectful, and conscientious, answering calls for help without delay? Linger with your eyes and ears open.
The meals and activities. Both are important events in the lives of nursing-home residents. Visit when a meal is being served. Does the food look appetizing, and are there substitutes for the main dish? Do residents who need it get prompt help with eating? Do most eat in the dining room? Visit the activities room. Is it well equipped and staffed? Is a list of activities posted? Do they seem varied, and does the selection include things your loved one would enjoy? Is an effort made to get residents out into the community and bring outsiders in? Is there a volunteer program?
The nursing home should be open to the community, and it should offer residents who are able regular opportunities to leave the grounds. As much as possible, it should also let residents exercise choice, in what they eat, in what they do. The ability to make choices enhances not only our psychological well-being but our physical health too.
The medical care. Are there physicians on the staff? Can residents select among them, or are they assigned a doctor? What hospitals are used if your loved one becomes ill? Is this home equipped to provide any needed specialized medical and rehabilitative care?
Health inspection information. Nursing homes are required by law to post the results of the most recent health inspection. However, since inspections occur infrequently and tend to focus on safety violations and the adequacy of the home’s physical plant, knowing an institution has passed will not tell much about the quality of care it provides. But information about violations and whether they are being corrected should be used along with your observations as a sign the home is good.
Admissions and cost. If the home seems acceptable, visit the admissions office. Is there a waiting list, and if so, how long? What forms are needed to apply, and how long are applications kept on file? If you are paying privately, what services are included in the basic rate, and what costs are extra? What is the refund policy for leaving prematurely? What is the procedure for applying for Medicaid?
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GENERAL HEALTH
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