Merck Manual

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Choosing a Nursing Home

Choosing a Nursing Home

Philosophy of Care

  • Does the home simply provide custodial care (such as bathing, feeding, and dressing), or does it try to optimize residents' ability to care for themselves?

Environment

  • Is the nursing home attractive, friendly, homelike, and relaxed?

  • Are there any unpleasant odors? Is the nursing home clean and well maintained?

  • Are the dining room and other common areas bright, cheery, and pleasant?

  • How is the noise level in common areas monitored to prevent it from disturbing residents whose rooms are nearby?

  • Are there safe, accessible walking paths on the grounds?

  • Is there a garden or patio?

  • Does the nursing home have appropriate safety devices, such as fire alarms and sprinklers? What are the plans for emergencies, such as fires?

Residents

  • Is the nursing home accepting new residents?

  • Do the residents seem reasonably happy and active, or are they wandering aimlessly or sitting and doing nothing?

  • Are the residents clean and appropriately dressed?

  • Are any of the residents restrained?

Staff Members

  • Do the staff members treat the residents with respect, patience, and friendliness?

  • Are staff members experienced and qualified?

  • Do the residents see the same staff members on a daily basis?

  • Is there a high turnover in staff members?

  • Do staff members respond to requests for help in a reasonable amount of time?

  • What is the ratio of staff members to residents?

Rooms

  • Is there enough storage or closet space?

  • Are the residents’ rooms bright and cheery?

  • Are private rooms available?

  • How are roommates selected?

  • How are private items stored or secured?

  • Can residents have their own telephone, television, and internet access?

  • Is water available and within reach for residents who need it?

  • Can residents decorate their rooms with personal items?

  • Are there safety features, such as grab bars and pull cords (to call for help)?

Meals

  • What time are meals served?

  • Are meals served hot?

  • Are snacks available between meals?

  • Can residents get from their room to the dining area easily?

  • Can meals be provided in a resident’s room if needed?

  • Are the meals tasty and nutritious?

  • How are special dining or menu requests handled? Are choices available at meals?

  • Can the nursing home provide special diets when needed? Is there an additional cost?

  • Are staff members available to help with feeding during meals?

  • Is there a registered dietitian on staff?

Health Care

  • Can residents keep their own doctor rather than use the nursing home’s doctor?

  • How often is the nursing home’s doctor available, and where?

  • Does the nursing home have an arrangement with a nearby hospital?

  • If residents have to be hospitalized, will a bed be available afterward?

  • Are other health care practitioners (such as dentists, podiatrists, physical therapists, optometrists, counselors, and social workers) available?

  • Are therapy programs (such as physical, occupational, or speech therapy) provided?

  • Does the nursing home have special programs for people who have disorders such as Alzheimer disease or HIV infection?

  • What services does the nursing home provide for residents with a terminal disorder?

  • How are prescription drugs ordered and given to residents? How is the use of drugs monitored?

  • What is the policy on residents keeping nonprescription drugs?

  • Are residents and family members encouraged to participate in developing a plan for care?

Services

  • Is help with daily dental care provided?

  • How is personal laundry done?

  • Is reading material available?

Visiting

  • Is the nursing home conveniently located for frequent visits by family members and friends?

  • Can family members visit any time?

Activities

  • What activities are offered?

  • Are residents encouraged to participate? How are the residents informed of the activities?

  • Is there an activity director?

  • Does participation in activities cost extra?

  • Are there rooms for other activities, such as a TV or game room?

  • Are religious services held on the premises?

Costs

  • Are all the services that residents need covered in the basic charge?

  • What services (such as beauty salons or laundry) cost extra, and what is the cost?

Residents’ Rights and Privacy

  • Does the nursing home have an active resident or family council or both?

  • Are residents allowed to go in and out as they please?

  • Are restraints used? When and why?

  • Is there a lock on the door to private rooms? Do staff members knock before entering?

  • Can married couples live together? Are they given privacy?

  • Are the sexual needs of residents respected?

  • How often are residents bathed? Can residents have a bath or shower whenever they want? Are bath and shower areas kept warm enough? How much privacy is provided in these areas?

  • Are pets allowed? Can visitors bring pets?

  • Can residents keep food or alcohol in their rooms?

  • What is the nursing home’s policy on lost or missing valuables?

  • Who contacts family members in case of an emergency?

  • If residents wish to leave, what are the policies on giving notice or refunds?