Caregiving can be an extremely demanding job. For those who need round-the-clock care due to disability or illness, a nursing home is a common choice. However, if you are thinking about a nursing home, make sure to investigate other options. Meet with doctors, nurses, therapists and other experts or advisors to see if arrangements can be made to provide care at home. Each state may have a different regulator of nursing homes, so it is important for you to do some investigation beforehand. In some states, it may be the Department of Health and Human Services, in others, it may be the Department of Aging.

Choosing a Nursing Facility

It is important to find a nursing home that can meet the care needs of your family member. It's also important that you feel comfortable with the facility, the staff and the level of care that your family member will receive there. The best way to do that is to visit a home personally. Here are some points to consider when you visit:

Location

• Would the home be convenient for you as a visitor? Is it convenient for the person who will be placed there?
• Is it near your care receiver's doctor's office?
• Is the home near a cooperating hospital?

Staff

• How do the staff members interact with residents?
• Are they readily available?
• Do the staff appear happy and friendly?

Residents

• Do residents appear neat and clean?
• Can residents decorate their rooms and choose the clothes they wear?
• Are most residents out of their beds, sitting up in their bedrooms or communal rooms?

Care Level

• Does the home specialize in the particular type of care that your potential resident requires, such as Alzheimer's Disease or cancer care?
• Are facilities available for any necessary therapy?
• Are other medical services provided regularly, such as dental care?
• Are there facilities to handle patients with contagious illnesses?
• What are the medical emergency/hospitalization procedures?

Counseling

• Is counseling available to residents and their families?
• Are there specialized services for family members of those with Alzheimer's Disease or other disorders?

Safety

• Is it easy to move around the facility?
• Could a wheelchair be maneuvered easily?
• Are hallways wide enough for two wheelchairs to pass through easily?
• Are there grab bars on the corridor walls?
• Is the home well-lighted with clearly marked and unobstructed exits?
• Are emergency evacuation plans posted around the home?
• Are entrances and exits monitored?

Dining

• Are meals appetizing?
• Do those who need help dining receive assistance?
• Are dining rooms comfortable and easy to get around in?
• Can meals be taken in your room or other place in facility?
• Can family members join you for a meal?
• Is enough time allowed to eat?
• Can special diets be accommodated?

Atmosphere

• Is the atmosphere warm and friendly?
• Are staff members courteous, respectful and amiable toward residents?
• Do administrators respond promptly to questions, problems and concerns?
• Are family members encouraged to visit and are accomdations made for family celebrations on site?

Comfort

• Are bedrooms comfortable and well-furnished?
• Is a nurse call button by each bed?
• Is it easy to go from the bed to the bathroom?
• Is it easy to move around the bathroom?
• Is enough drawer and closet space provided for each resident?

Recreation

• Are residents encouraged to take part in recreational programs?
• Can the home handle residents' hobbies?
• Are those who can go for fresh air or outside trips able to do so?

Policies

• Can the home accept Medicaid if needed?
• Are there admission restrictions that would prevent your potential resident from living there?
• How is the family viewed? Are family members considered visitors who must abide by rules? Are they severants who are expected to do various tasks for the family member or are they viewed as a partner who together the best possible care if provided to the care receiver?

Residents' Rights

• Does the home have a written list of residents' rights on hand?
• Is a residents' council in place?
• Are private rooms set aside for visits with family and friends?
• Are their spiritual activities that residents may be a part of?

Investigating the Facility

It's important to investigate any and all reports you can find related to the potential facility. Visit the Nursing Home Compare site. This website provides detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country. You can find this site at: http://www.medicare.gov/NHCompare/home.asp.

In addition, your state may have other information regarding nursing homes under its jurisidiction. Check with your state's regulating agency to find out.

Written by John Merrill, Professor, Department of Environment, Textiles and Design, University of Wisconsin-Madison and Housing Specialist, Univeristy of Wisconsin Extension, 1994. Adapted by Sarah Kirby, Associate Professor and Housing Specialist, Department of 4-H Youth Development and Family and Consumer Sciences, North Carolina Cooperative Extension, North Carolina State University, 2007.