Top Tips for Nursing Home Placement
Take tours of facilities before selecting if at all possible.
- Use all of your senses to evaluate the facility. What do you hear, smell, see, etc.
- Use your instincts. How would your loved one feel here? Does it meet their needs?
Know all of the costs up front.
- What is the daily/monthly rate for the care my family member requires?
- Will rates change, as my family member's needs change?
- What are the extra charges over and above the daily/monthly rate? (i.e. phone, medications, laundry, newspaper) How will they be billed?
- What is the procedure when funds to pay for care are about to be diminished? Can someone at the facility guide me through the next steps?
Have all of your loved one's legal papers in order.
Keep Originals, Provide Copies: Have all of your legal papers in order, including Power of Attorney (both for Health Care and for Finances), Advance Directive, and/or Guardianship Court Orders. Be sure to retain the original. Provide copies. If your loved one has not completed any advance directives and they are still competent to do so, encourage them to consider completing the forms.
Medical Records: You have the right to see the medical records and purchase photocopies of them, if you have your loved one's permission, Power of Attorney, or other legal authority.
Insurance Cards: Have originals and provide copies front and back of all Medicare Cards and Medical and Long Term Care Insurance Cards.
Visit your loved one often.
Introductions: Check in and introduce yourself to the Executive Director/Administrator, Social Worker and Director of Nursing at the nursing home. Provide a brief background about your loved one to assist them in getting to know the real person behind the "patient".
Ask Questions: Don't be afraid to ask questions. The more the staff gets to know you the better for yourself and your loved one.
Changes in Condition: Be observant of changes in your loved ones condition. Be aware of weight and weight changes. If you notice your loved one is lethargic, unusually sleepy, etc. contact the nurse and see if there has been a change in medications or treatment plan. If not, it may mean a change in their condition and a need for their doctor to check on them. Do not be timid about this.
Care Plan: A care plan should be requested to discuss anytime that you believe your loved one has experienced a change in their usual status.
Visiting Schedule: Keeping track of visitors, especially in a large family, can be easily done by placing a chart on the bulletin board in your loved ones room. Have a place for the name, date and time of the visit and comments if desired.
Get to know the routine of the facility.
Meals: Check on meals and visit during meal times to see what and how your loved one is being fed.
Activities: Be familiar with the activities. Request a schedule. Ask if family members can be present. If your loved one has particular interests that are not part of the current activity schedule, let the Activities Director know. Perhaps new activities can be added.
Interact: Watch the interaction of staff and residents and learn names of staff that deal with your family member.
Emergency Plan: Find out the emergency plan for the facility. If there is a need to relocate from the facility, where will they go? How will you be notified?
Bathing: Check the bathing schedule for your loved one. Are you satisfied with the hygiene care your relative is receiving? If not, speak to the nursing staff.
Cleanliness: If you have concerns regarding the cleanliness of the facility, bring it to the attention of staff. If you notice repeated or significant infractions speak with the Administrator. If you do not receive a satisfactory resolution, contact your Ombudsman Program.
Stay on top of the resident's care.
Medications: Ask for the current list of medications your loved one is receiving and keep it updated.
Care Plan Meeting: If the nursing home does not have a regular care plan meeting to update you on your loved one, ask for one and have all your questions ready ahead of time. Try to have other family members attend as well.
Contact Information: Have the physicians name, address and telephone number with you always. Make sure this doctor has privileges at the hospital where your loved one would be taken in case of emergency.
Nearest Hospital: Ask which hospital would be used in case of an emergency. Keep in mind that a facility does not always have control over which hospital an emergency patient will be taken to because of emergency room capacities.
Be active with other families.
Meetings: When are the family council and resident council meetings conducted? Plan to attend so you can meet others in similar circumstances and have positive interaction with the staff.
Support Groups: Some facilities offer support groups for family members. Ask if this facility does, when and where they meet. Support groups can often help ease the anxieties that come with placing a loved one in a nursing home.
Be familiar with
- Read our comprehensive glossary of terms.
- If you have concerns that you believe are not being addressed satisfactorily, you may contact grievance groups such as the Baltimore County Long Term Care Ombudsman Program 410-887-4200; the Office of Health Care Quality (the State Licensing Agency) at 410-402-8201; Baltimore County Senior Information and Assistance at 410-887-2594. These contacts can be anonymous if you so choose.