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Hello. Should I choose a long term care nursing home for my 94 year old mother that is close to me (3 miles away) and clean and modern but not the best rated but decent, so I can easily visit and make sure the care is good, or one that is farther away (20 miles) but is rated top notch 5 stars and don't have to worry so much about the care?

My mother has beginning dementia, just got over pneumonia in the hospital, stenosis, hard of hearing, arthritis, depression and anxiety. I assume the dementia will get worse.

I'd like to visit daily for a few weeks to make sure she is ok, then visit every other day.

Thanks.

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My mom's facility is not fancy..IL AL, MC, SNF are all available. The IL and AL reminds me of a college dorm hallways. Very nice rooms. MC floor from what I saw are nice. Mom started out in AL and now in SNF. When I took my CNA class the teacher told us that when we go on interviews if it smells like pee, turn around and leave. When I was working we were told to greet everyone we passed and asked if they needed assistance. The staff on SNF are wonderful with the residents and visitors. It's not fancy but it's clean and efficient. So look past the the 5 star ratings and look at the big picture..
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Has nursing home care been recommended? Granted, she's 94 and has a few medical issues. I'd just check it out, so you know all her options.

I would also confirm that the rankings you have are updated and valid. By chance, I found my state's Star rankings of AL facilities online on our state's facility regulation website. It also lists the violations, fines, how they were discovered, what correction measures were taken, etc. I found that very informative.

I learned that the fancy places might look nice, but, it had little relation to the actual care of the resident. If you can, though, I'd go with a facility that is nearby you. Don't underestimate the ease of accessibility if you are only a few miles away. In some cases, you may have to make one to two trips per day to the facility. To me, being able to stop in at any time is important, even if you don't do it that much.

I went to some facilities and sat in the parking lot on Sundays. I asked family members who were entering and leaving what they thought of the place. I got some candid answers.

I also asked around to friends and family members to see what they knew about various places.
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Are there any memory care facilities near you to consider? When I was looking for nursing homes, one of the admissions folks suggested memory care to me. I didn't know much about it but it worked out great in my situation.
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Look very critically (i.e. discriminatingly) at the criteria covered in the ratings. You should be able to find some kind of breakdown showing what the nursing homes were given marks for. You then see where the "inferior" NH scored less highly than the fancy-pants one, and if it turns out that their lower marks didn't relate to anything you agree is important, then you need have no qualms about consulting your own convenience and choosing the one closer to you.

If you can't find any information about the ratings, or if you're still not confident about the choice, visit both for a good thorough inspection. Have lunch there. Ask around. Talk to other families that you might meet.

Don't get carried away by highlights like fish ponds, petting zoos, a fully-equipped multimedia studio or smoked salmon on the breakfast eggs if these are not things your mother gives two hoots about.

Do pay attention to how the staff behave towards their charges when they think no one's looking. Because when push really comes to shove in caregiving, attitude is *everything.*
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