Aquacize, yes it is such an emotional process. I would start by narrowing what the need is; i.e. does it matter how close to you it is located? Does it matter that it accepts Medicaid? That it offers a continuum of care, from IL to AL to LTC to MC to hospice? You definitely must schedule a visit to check out that it appears "fresh", well-run, clean, well staffed, signs of activity. Does it have a shuttle that takes residents to stores and services? Does it cost money and how often does it run? I would ask how long the administrator has been in place. High turnover is not a good sign. Is it for profit or run by a non-profit? Does it have well groomed grounds? Do they allow pets (or visits by pets)? Do they have a calendar filled with activities? Religious services? Also, taste the food and check out the menu. Others will provide additional insights. I wish you peace in your heart as you make a decision on behalf of your LO.
We have few NHs in my area. I went to each of the 3 near me.
#1, didn't like when I immediately walked into the facility the residents rooms were there. Common areas were down halls where the residents rooms were. Didn't like the "feel" of the building.
#2, Mom had been here during rehab. There activities room was a joke. One long table residents were sat at. TV was an old projection one. Color more red. Had a woman just missing the table by an inch with her head saying "I want to be dead" over and over. People in wheelchairs and geri chairs sat in front of TV and left. No interaction.
#3, I walked into a large open area with couches and chairs all over. I went thru to the dining/activities area. Again Big and open. Something going on all afternoon. Either an activity, movie or entertainment. This was the place I picked for Mom.
Contact the homes you are interested in and meet with them. Ask for a tour and what activities are provided. Some don't do much with activities and others do a lot to keep the residents active and busy doing things they love. Also ask the families of the residents their opinions. Last but certainly not least. Be sure it is close to you. No matter how good the facility is, sometimes the care of your loved one is only as good as the visitors she gets. In other words if they know you or other family members could come at any time there care is better. Don't make your visits routine. Change up times and days. Just my experience. Best of luck to you and your family member.
If you show up unannounced (or for some purpose other than a formal tour), you ask to see what type of room your loved one will have, and they show you a room without any hesitation whatsoever, that's a great sign that it's a decent place. I'm not talking about a lengthy tour (you'd want to plan that in advance), but if you ask to see a room or the dining area or something specific, they should be prepared to show you that.
Yes, agreed it is difficult and sad. I’m sorry you’re there now. If you can tap into what my dad calls his “old people network” it may help. Seniors who may face this and often know friends who have tend to know the good nursing home, the ones that have fallen out of favor, and the ones with bad reputations. The therapists staying at a place long term is a good sign, they’re well paid, in demand, and tend to jump when a facility isn’t good. Nothing replaces a visit. What you see and smell is important. Not what the person touring you around says. Are residents content, clean, out of bed for the most part? Is staff engaged in care, do they have positive attitudes? Are there frequent activities, religious services, pets brought in, is the vibe depressing or upbeat? Does it stink? Fleeting smells are inevitable but it should never just smell bad. Talk to families who are visiting, are they pleased? Is the food appealing? Is the place clean? It doesn’t take long on a visit to get an impression. I wish you the best in this. Always remember you’re an advocate for the resident, caregiving is different in a nursing home but it doesn’t end
Thank you for your advice. I did go to one NH with a good reputation. But I was not taken to nursing home building. And that was with an appointment yet!
If you see one you like, try to drop in at off hours...early morning. Weekends. Evenings. Check staffing levels. Ask how many aides are on shift right now. I like to see a staff member for about 8-10 residents, (maybe it could be more at night). See if the staff are working or playing with their phones. See if staff greet you or glare at you. If you hear a call bell go off, wait and see how long it takes someone to respond.
A good place will have pleasant staff who are not sitting in the hall playing with their phones. The staff will be working. Watch how they treat the residents. Do they speak to them before wheeling them away or do they just walk up in back of them and start to push?
I went to an absolutely beautiful facility where the staff was just plain angry and glared at me as I walked by. I saw them push the residents' wheelchairs without even speaking to them- which frightened the resident. Everything looked lovely but the care looked awful.
I went to a very old facility that didn't have a lot of glitz and was greeted pleasantly by almost every aide I walked by. They seemed happy to be there. They were all working. A bedridden resident's call for help was answered in minutes. I was much more impressed by the care at the old facility than the new.
Good luck. This is a hard journey. Many people here will support you!
In addition to the good advice so far, I'd add these:
1. Activities, including music.
One rehab had 4 pianos, one of which was a player piano. One piano was in the memory care unit.
Some activities such as bingo are fairly common. I looked for more unusual activities to address a variety of patients. Room TVs with all music channels are great; patients need that more than news. But to me music therapy with guest musicians is the best, along with:
2. Animal visits
They're the best therapy yet!. At the best rehab ever, the DON brought her dog with her to work. The dog made rounds with her.
3. Security.
One place had no receptionist at all; the place was deserted when I arrived except for the kitchen staff clearing the tables. I had to start wandering around before I found anyone to speak with about potential admission. It was far too easy for someone with bad intentions to come in and explore...and perhaps engage in nefarious activities.
The absolute best facility had closed circuit tv, with a locked door which visitors could open up until the time the receptionist left. There also was a security car the patrolled the premises.
4. Staff to patient ratio
11 or 10:1 or less was the ratio at the best place. Ratio at the place with no receptionist was something like 14:1, not good at all.
5. Chef, who can prepare pureed dysphagia meals if necessary. Also, a variety of choices, some variable and some standard and available daily, gave patients a choice of menus.
6. Rehab room; the best ones I've seen had a variety of equipment, including parallel bars. It was surprising how many facilities didn't even have those.
7. Clean bathroom facilities. I took a peek in several bathrooms to see if cleanliness was standard.
8. Outdoor views. One place was adjacent to a forest; my father saw birds, squirrels, racoons, and even deer. Once when we were in the occupational therapy room a paid of sand hill cranes came over, to within 6' from the door. We watched as they examined the ground for lunch or snacks.
The last facility also had a small woods and a deer population which came out in the evening to dine.
9. Consideration for visitors, and a visitors' log. Coffee, tea, and even a small deli were great. The visitors' log helped with a list of visitors at a sign-in sheet by the reception area.
It looks good to you, but the patient doesn't really care. My Mom wasn't interested in crafts, bingo, piano, movies, outside gardens, food, animal visits. She was just miserable there and didn't talk to us for 14 months because we put her there.... sat in her wheelchair everyday.... then passed away ...
There is a government website, every state has one, that will list every nursing home in your state & you can see how it’s rated & what problems the state has noted. We used it when looking for my mom, an elder attorney told us about it. Sorry I don’t remember the specific info, but you can probably GOOGLE for it. Someone will probably come along that can post it for you.
Go to Medicare.gov and click on Find Care, then Nursing Homes. Enter a location and you can see ratings for every place including health inspection reports. It is really helpful!
#1, didn't like when I immediately walked into the facility the residents rooms were there. Common areas were down halls where the residents rooms were. Didn't like the "feel" of the building.
#2, Mom had been here during rehab. There activities room was a joke. One long table residents were sat at. TV was an old projection one. Color more red. Had a woman just missing the table by an inch with her head saying "I want to be dead" over and over. People in wheelchairs and geri chairs sat in front of TV and left. No interaction.
#3, I walked into a large open area with couches and chairs all over. I went thru to the dining/activities area. Again Big and open. Something going on all afternoon. Either an activity, movie or entertainment. This was the place I picked for Mom.
You will know when its the right one.
A good place will have pleasant staff who are not sitting in the hall playing with their phones. The staff will be working. Watch how they treat the residents. Do they speak to them before wheeling them away or do they just walk up in back of them and start to push?
I went to an absolutely beautiful facility where the staff was just plain angry and glared at me as I walked by. I saw them push the residents' wheelchairs without even speaking to them- which frightened the resident. Everything looked lovely but the care looked awful.
I went to a very old facility that didn't have a lot of glitz and was greeted pleasantly by almost every aide I walked by. They seemed happy to be there. They were all working. A bedridden resident's call for help was answered in minutes. I was much more impressed by the care at the old facility than the new.
Good luck. This is a hard journey. Many people here will support you!
1. Activities, including music.
One rehab had 4 pianos, one of which was a player piano. One piano was in the memory care unit.
Some activities such as bingo are fairly common. I looked for more unusual activities to address a variety of patients. Room TVs with all music channels are great; patients need that more than news. But to me music therapy with guest musicians is the best, along with:
2. Animal visits
They're the best therapy yet!. At the best rehab ever, the DON brought her dog with her to work. The dog made rounds with her.
3. Security.
One place had no receptionist at all; the place was deserted when I arrived except for the kitchen staff clearing the tables. I had to start wandering around before I found anyone to speak with about potential admission. It was far too easy for someone with bad intentions to come in and explore...and perhaps engage in nefarious activities.
The absolute best facility had closed circuit tv, with a locked door which visitors could open up until the time the receptionist left. There also was a security car the patrolled the premises.
4. Staff to patient ratio
11 or 10:1 or less was the ratio at the best place. Ratio at the place with no receptionist was something like 14:1, not good at all.
5. Chef, who can prepare pureed dysphagia meals if necessary. Also, a variety of choices, some variable and some standard and available daily, gave patients a choice of menus.
6. Rehab room; the best ones I've seen had a variety of equipment, including parallel bars. It was surprising how many facilities didn't even have those.
7. Clean bathroom facilities. I took a peek in several bathrooms to see if cleanliness was standard.
8. Outdoor views. One place was adjacent to a forest; my father saw birds, squirrels, racoons, and even deer. Once when we were in the occupational therapy room a paid of sand hill cranes came over, to within 6' from the door. We watched as they examined the ground for lunch or snacks.
The last facility also had a small woods and a deer population which came out in the evening to dine.
9. Consideration for visitors, and a visitors' log. Coffee, tea, and even a small deli were great. The visitors' log helped with a list of visitors at a sign-in sheet by the reception area.
Follow your nose.
It is not true that a NH has to smell like urine.
Then follow all the good advice already given.
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