Step 3, Part 1: Size Up a Nursing Home by Visiting

Ask the right questions, know the signs of good and bad care, use your senses. It's detective work.

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See how they play. No matter what age, everyone needs recreation and playful stimulation. Walk into a nursing home and see wheelchairbound residents parked in a semicircle around the television? "That's kind of a bad sign," says Harrington. Checking the activity schedule or, better yet, speaking with an activities director, will give you a feel for the facility's level of creativity—even if funds are tight—and its commitment to residents' emotional and cognitive health. Excursions should be expected, says Harrington, to the local art museum, a park, or a ballgame. And because volunteer groups are typically just a few phone calls away, Harrington says a facility should be able to recruit outside help, say, someone to come in and teach an art class, kids from a nearby school to do skits, or amateur musicians to perform. Special events—like a barbecue to which families are invited or holiday-themed parties—should be regular occurrences.

Talk to residents and their families. These people will have some of the best insights about the level of care at a given nursing home. But a generic question like, "Are you happy here?" will get you a generic response. It's wise to tactfully inquire about the things that matter most to your loved one. If incontinence is a primary reason you're considering moving your mother into a nursing home, ask residents if they get timely help to make it to the bathroom. Wells suggests also posing similar questions to family members: "If your parent needs to go to the bathroom, do they get help? Have you ever visited to find your mother sitting in her own waste?" If your concern about your dad is that he's not particularly mobile, tailor the inquiry, says Wells: "If they have a pressure sore and need to get repositioned, does it happen?" Be sure to ask if the residents have the same nurses and aides caring for them most of the time. Being on the receiving end of a rotating staff schedule is unsettling, and the nurses and aides won't get to know your loved one's specific medical needs and personality quirks. Many facilities have resident or family councils that may be able to offer advice and comfort.

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