Heavy reliance on temporary nurses and aides also hampers relationship-building, says Susan Lutz, project manager for AARP education and outreach. She advises asking specifically about the proportion of direct caregivers from temp agencies.
You can pick up signs that staff members respect and care about residents in the small interactions between them, Burke says. Before entering a room, for example, do nurses knock? Do staffers address residents casually and impersonally, or politely and by name?
Nursing homes that treat their residents well tend to have solid connections with the community, Lutz says. Families should find out whether homes have ongoing relationships with schools or local houses of worship. Maybe Dad can't play the piano any more, but hearing student recitals might rekindle some of that same spark.
Find out other ways the staff keeps residents occupied throughout the day. You don't want Mom in the hall in a wheelchair all day, says Sharon Brangman, division chief of geriatrics at SUNY Upstate Medical University in Syracuse, N.Y.
Don't ignore similar personal preferences and habits your loved one holds dear. Religious practices, such as pastoral care or kosher meals, could be the most important factor to your loved one, says Jennifer Brown, director of admissions and marketing for the Methodist Home and Forest Side Assisted Living, a continuing-care facility in Washington, D.C. U.S. News indicates a home's religious affiliation, if any, on its profile page in Best Nursing Homes.
In the end, a home has to be affordable. A year in a nursing home now costs an average of close to $100,000, and not all charges are obvious. Some homes, for example, tack on fees for physical therapy or dentist appointments. Medicare only pays for short stays following hospitalization, and Medicaid—which not every home accepts—requires depleting most of a resident's assets.
[Read U.S. News advice on how to pay for a nursing homes.]
Regardless of the expense, you won't want to economize in ways that compromise your loved one's quality of life. The latest MetLife Mature Market Institute survey shows that choosing a shared room over a private room saves an average of nearly $10,000 a year. But if Dad values his privacy, and a home that's a little farther away can offer him his own room at a price that makes a less-convenient home more affordable, you'll probably want either to figure out a way to keep him nearby and make the higher payments, or put up with the longer drive. Why compel him to accept a roommate?