There is no way to choose an ideal home or to feel confident that
a relative will receive wonderful care. Although some families experience
problem-free stays, problems arise at all homes. All New York homes
are understaffed. Mistakes are bound to happen in large institutions
that employ large staffs in three shifts that care for very sick
people.
Often, homes are better at some things than others. Different homes
offer quite different feelings and surroundings.
To Choose a Nursing Home
Network
within your community. Citizen advocacy groups like FRIA are good
resources as are churches, special diseases groups like the Alzheimer’s
Association chapters, local long-term care ombudsman programs and
area offices for the aging.
Try
to connect with other families who have nursing
home experience.
Visit
several homes. Ask to see floors not on the prearranged tour, stay
through at least one meal and talk to residents and visitors as
well as staff.
To read FRIA’s checklist for visits to prospective
homes, refer to the link above.
The following information should help you make the best choice for
your family:
Eliminate sub-standard homes
Recognize
them by visiting, networking within your community (remember FRIA’s
helpline), and checking state and federal websites giving information
about inspection survey results and quality of care indicators.
For
more information about inspection survey results, click
here. For more information about quality measures,
click here.
Meet your relative’s care needs
For someone bed bound, needing highly skilled care and with limited
ability to interact socially, top nursing standards are the first
concern even if the home has few activities and feels very hospital-like.
A model Alzheimer’s unit will mean little to someone whose needs
stem from a physical disability. For someone mentally alert but
physically dependent, activities and socially active peers are key.
Families with cultural or language concerns may face especially
hard choices. Some choose to meet medical needs first and advocate
for cultural responsiveness after placement. Some homes have specialized
language, diet and activity resources. A few homes offer a welcoming
atmosphere to gay and lesbian residents.
To read “What Families Need to Know and Do: Nursing Home
Placement When There are Cultural and Language Concerns”,
click here.
Focus on your relative’s preferences,
not yours
An
on-site chapel or kosher-style food may be a deciding factor. Some
people find a structured, formal atmosphere comforting. Others prefer
a home that appears freer, allowing Alzheimer’s residents to choose
their own clothing and wander freely within a monitored space.
If your relative has strong feelings about end-of-life care, you
should check which homes have religious or morally based policies
that limit resident options.
To read “Conscience Policies in Nursing Homes” and
identify New York City homes with conscience policies, click
here.
Choose a place convenient to likely visitors and make visits
frequent and unpredictable.
Residents get better care when outsiders visit regularly, monitor
their condition and work to resolve any problems that arise. Most
families chose homes close to visiting relatives even if others,
further away, appear to have somewhat higher care standards.
If possible, choose a home that will be responsive to your concerns.
Some families choose to settle for lower standards in some areas
in order to obtain a greater responsiveness to residents’ every
day preferences and idiosyncrasies and a willingness to investigate
and correct problems promptly.
The presence of many visiting families is usually a sign of “better
than average” conditions and responsiveness. It is also a protection
and tool for addressing problems and for enhancing quality of life
for all residents. Visiting families in well-run homes should be
willing to speak to prospective visiting families about the home’s
good and bad points.
