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21 Questions to Ask Before You Place Your Loved One in a Nursing Home

If you have an aging parent, loved one, or handicapped loved one that you are considering putting in a nursing home this is the guide for you.

Finding a nursing home (-LTCF) for a loved one can be overwhelming. I was a nurse, charge nurse, and Assistant Director of Nurses at a nursing home up until I had my daughter. I have seen really good ones and places I wouldn’t let keep a roach for five minutes. I hope to lay out a plan that will make it easier to find the right home for your loved one.

Take a tour of several facilities. If possible do not schedule this tour beforehand. Bring a notepad and pen with you. Nursing home are generally going to have a tinge smell of urine. With so many incontinent patients in one place it is inevitable. However, the aroma of urine and feces should not overpower you. If so, the nursing home is not properly changing the patients and/or cleaning the common areas. Take notes on the smell, the cleanliness, how many staff you see, if there is an abundance of call lights going off for a prolonged period of time, if there are activities going on, etc. Notice the other residents mood and behavior- if everyone in the place looks browbeat its not a good sign! Try to schedule your visit at a meal time and notice if the food is attractive, aromatic, and plentiful. Compare your notes to the answers from the questions bellow. Most of the time the Social Worker will be the one to guide your tour and answer your questions. However, sometimes it may be several people, but don’t let that intimidate you. There are five key staff you want to know: Administrator, Social Worker, Director of Nurses (DON), Dietician, and Activity Director.

Ask these questions:

  1. Is the nursing home’s state operating license current?
  2. Is the facility Medicaid and/or Medicare certified?
  3. Can I see a copy of your last state inspection? (this inspection report will tell you the things the nursing home received fines for not being compliant on,)
  4. What is the nurse to resident ratio? (if more than 30.…RUN AWAY)
  5. Is there a 24/7 on call physician? Who?
  6. What fees will the resident be billed for each month & what is the cost of the bed per month? Be sure to compare prices. Specialty care centers are generally more expensive. Some facilities will charge you for EVERY over the counter medication the patient takes. This can rack up a lot of cost when they charge $1.00 per Tylenol…etc.
  7. Who will be responsible for taking the resident to doctor appointments? (Some nursing homes make the family responsible for this and provide little warning when it is time for the appointment.)
  8. What is the visitation policy?
  9. Are the exterior doors locked at night? Are the doors coded during the day? (This is especially important if you have a confused wondering prone loved one. )
  10. Are the nursing stations manned at all times. (in other words is there someone at the desk to attend to residents needs while the medication nurses are passing medications.)
  11. Are the rooms private or semi-private? If semi-private can a resident change rooms if they do not get along with roommate?
  12. Is there a communal room(s), how often are activities planned, is there an activity director, how often are outings planned, and are there snacks provided during the day?
  13. Can the resident have input on meals or are there choices?
  14. Are there showers and whirlpools? (If your loved one is unable to sit up unassisted you will want to make sure there is a whirlpool AND lift. )
  15. Does the facility have a hair dresser or barber visit the facility? If so what are the charges and if not how are grooming needs met? Who trims the fingernails and toenails and how often? ( if your loved one is a diabetic you want to make sure a nurse or Podiatrist cuts toenails and nurse cuts fingernails. )
  16. If the resident goes up or down in ADL (-activities of daily living) ability can they still stay at the facility?
  17. Most likely you will be asking these questions to the social worker….if not ask if the facility has a social worker and if they are full time. (The social worker usually deals with resident complaints)
  18. Who is the Ombudsman (-patient rights advocate) and what is their phone number?
  19. Does the resident have access to a telephone and is it private?
  20. Is there a staff Physical, Occupational, and Speech therapist on site or available?
  21. Who is the DON, Social Worker, Administrator, Activity Director, and Dietician? Are these people readily available to family members and the resident?
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  1. Wonderful article.

  2. Sometimes with the rising cost of healthcare, the demands on us as caregivers along with our own personal duties, we often are not aware that there is any other choice besides assisted living or skilled nursing homes. When I found ResponseLINK I was on wits end trying to decide what was best for my elderly uncle. He has no children, and is still able to live on his own, but seems to forget his medications at times, which poses a health risk for him since he is diabetic. ResponseLINK reminds him every day at his every medication interval to take his insulin and to eat and then again to remind him to check his sugar level. Also, if he needs any help at all, he just pushes his button on his pendant and a trained operator responds and alerts us and or his family physician.

  3. An excellent reference for those considering respite or long-term care for their elderly loved ones. I too work in aged care but I don’t think I would recommend my workplace to anyone considering respite/long-term care for their disabled/elderly family members. We are seriously understaffed and the elderly people often miss out on a bus trip or other activities because the recreational activities officer has offered to do a nursing shift to compensate for the lack of casual staff available. We have so-called experts who come into the workplace and make changes that either add to our already unmanageable workload or changes that realistically serve no benefit for the residents whatsoever..it just looks good on paper. There are many accredited facilities that offer excellent accommodation and a range of services from physiotherapy to psychosocial activities and stimuli..but for some, the costs can be phenomenal for this type of care.

  4. Very good advice ! One really needs to check out the nursing homes because of the abuse towards the elderly that happens much to often.

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