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Signs of Good Nursing Home Care

A nursing home provides medical care for sick people, but it is also a home and may be the last place your loved one will live. The choice of a good facility involves qualities that relate both to medical care and the comforts of home. Things like regularly scheduled exercise or rehabilitation sessions, frequent interactions with staff members and friendly relationships, adequate stimulation and scheduling of activities or events, and a noticeably pleasant and safe environment are all indications that your loved one may be in good hands.


When deciding on a facility, use the following four categories as a guideline:

  • Safety and good medical care. You want to know that the facility you choose places a high premium on meeting residents' safety and basic-care needs. For example, stairway doors should be locked to prevent accidents. Toileting needs should be met promptly. Exercise or rehabilitation sessions should be scheduled regularly so that residents don't lose mobility.
  • Interactions with staff. Research has shown that relationships with staff are one of the most important aspects of life in a nursing home. Nursing homes are experiencing serious staffing problems today, and you may find that almost every home you visit is chronically understaffed. Nonetheless, the staff interactions that do take place should be pleasant and helpful.
  • Stimulation. Even severely demented people need stimulation and can express pleasure. A nursing home needs to provide such stimulation and must do more than post a list of activities on the bulletin board. Residents should be encouraged to attend activities and make the most of what the facility offers.
  • Pleasant and safe environment. The nursing home should be pleasant, bright, clean, and odor-free.

If you have a family member already placed in a nursing home, there are steps you can take and problems to look for to help ensure that your family member gets adequate care:

  • Make sure that your family member is drinking enough water and eating well. Don't always rely on the staff telling you your family member is eating "just fine", or the CNA charting on how much each resident is eating, because they can be notoriously inaccurate.
  • You need to closely watch for any weight loss by your family member. Do not rely on the nursing home's stated weight. Federal regulations require certain corrective measures if there is a significant weight loss. To check for dehydration, you should look at skin tone and dryness in the mouth and lips.
  • If your family member is immobilized in bed or in a wheel chair, they are at risk for bedsores. Someone from the family should regularly check the pressure points on the buttocks, legs, elbows and heels to make sure that he or she is not developing pressure sores. Federal law says that residents are not to develop pressure sores while at a facility. It is a direct sign of lack of care, and you should meet with the Director of Nursing if one appears.
  • If your family member starts showing signs of confusion and/or dementia after entering the nursing home, don't let the nurses or a doctor convince you that these symptoms are just part of normal aging. These symptoms are usually caused by some type of disease or can be triggered by malnutrition or dehydration. Insist that the facility and the doctor run blood tests to rule out disease or malnutrition and dehydration.

When assessing a nursing home, always trust your instincts. But don’t be afraid to look beyond the superficial appearance of the facility and read into the small details. When evaluating a nursing home, keep high standards in mind and ask many questions.

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