Choosing a Nursing Home

Dave's picture

Even if picking a nursing home for a parent or loved one is not in your immediate future, planning for the eventuality should.  Moving a loved one to a nursing home could happen quickly as the result of a health emergency or it may be a slow process as physical and cognitive capabilities deteriorate.  Taking the time and effort beforehand can ease the stress and angst when the time comes.  Let’s think about it for a few minutes and offer some practical advice.  Let’s frame it by answering the who, where, why, when, and how questions.

Who?  You and your siblings.  If you are the only surviving sibling, the choice is obvious – it’s you.  If not, talk to them and devise a plan that is mutually agreeable realizing that strongly held opinions may be compromised by all those involved.  In many cases, one person basically takes over, because they feel the responsibility or other siblings do not want to deal with this.  Also, a spouse may be dealing with health issues of their own, and may not be capable of performing what is needed to be done.  Also, recommendations may come from medical authorities such as the physician or hospital social worker who is connected to the case.  Tasks should be assigned to those most able to perform them, even if others are closer.

Those important tasks are:

  • Monitoring the current health and well-being of your loved one.  That should be assigned to the sibling that lives close-by.  Families disperse, some kids move away, some don’t.  Even a friend or neighbor who is nearby can alert family members, if they are far away.  It makes sense that someone who is nearby performs this function and reports to the others.  If you are the kid that moved away, returning home to check first-hand is a must because many choices are made initially which affect decisions later on. 
  • Legal documents.  Insure the legal documents are in order.  Is the will up-to-date and reflect the wishes of your parent?  Is a living will in place so when faced with possible end of life decisions, the correct one’s are made.  Many nursing homes will require that a living will, or health care directive, be completed upon entry to the nursing facility.  They don’t want to make mistakes either.
  • Finances.  Is your parent (or loved one) able to maintain their checkbook and month-to-month finances?  In general, a trusted person is designated to take care of the finances for the person involved.  Who watches their nest egg to make sure they are not being scammed or cheated?    Are unneeded purchases being made or larger than normal charitable donations being made?  How do you help in preventing that from happening?  Assign one of you to co-own the checking, savings, and investment accounts and charge that person with actively monitoring the accounts.  More than one person needs to be able to see what is happening financially, if asked.  Then as an extra precaution, each sibling (or person involved) should have on-line access to view account activity, and each sibling should, at least once-a-month, logon and take a look.
  • Medical.  Make sure that any pertinent medical information is shared to the family by any medical provider.  Don’t forget to monitor prescription drugs too.  Nursing homes conduct periodic conferences with the family, attended by the nursing home social worker and a medical person in charge of the patient’s care.  Ask questions, what are the medications given, and what are they for? 
  • Other.  By other, look at other items you may have overlooked.  Do you need to engage a bookkeeper or accountant?  Where is the bank? Is there a safety deposit box at a bank and who has access to it?  Do you have the name and contact information of insurance agents, spiritual advisors, pension providers, and valued friends?  Can you find the will?   Make a list of the Medical, Legal and Family members that must be consulted and/or notified if something happens, and add to the list as needed.  Attached to this article is a blank form that may be filled in for this purpose.

Where?  Which nursing home do you choose?  One in which your parent or loved one will be cared for with dignity, attentiveness and one that fits the budget.  The physician may direct you to a home where they make normal rounds once per week or at specific intervals.  Do your homework beforehand if you can.  Ask the doctor or hospital social worker what they recommend.  Sometimes the nursing home decision has to be made quickly, like after a surgery or life-threatening event.  Having a place in mind that meets your criteria is a good thing.  Chances are your parent has already visited friends or relatives who live in a nursing home, and has an opinion on the viability of the homes.  If not, do the research by asking friends, relatives, medical professionals; checking the internet; and probably most important, visit the homes to get a feel for yourself.  Try to find one close enough for visitors to get to, in order to visit the person.

Why?  Because you love them.  You want them safe.  Your want them secure and well cared-for.

When?  Watch for signs.  Has he or she fallen?  Is he or she feeding themself? Is the person losing or gaining weight?  Does he/she have a cold or cough that will not go away?  Are they taking their prescriptions?  Displaying loss of cognitive functions?   Can they still drive, if so, how well?  If not, who has the car keys?   What about mobility?  Can he or she still move about the house or apartment without assistance?  What about bathroom use?  There are many devices to help inside the house, a walker with a seat, bath bench and grab bars for the shower, try to use these if they will help.

How?  When the decision is made to make the move to a nursing home, do your best as a family to make the move as painless as possible.  First of all make sure the home is ready to admit your parent.  There may be a waiting list.  If you can, encourage your parent to make the decision on their own.  You may be able to nudge him or her into making this decision with the help of others.  Take a comfortable chair, a TV, and pictures, so that they are reminded of home, a bulletin board to display greeting cards and snapshots, which also helps them to remember the family.  A tin of candy, cookies or treats that they can share with visitors, or friends within the home, are helpful also.   Another comfort is beauty/barber services within the home, and magazines or books.  One person I knew had a tape player and listened to books on tape, because she was blind.  A blooming plant, such as a geranium, was a welcome addition to my Mother-in-law’s room.  Try to think of what you would take, if it were you.  See Dave’s blog of September 6, 2012 for a personal story in this regard.

That’s our take.  We’ve blended our own personal experiences having been both through it. We welcome your thoughts.  This is all about sharing ideas.

Do you have a story to share?  We would love to read it and so would rChance readers.

Remember, It’s rChance to Live and Thrive, Every Day and in Every Way!



Care Facility Name_________________________________________Phone____________________

Residence Address__________________________________________________________________



Name / Function






Main Nurse Nancy


### - 555-1212  x 123


Nurse at 3rdFloor Station


Doctor John Doe, M.D. , Hopkins Clinic



Office Hours 9am to 4pm


Social Worker








Legal Advisor




















Social Security




Insurance Agent












Financial Advisor




























































































































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