How to Choose a Nursing Home for A Loved One

Claire’s 84-year-old mother, Eve, suffered several small strokes and a few falls in the two years after her husband passed away. While Eve was still living independently in the family home, Claire was constantly checking up on her and was continually plagued with worry that something would happen to her mother while she was home alone. She’d bought her a lifeline, a shower rail, and an adjustable bed to make living at home safer for her, but after Eve’s third fall landed her in the hospital with a broken hip, Claire knew something had to change.

Claire’s 84-year-old mother, Eve, suffered several small strokes and a few falls in the two years after her husband passed away. While Eve was still living independently in the family home, Claire was constantly checking up on her and was continually plagued with worry that something would happen to her mother while she was home alone. She’d bought her a lifeline, a shower rail, and an adjustable bed to make living at home safer for her, but after Eve’s third fall landed her in the hospital with a broken hip, Claire knew something had to change.
So, she did what many concerned adult children do—she decided to move her mother into a nursing home. The problem, however, was that there were several nursing homes in San Francisco to choose from, and she really didn’t know where to begin. Faced with her mother’s declining health and mobility, and the thought of giving up the home, the process of finding her a nursing home felt all too daunting.  
Moving an aging loved one into a nursing home is an incredibly tough decision. It breaks our hearts and theirs to take away the comfort of their home and much of their independence to move to an unfamiliar place. But finding the right nursing home can be a blessing. That’s why it’s important to know how to choose a nursing home for your aging loved one so that you can both feel at peace with the decision and know you’ve made the right choice.

How to Choose a Nursing Home: Consider Cost and Location First

While the quality of care and comfort of your loved one should be the top priority when choosing a nursing home, it can be helpful to start narrowing down homes based on cost and location. Given how incredibly expensive nursing homes can be (with average costs hovering around $200 a day), finding one that is certified by Medicare or Medi-Cal (in California) is critical if finances are a concern.
Of course, eligibility to receive help with nursing home payments will depend on your aging loved one’s financial status, but given the astronomical costs of nursing homes, many people qualify. In California, in fact, two out of three residents in Medi-Cal-certified nursing homes receive some degree of financial assistance to cover residential costs.
Another key consideration when choosing a nursing home for your aging loved one is location. Making sure that the home is in an area that is easily accessible for family members and friends will ensure that your loved one receives plenty of visitors—something that can really help them adjust to their new surroundings. Being in close proximity to the nursing home will also allow you to be active in your aging loved one’s care and participate in any activities or special events held at the nursing home. Of course, being able to get there quickly in case of emergency is also critical.

Assessing Quality of Care in Nursing Homes

Once you’ve narrowed down your list based on nursing homes that are affordable and close to your home, you can begin to look into the quality of care that each home offers. Elder abuse is a real concern, so you want to do your due diligence to make sure that your loved one is safe, respected, and well looked after.
Here are the steps you can take when assessing the quality of care in nursing homes:

  • Check the ratings: Use a reputable online nursing home rating system to find the top-rated nursing homes in your area. CalQualityCare.org and Medicare’s Nursing Home Compare are both great resources for this.
  • Surf the web: Visit the websites of the nursing homes that received top ratings and get a feel for each place. Set up appointments with each of the homes that appeal to you and prepare a set of questions to bring with you for each.
  • Pay a visit: During your appointment, pay close attention to the demeanor of the staff, the happiness of the residents, and the cleanliness of the facility. Be sure to ask the questions you’ve come prepared with. Finally, consider how the space makes you feel. Is it uplifting? Calming? Bright?
  • Bring home info: Before you leave, request an information package that you can bring home to your aging loved one to look at. Only do this if you really like the facility and feel that your loved one would be happy and comfortable there.

It is typically a good idea to do the initial assessment of nursing homes without your aging loved one present. While you do want to make sure to let them play an active role in choosing their new home, narrowing down the list to only the best options will make the experience a lot easier for them. Once you’ve found a few nursing homes you like, you can then take your aging loved one for visits so that they can assess the places for themselves.

Considering At-Home Care Options for Your Aging Loved One

It’s important to remember that after you go through the process of searching, assessing and visiting, it’s okay to change your mind about moving your aging loved one into a nursing home. While nursing homes can indeed be a great fit for some, if you fail to find the right fit or your loved one strongly resists the idea, there are several other at-home care options for you to consider.  
Hiring a part-time or full-time caregiver, depending on your loved one’s needs, can be a great alternative to a nursing home. This way, your aging loved one can live safely and comfortably in their own home while also receiving the care that they need. In some cases, family members can even get paid to be a caregiver for their aging loved one, which can help lessen the financial burden of home care. Remember, there are so many resources and services available to you and your aging loved one that can help make it easier for them to keep living happily in their home.
Here in San Francisco, for example, PACE offers a Program of All-Inclusive Care for the Elderly (PACE) that makes it possible for ill or disabled aging adults to keep living in their homes. Lok Lifeways centers provide a community space for aging adults to exercise, engage in social activities, have meals, and access medical care—regardless of their income. Home care assistance is even available for older adults, and transportation to and from the centers are arranged, making this an incredible option for those require extra care but want to remain living at home.
No matter what care scenario you decide, the most important thing is to be sensitive to the needs and wishes of your aging loved one. Making sure that they maintain a sense of independence and control over major life decisions is integral to aging gracefully and peacefully, no matter where they live.
At Institute on Aging, our mission is to connect aging adults, their caregivers, and their families with the resources they need to make living at home possible. Get in touch with us today to learn more about how we can help your loved one age happily and comfortably.

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