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7 Red Flags to Watch for When Choosing a Nursing Home

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The in-person advantage

If you do it right, choosing a nursing home isn’t easy. “It could take days and several conversations and several good cries to make sure that … your loved one [is] in a place where their needs will be met,” says Greg Crist, spokesman for the American Health Care Association.

And while nursing home ratings can help you see how different facilities stack up on important measures like staffing, nothing beats visiting places in person, experts say. Here are seven signs that a facility isn’t right for your loved one.

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1. Loud noises

When you walk through a nursing home’s doors, don’t just look – listen. “How noisy is it? How chaotic is it?” Crist asks. “Usually, the higher-functioning organizations tend to be much calmer and not as chaotic.” Loud overhead paging can also “enhance agitation, especially among people with Alzheimer’s disease and dementia,” says Farida Ejaz, a senior research scientist at the Benjamin Rose Institute on Aging in Cleveland.

The in-person advantage

If you do it right, choosing a nursing home isn’t easy. “It could take days and several conversations and several good cries to make sure that … your loved one [is] in a place where their needs will be met,” says Greg Crist, spokesman for the American Health Care Association.

And while nursing home ratings can help you see how different facilities stack up on important measures like staffing, nothing beats visiting places in person, experts say. Here are seven signs that a facility isn’t right for your loved one.

1. Loud noises

When you walk through a nursing home’s doors, don’t just look – listen. “How noisy is it? How chaotic is it?” Crist asks. “Usually, the higher-functioning organizations tend to be much calmer and not as chaotic.” Loud overhead paging can also “enhance agitation, especially among people with Alzheimer’s disease and dementia,” says Farida Ejaz, a senior research scientist at the Benjamin Rose Institute on Aging in Cleveland.

2. Disrespect

How staff and residents interact speaks volumes about life at a long-term care facility. Do the nurse assistants – the “backbone” of resident care, Ejaz says – know the residents’ names? Do they respond promptly? Does the respect go both ways? Staff members who talk more to each other than to the residents is another red flag, adds David Gifford, AHCA’s senior vice president of quality and regulatory affairs.

3. Absent administrators

Talking to the facility’s staff is just as important as watching them in action. Are they overworked? Stressed? The facility’s administrator should be accessible and open to questions, too, Crist says, since he or she will be your go-to contact in the months and years to come.

4. A lack of choices

A move from independent living into a long-term care facility strips older adults of a lot of autonomy. That’s why it’s important for them to make choices, be they about what and when they eat, what they wear, and when they go to sleep and wake up. Variety matters, too, Ejaz says. “Do they have bingo every single day? Or … can residents choose what they really want to do?”

5. Visiting hours

Visiting hours is “an old-fashioned concept,” Ejaz says. While it’s reasonable for nursing homes to request that family members don’t barge in at 1 a.m., you should be able to come and go as you please, perhaps joining your loved one for a meal or activity. Check out the place on nights and weekends, Ejaz suggests. If the staff has fled, you should too.

6. An unsafe neighborhood

While nursing home residents tend to spend most of their time inside, the neighborhood still matters, since getting outside safely can make a big difference in mental health. “Wandering helps calm you down … rather than being restricted or drugged and sitting in a wheelchair all day long,” Ejaz says. Look for outdoor space that’s secure so that residents don’t get lost, she adds.

7. Misaligned values

What’s the facility’s philosophy of care? How does it approach end-of-life? How do those answers align with your family’s values? “It’s mostly about picking a place that behaves in a manner that’s consistent with your preferences, which means that you’ve got to be really honest about why [your loved one is] using the nursing home,” says Vincent Mor, a professor of health services, policy and practice at Brown University. “And that’s the most difficult question of all: Why?”





Anna Medaris Miller, Contributor

Anna Medaris Miller is a Senior Health Editor at U.S. News, where she covers fitness and …  Read more

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