Things to Consider When Picking a Nursing Home

Posted April 19, 2011 in Personal & Home Safety by

About 10 years ago, my late grandmother – who was then in her early 80s – realized it was time to consider moving into an assisted living facility. Although she was still physically and mentally strong, she had taken a few falls and had some medical issues.

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The dilemma she faced – and many of us with aging relatives will face – was choosing the right place to call home. If you’re looking at a nursing home, age-restricted independent living facility, extended care or assisted-living facility, here are some things to consider.

Type of Facility

When I was little, the term "nursing home," conjured up images of old people gathered in a common room, sitting in wheelchairs, staring blankly at a TV screen. I’ve since learned that this is the exception, and there are a variety of options available to older adults who need a little or a lot of assistance in their day-to-day lives.

There’s a range of care available to residents of long-term care facilities. From least restrictive to most restrictive, they include:

  • Independent living residences: Each person has separate living quarters and doesn’t require special living or medical assistance
  • Assisted living facilities, with small private living quarters: Some help with daily tasks such as eating and dressing, and monitoring of health issues when needed
  • Nursing home or rest home facilities: These may offer 24/7 assistance with daily living tasks and full-time health monitoring, but usually no extensive medical care
  • Intermediate care facilities or skilled nursing care facilities: This type may have intensive medical care for the chronically and seriously ill
  • Extended care facilities that are hospital-affiliated: These provide short-term care for seriously ill patients

In many instances, you’ll find a residence that offers several services under a single roof. For example, a couple may move into an apartment in the independent living wing. If the husband, for example, starts to need more care, an aide or nurse could come into the apartment to provide assistance on a regular basis. Or the couple could move to an apartment within the assisted living wing. If one has a temporary medical issue and requires more extensive care, he or she could move to the extended care area.

Immediate & Long-Term Needs

When evaluating the kinds of services offered, look at both your (or your loved one’s) current and future needs.

A senior who’s still in good health and physically active will want a facility that offers a lot of recreation and entertainment opportunities. Someone who doesn’t like to cook – even while in independent living – will want a dining room that serves tasty food. Are housekeeping and laundry services available?

Thinking about the future, does the facility have established relationships with your preferred hospital? Is the residence convenient to your doctor’s and dentist’s office? What kinds of special assistance is available?

In my experience, moving becomes more disruptive and traumatic as a person ages, so there are a lot of advantages to choosing a facility that offers a variety of services. This minimizes the need to cause upheaval in your loved one’s life.


Money, of course, is a huge factor when selecting a nursing home, independent living residence or assisted living facility. While Medicare and other insurance may cover certain costs, it probably won’t cover all expenses, particularly related to independent living.

Most facilities will have a finance person who can walk you through the costs to help determine whether you can afford the facility. Be prepared to share detailed information – including insurance and savings details. This helps you both understand whether and what you can pay for a facility.


You also want to consider the reputation of a nursing home or senior residence before you or your loved one moves in. Talk to:

  • People who live in the facility: Are they happy? Would they recommend the facility to a friend? Do they feel as if they are well-cared for? What complaints do they have?
  • Seniors in the community: Do they know anyone who’s moved into the facility? Would they consider it themselves? What kind of reputation does the facility have?
  • Medical providers: Which facilities are most popular among their patients? Which facilities most impress your health care providers? Which facilities should you avoid?
  • The staff: Do they seem happy and dedicated to their jobs? How do they interact with residents? Do they seem patient or are they rushed in their jobs?
  • The government and non-profit agencies: Are there complaints about the facility? Can you see licensing and inspection reports?

It may require some time and effort, but by considering these factors it will help you choose the right independent living facility, assisting living center or nursing home for you or your loved one.

Related Apps for Your Smartphone*

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