How to Find a Nursing Home for a Senior

Two Methods:Determining If Assistance Is NeededFinding a Nursing Home

Most seniors wish to live independently for as long as they can. However, as a loved one's ability to care for himself or herself diminishes to the point where assistance is needed, and family and friends are no longer able to help, it may be necessary to find a nursing home to provide the care the person needs. Here are things to consider when planning to find a nursing home for a senior.

Method 1
Determining If Assistance Is Needed

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    Look for signs of weakening physical condition. One or more of the following signs may mean that a loved one may need the care a nursing home can provide:
    • Unsteadiness when standing, walking on getting onto or off of his or her feet.
    • Difficulty eating with utensils.
    • Readily gets tired from light to moderate activity.
    • Excessive weight gain or loss.
    • Unusually thirsty.
    • Urine odor on person or in the home, indicating incontinence.
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    Look for changes in behavior. Older people may suffer from depression or a more serious mental condition such as the after-effects of a stroke or dementia. Some of the signs that a senior may need the care of a nursing home include:
    • Decline in personal hygiene (wearing stained or smelly clothing)
    • Inattention to household tasks (unopened mail, unpaid bills, piles of dirty laundry, un-mowed grass, spoiled food or burnt cooking utensils)
    • Memory problems (frequently gets lost in familiar places, misses appointments, forgets to take medications)
    • Seems withdrawn or avoids contact with family and friends
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    Have the senior evaluated by a specialist. While your family doctor may be able to give the person a complete physical, it may be necessary to refer him or her to a someone with specialized training, such as a gerontologist, geriatric nurse practitioner or neurologist.
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    Examine options to keep the senior at home. If the senior is having problems in only a few areas, such as having difficulty in cooking and cleaning, but not in getting around, community programs available through local social service agencies, such as Meals on Wheels or cleaning services, may be enough. You may also need to make modifications to the home, such as installing grab bars or raised toilet seats in the bathroom, to help seniors with difficulty in standing and sitting.
    • Consider also the opinions of other family members and close friends, as well as your own ability to care for the senior. Being a caregiver can be taxing and at times frustrating; it may be necessary to put a loved one in a nursing home for your own well being as well as his or hers.
    • Another option to consider is hiring a geriatric care manager to provide in-home care or consultation, particularly if you live in another city or if there are few other available alternatives to a nursing home.

Method 2
Finding a Nursing Home

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    Determine your ability to pay for nursing home care. Determine which nursing homes are covered by private medical insurance or government funding.
    • In the case of Medicaid, many times it is necessary for the person placed in a nursing home to spend down his or her own assets before Medicaid funding kicks in to cover the cost of ongoing nursing home care.
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    Research available nursing homes online. You may want to begin your search with an online search engine; if so, use the most specific keywords you can when searching for a nursing home, such as "around-the-clock care" if that's what your loved one requires. You can also use government Web sites such as Medicare's Nursing Home Compare, independent review sites such as or, or background-checking sites such as LexisNexis' ChoiceTrust.
    • You can also contact individual nursing homes through their Web sites; many have online forms that let you specify the kind of services you're looking for.
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    Consult with experts in nursing home care for recommendations. These experts may include family doctors or specialists in geriatric medicine, as well as social service agency representatives, clergy and state and county health departments. They may have a working knowledge of which nursing homes have good overall track records and can direct you to the people to contact at those homes to arrange an interview.
    • You may also want to consult with your state's long-term care ombudsman, whose office usually has insight into the rankings for a given nursing home as well as a record of complaints filed against that home and their resolution.
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    Determine the right balance of criteria for your situation. This requires evaluating not only the services available and what they cost, along with the quality of care, but also the distance from your love one's original home to permit close family and friends to visit regularly. Deciding which items are most important will help you build a list of nursing homes to visit. In some cases, how close the nursing home is may outweigh cost and quality of care.
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    Visit prospective nursing homes. Evaluate the homes for overall appearance and cleanliness. Look at how well-staffed the home is on both weekdays and weekends and get a sense of the overall attitude of the people who work there, as well as how frequently the residents are visited by how full the home's parking lot is. Look at the residents themselves to see if they appear clean, well-fed, happy and active or messy, malnourished, sullen and bored.
    • Take along copies of any nursing home checklists you may have found online. They'll help you determine what you should be looking at if you don't trust your own common sense.
    • Be aware that a strong antiseptic smell may mask odors of urine or fecal matter, indicating that the nursing home has difficulty handling incontinent residents, as may having a large number of residents on urethral catheters.
    • Listen as well as look. If you hear the staff gossiping about someone's late-night partying or hear a resident's plaintive, unanswered cry of "I want something to eat!," the home may not provide adequate care for your loved one.
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    Interview the nursing home's administrator and staff. In addition to looking over the nursing home inside and outside, interview the home's administrator and members of the nursing staff to evaluate whether or not the nursing home would be suitable for your loved one.
    • Ask the administrator or director of nursing how the home handles general issues such as nutrition, falls and incontinence and specifically how they will provide for your loved one's individual needs. You should also get copies of recent health inspection reports and ask how the home remedied problems identified in those reports.
    • Ask the staff about the workload, employee morale and turnover rates, as well as the ratio of staff nurses to nurses from medical temporary services and how many families hire private nurses to assist in their loved one's care.
    • Ask both the administrators and staff about any upcoming changes in ownership. If the nursing home is to undergo a change in management, the change could be either beneficial or negative. You'll need to investigate the incoming owner as you did the home itself.
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    Ask residents and their families about the quality of care the home delivers. It's helpful to corroborate the information given by the nursing home's administrator and staff with the opinions of the residents and the observations of their family members to give you a more complete picture of the home.
    • Ask residents how well they're treated by the nursing staff and whether they have the same nurses caring for them regularly. Also find out if they need and get help with eating, bathing or going to the bathroom.
    • Ask residents' family members for their observations about how the home handles nutrition, falls and incontinence and how well it meets their loved ones' specific needs. Also note their comments on the residents' quality of life.


  • Expect a period of adjustment for your loved one to settle in to the home and for you to settle in to a new routine. Your loved one may initially experience feelings of abandonment or confusion, and you may experience feelings of self-doubt. If the feelings persist after a month, you may wish to reconsider whether the nursing home is the right one.


  • Once you admit your loved one to a nursing home, pay attention to any sudden changes in his or her health, appearance or outlook. A sudden change for the worse may mean the care he or she is receiving is inadequate.

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Categories: Aged Care