6 questions to ask before selecting a nursing home

Posted on May 20, 2012


This article has a lot of really good info in it and it references a series that I can recommend also from the Boston Globe.  If you are looking into nursing homes you need to read these articles so you are prepared to ask the right questions and know what to look for but remember you can get help to stay in your home, keep a loved one in their home or help you care for a loved on in your own home.  See below the article for information.



My colleague Kay Lazar wrote a fantastic series for the Globe last week exploring the overuse of antipsychotic drugs in nursing home patients with dementia. The two-part series — which included a database of facilities nationwide and their frequency of prescribing antipsychotic drugs inappropriately — prompted a flood of calls to the toll-free Alzheimer’s helpline, (800) 272-3900, and a 35 percent increase in traffic to the Massachusetts/New Hampshire Alzheimer’s Association website.

No question, finding the right nursing home for a loved one, especially someone with Alzheimer’s disease, can be the most heart-rending and perhaps toughest decision that many of us will ever have to make.

Susan Rowlett, manager of care consultation at the Alzheimer’s Association’s Massachusetts/New Hampshire Chapter, recommends consulting one on one with a professional before choosing a facility — her organization provides such services for free — but also says it’s important to ask the right questions when visiting a nursing home. Here are some key ones to ask yourself and the professionals:

1. What is the percentage of residents in Alzheimer’s Special Care Unit that are on mood-altering medications like antipsychotic drugs? If more than 25 percent of residents are using antipsychotic medications, this may indicate that the Unit relies more on medications rather than behavioral techniques to calm aggressive symptoms, according to the Alzheimer’s Association.

The Globe report winnowed this down further to determine the rate of prescribing antipsychotic drugs to those without psychosis or a related condition — which isn’t recommended by the US Food and Drug Administration for safety reasons. The report found that the national median for using antipsychotics in such patients was 16.7 percent, but you also need to ask about the percentage of residents with behavioral problems in the facility since that can correlate with rates of prescribing these medications. “Some nursing homes may work with those who have higher likelihood of psychiatric problems,” pointed out Rowlett, “while others don’t accept any patients with behavioral challenges.”

2. What feeling do you get when visiting the nursing home? Are the nursing assistants smiling when they do their work? “Sit and watch the staff interact with the residents and count the number of times you see a resident hugged or touched affectionately by the staff,” said Rowlett. Does the staff make eye contact with residents? Do they speak slowly, clearly, and respectfully? If you see a lot of residents sitting by themselves, staring into space, that’s not a good sign.

3. What’s the patient to staff ratio? The Alzheimer’s Association recommends at least one staff member for every five residents from 7 a.m. to 8 p.m. The ratio should be at least one staff member to nine residents for the overnight shift.

4. What are the activities like? Ideally, there should be at least one full-time therapeutic activity person. This person should organize age-appropriate stimulating programs for the mind and body whether it’s music, art, or games. Are the activities geared specifically to the interests of the residents? Does each resident have an activity plan that provides activities that focus on the person’s remaining cognitive strengths and avoid their cognitive weakness?

Safe walking paths outdoors and off-site excursions are also crucial, as well as the appropriate supervision.

5. Does the facility seem different on the weekends? Some nursing homes are notoriously short-staffed on the weekends. Make sure you visit during different times of day and on a Saturday or Sunday. “Taste the food, and talk to other family members who have loved ones there,” said Rowlett.

6. Is there a dedicated Alzheimer’s special care unit in the nursing home? This may be extremely important if a loved one is suffering from dementia. At the very least, a facility should have a staff person specialized in Alzheimer’s care. “Unfortunately there aren’t state regulations for a standard of care that should be delivered to dementia patients” in facilities with special care units, said Rowlett. “We’re fighting to get a bill passed in the Massachusetts legislature.” Here are more details on the bill that would set standards — already implemented as law in 44 other states — for special care units.

via 6 questions to ask before selecting a nursing home – Daily Dose: A Boston Globe blog with health news, advice, and information..

Can you stay in your home?  Medicare only pays for some of the care that people need to stay in their homes and they are getting more restrictive on what they will cover.  There are other resources to assist in keeping us in our homes as we age and that is private duty home care.  BrightStar specializes in this kind of care and we would be honored to be able to help you or a loved one.

BrightStar Care of Downtown Houston

BrightStar is an in-home health care company designed to help, give us a call at 832-730-1255.

All of our services are personalized to fit the specific needs of the client.  We work with clients and their families to design a customized care plan, and we match each client with a qualified, pre-screened caregiver.

From childcare to elder care, the BrightStar of Downtown Houston team provides peace of mind. We are available 24 hours a day, 7 days a week. Our Director of Nursing ensures that each client receives the highest level of care administered by highly qualified personnel.

Home Healthcare and Staffing Services Provided

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