Choosing a nursing home is daunting process. But with some basic online research and a willingness to visit and revisit the homes that make your final list, you can ensure your diligence will pay off in the form of a comfortable and caring environment for your loved one.

Starting Your Online Search for a Nursing Home

A good resource to begin with is the Nursing Home Compare tool operated by the U.S. Department of Health and Human Services. With it you can compare senior care facilities in or around your preferred zip code based on quality ratings, staffing levels and health inspection data gathered by the government. Consumer Reports also publishes a Nursing Home Quality Monitor based on similar criteria, and boils the information down to a list of the very best homes in your state, and a list of the homes to definitely avoid.

Nursing Home Visiting Hours

Once you've compiled a list of six to ten facilities with excellent ratings and within your geographic limits, commit yourself to the many, many hours you will need to visit each home before you make a final decision. At the bare minimum you should visit each facility twice. One visit should be during a meal to get a sense of dietary dynamics like menu, choice, staff assistance and general atmosphere. The other visit should be at another time of the day to get a sense of what exactly the residents are doing when they're not eating.

An easy and important first question to ask yourself during a visit is 'Does it feel like home?' If you get a subjective sense that you or your loved one would just not be comfortable or happy living in the environment you observe, it's time to visit another facility.

Questions to Ask Yourself About Nursing Homes

When you find a nursing home that elicits a 'Yes' response to the first question you can begin a thorough evaluation. The following are some of the questions recommended by the National Citizens' Coalition for Nursing Home Reform:

Is there cheerful, respectful, pleasant, and warm interaction among senior care staff and the residents?

Does the administrator seem to know the residents and enjoy being with them?

Do the rooms of the residents appear to reflect the individuality of their occupants?

Are rooms, hallways, and meal tables clean?

Do residents look clean, well-groomed, well-fed, and free from bruises?

Do the residents seem alert? happy? peaceful?

Is the home free from any unpleasant smells?

Are there residents calling out? If so, do they get an appropriate response from staff?

Do the meals look appetizing? Are residents eating most of their food? Are staff patiently feeding residents who need it?

Are there residents in physical restraints (formal or informal devices that tie residents to beds, chairs, and wheelchairs)? Why?

Are residents engaged in meaningful and pleasant activities by themselves or with others?

Questions to Ask Nursing Home Staff

Are staff permanently assigned to residents?

How long has the current administrator been at the facility?

How does the staff assure family and resident participation in senior care planning meetings?

Does the facility provide transportation to community activities?

What kind of therapy is available to residents?

Does the facility employ a professionally qualified social worker?

Is there a resident and/or a family council? Can you talk to members of these councils?

What happens if someone has a complaint or problem? Are family/staff conferences available to work out a solution?

What approaches does the facility use to prevent use of physical or chemical restraints?

Are residents involved in roommate selection?

Under what circumstances might a resident be transferred to another room or unit or discharged? Is the family/resident able to refuse?

Ask Nursing Home Residents & Families

Does the facility respect the resident's wishes about their bedtime, baths, and meals?

Is attention given to residents at night if awake?

Does the resident have the same nursing assistant most days?

Are staff responsive to resident requests?

Are snacks like fresh fruit always available to residents?

Do residents participate in care planning conferences? Are his or her opinions valued?

Has the resident had missing possessions?

Who handles resident or family member concerns? Is that person responsive?

Does the resident get outside for fresh air or activities as much as he or she wants?

What is best/worst about living in this nursing home?