Choosing a nursing home guide

01.Planning ahead

Planning ahead

Most of us don’t want to think about nursing home care while we’re still relatively healthy and independent; we tend to leave it until an emergency forces us to face the issue, utterly unprepared. But planning ahead for the later years of your retirement means you — or your family — won’t have to make important decisions on the run.

• Talk things over with your family while you’re still able to.
• Involve yourself in the decision about where and how you’d like to live if you can no longer look after yourself.
• Visit a number of different types of home: some are church or community-based, others are operated for profit.
• Once you have your Aged Care Assessment Team assessment (ACAT) that confirms your eligibility for subsidised nursing care, put your name on as many waiting lists as you wish and then, when you’re happy with a place offered, let the other homes know.

Checklist

These points should help you focus on your needs when checking out nursing homes. Make sure you ask lots of questions and take notes.

The home

• While it’s important to choose a location you’ll enjoy, don’t forget friends and relatives, who’ll be less likely to visit if it involves a long trip.
• Are the common areas clean, well maintained and easy to access? Is there a laundry service, a good outdoor area, a pool? Are the corridors wide enough for trolleys, wheelchairs or a mobility scooter?
• Is there a nurse on call 24 hours? How are medical emergencies handled? Can your own doctor visit or will you have to rely on the home’s contracted medical professionals? Can you get help seeing your own health providers?
• Can you ‘age in place’? If your care needs increase over time, it’s good if you can move from low-level to high-level care within the same facility.
• Does the home provide palliative care (when people become close to death) or does a resident in this situation have to move?
• Is the home welcoming to visitors? Are visiting times restricted? Was the manager prepared and helpful when dealing with your inquiries?
• Can you get ‘extra service’ if you want to? What’s provided and how much does it cost?  

The rooms

• Are there single or shared rooms? Could you get a shared room for yourself and your spouse? (While some homes provide facilities for couples, others frown on it, especially in high-care nursing homes.)
• Is there a kitchenette and ensuite bathroom or do you share these facilities?
• Are the rooms airy? Are they completely furnished or can you add personal soft furnishings? Do they have verandahs, balconies or large windows?
• Is there a phone, a TV, a computer, internet access? How are you charged for this?
• If the rooms are small, are there other areas where you can meet visitors in relative privacy?

The residents

• Observe the residents. Are they dressed in clean clothes, or can you smell urine? Do they have clean teeth and clean, combed hair?
• Are their fingernails clipped? If you spot many bandaged arms or legs, bruises or bedsores, these could be — but don’t have to be — signs of neglect. Management should be able to tell you how prevalent bedsores are, and how they’re treated.
• Talk to the residents. Do they appear content? Ask them about their daily routines. Can they have input into making choices about their daily routine or some aspects of it? Is there a residents’ committee and/or a similar organisation for relatives?

The staff

• Observe how many staff are around. Do they appear compassionate, caring and gentle with the older people, or rushed and impatient, which could point to staff shortages. More staff are needed if many residents are bedridden, need help getting around or with feeding, or have problems sleeping through the night.
• Ask the management how many staff are on duty during the night, how they’re replaced when sick and about the proportion of casual staff.
• What's the Director of Nursing like? What are their care values, and how do they fit with yours? 

Activities

• If you’re visiting mid-morning or afternoon, observe whether the residents have something to do, or are just sitting around.
• Is there a qualified diversional therapist on staff who facilitates the leisure and lifestyle needs of residents?
• Are outings organised, facilities provided for craft, choir, dancing or theatre activities? Are pets allowed (to stay or visit)?
• What fitness routines are in place?

Special needs

• Are there in-house church services and/or visiting clergy?
• Are there people who come from your language or cultural background or share your religious beliefs?
• Are staff specially trained to cater for residents with dementia?
• Are there activities for people who aren’t mobile?  

Food

• Try to arrange at least one of your visits to coincide with meal time. Is enough help provided?
• Is the food nutritious, appetising and sufficient?
• Is it freshly cooked on the premises, or brought in? Can you prepare some yourself? Do you have a choice of meal? Perhaps you can see a meal plan.
• Are fruit and snacks freely available? Is fresh water provided in rooms?
• Discuss any special dietary needs.