A Visit to a Small Nursing Home


Yesterday, I went to visit a small nursing home near my home.  Before I went I had phoned for an appointment.  I was told to come anytime as they were small and whoever was available would show me around.  I also prepared myself a check list/grid to organize my questions so I would remember to ask the same questions of all the facilities I look at.

I used the checklist I had prepared about assisted living facilities for a template and then made changes specific to nursing homes.      I used several reference books when I prepared the first list.  These included “Aging in Stride” by Christine Himes, Elizabeth Oettinger and Dennis Kenney” and “The Complete eldercare Planner” by Joy Loveride.    I probably should have gone back to the first one when I was adding questions, but I didn’t take the time.  In any case, I can add more later if I decide to.

There are also checklists available online such as those found at ehow:   I would suggest looking at some of these web pages as well if this is the first time you are looking at such a facility.  In fact, I should probably review some of them again myself!

In any case, I already had some specific questions in mind because of dad’s experience in the large nursing home last November and the experience he has had in his large and small assisted living facilities.

At the top of each form, I write the name of the facility and the date that I visit.  I write the name of the person that gave me the tour.  And then, of course, I need to record the room rates and to ask how often the price might go up.  Also it is important to ask what is included in those rates.  For this facility, they included cable television but not telephone service.

They provide the furniture but residents can bring in their own.  Still, there is very little room for much beyond one comfortable chair.  They work with only one pharmacy and they use the blister packets, which I think are required by law for nursing homes.

Many of my questions were about staffing, and especially the type and number of nurses and when they were there.  The staff ratio looked good at 7 aides for 40 residents.  In addition, they had 3 daytime nurses and 2 evening nurses plus one in the middle of the night with 2 aides.

This nursing home only had 6 private rooms and the rest were shared rooms.  When I asked about a bed, I was told it was harder to get a “Male bed”.  I asked how a male bed differed from a female bed.  Actually, it is the roommates that make a difference.  Most of the time there are no private rooms available, so one would be sharing a room and it would have to be available in a room with a roommate of the same sex.

I much prefer the private rooms, both for visiting and because dad prefers to be in a private room.  The rooms are not very large, and the doubles share the small amount of bureau and closet space available.

I asked about mealtimes and location.  Meals are at 8, 12:45 and 5:45.  The lunch and dinner times seemed rather late to me.  Dad is always ready to eat at 11:50 and 4:50 when his ALF opens the dining area for meals.  I suppose he could get used to it if he had to.

I asked what types of residents they didn’t take.  They don’t take people with dementia who might have disruptive behaviors.  They don’t take residents who have a lot of medical needs like for IVs or for ventilators.

They have 2 geriatric physicians who come in regularly, each covers half the clients.  They also have a dentist who checks in residents when they arrive and come in to treat them if necessary after that.  They also have a foot doctor that comes in.  They don’t provide transportation to doctor appointments, but they will arrange it with a local medical transportation company.

They work with one local Hospice provider, and only that one.  The only objection I might have to that is the fact that this Hospice is headquartered on the other side of the small city of which our town is a suburb.  I haven’t driven there yet and can’t see doing so or at least not in the winter months (which is almost half the year around here).  Hospice care for the resident is provided right there in the nursing home.  But support groups and other things for families would be on the other side of town.

Overall, there were things I liked about this nursing home and other things that I didn’t like as well.  There are 2 other facilities owned by the same family and they are in newer buildings (and thus cost a little more).  I may look at the others as well, though this is the most convenient to my home.

I liked the size of the facility and the proximity to my home.  I liked the fact that it was quieter and less chaotic there.  Many of the residents were taking part in some kind of craft activity in the dining area.  I didn’t like the age of the building and the small size of the rooms nor the fact that so few private rooms were available.  I still feel that I need to check out a few more facilities to see if there are others I like better and because this one may not have a “male bed” available when dad needs one.

On that topic, I will add that the care manager I met with left me a message today saying that the newer nursing home I had asked about would also be open to him.  The discharge planner had told me he wouldn’t be a good match there because of his dementia.  The care manager called her friend at that facility and was told dementia was not an issue unless someone were disruptive.  Dad is very quiet most of the time and not likely to be disruptive.  I just have a feeling that the discharge social worker had another client or two that she wanted to get the opening at that newer small nursing home that I wanted for dad.

Again, I am making progress on my search to know what is available in the area when the sudden need arises.  I will look at some other places, but I am gaining confidence in my ability to meet the next crisis when it arrives.

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About letstalkaboutfamily

I am a retired and was the primary caregiver for both my parents before they passed. I have children and grandchildren. This blog is an attempt to connect with other caregivers and share ideas and experiences. I hope you will let me know what worked for you if you had an experience similar to mine. The main issues I am going to talk about are elder care, death and dying, assisted living, family relationships and hoarders and hoarding. Other topics will come up as I address the issues and my relationship with other family members.
This entry was posted in Alzheimer's Disease, Assisted Living Facility, Caregiving, Elder Care, Eldercare, nursing home and tagged , , , , . Bookmark the permalink.

12 Responses to A Visit to a Small Nursing Home

  1. terry1954 says:

    oh i dread what you have done today………..

    • I put it off since spring! I am glad I went. Now I know something a out this small one and the large one he was in last December. I still need to do more. I have a spreadsheet with my questions. I write in the responses when I am there and type it in on the computer later. Then in a few months or years I should be able to read it and hopefully remember something about each one. I did forget my camera though and I wished I had brought it. It helps me also to remember what each one looked like. That was what I did with all the assisted living facilities I looked at.

  2. Teresa Cleveland Wendel says:

    It looks like you’ve got your facility tours down to a science. Good for you. It’s the only way to find a good fit.
    PS: Close to your house is a big bonus.

    • Yes, I did It with assisted living facilities in 3 states before I knew where mom and dad would end up. I looked in my current state, the southern state where mom and dad spent winters and my former state which was easiest to learn the process before I knew I would move closer to mom and dad. I learned also that laws about facilities differ by state, so it is best to know where (city) you expect to place them. It would be easier on me if dad is close to my home, but since they didn’t currently have a ” male bed” and said they were harder to get, I have to have more options.

  3. Jane says:

    Several years ago, I also disccovered websites that were “watchdogs” over LTCFs. These sites rated nursing homes based on public information (also on the website) gleaned from various agency reports. In the lobbies, I believe there are also supposed to be copies of all these reports. Good luck to you 🙂 Jane

    • Thanks, Jane. I did get a copy of their most recent state inspection report which they had just gotten back. The inspection was done In July 2012 so it was very recent. I know other reports and comparisons are online but last time I looked (in November) I found the categories very general and not that useful. I imagine I will look again sometime when I know which homes I want to compare.

  4. well done. never easy but always enlightening. be careful about the agitative behavior thing, because many people experience this in the end of life stages and you want to be sure this would be managed by hospice rather than a reason for an abrupt move. hang in, you are doing great. beth

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