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How to choose the right care facility for your elderly parent

Past generations of Americans used to care for aging and infirm relatives in their own homes. But today, when both spouses typically are working while trying to rear their own families, this option might not be feasible.

If you are transitioning a parent into assisted living or a nursing home, you'll want to make sure that the facility you choose will provide good care for your mom or dad. This can sometimes be challenging if you don't know how to ferret out information about the facilities you are considering.

Below are some good ways to get a clearer picture of an assisted living center or nursing home that have nothing to do with the glossy brochures the care facilities offer.

Arrive unannounced

You might need to schedule an appointment to meet with the administrator, but on your first visit to tour the facility, don't schedule your visit. That gives staff the chance to clean up the area and hide any glaring red flags.

Instead, arrive unannounced and ask to do a walking tour of the nursing home. Use your nose. While residents will have accidents, if there is a permeating odor of urine or feces on the residents or in the rooms, the nursing home may be neglecting to change residents' diapers or mop up any messes.

Read the reviews

Keeping in mind that people are more likely to lodge online complaints than kudos, online reviews are still a good jumping-off point for information about care facilities.

Do most of the reviews mention the same unaddressed problems? That could indicate a tone-deaf administration that is unresponsive to complaints from patients and their families.

Investigate violations

All nursing homes are subject to government oversight because they receive funds from Medicare. As such, the public can view all safety and health code violations for which the facilities have been cited by visiting The site allows consumers to compare the quality ratings of three facilities at one time.

It should be noted that all violations are not equal. For instance, failing to properly chart the administration of an antibiotic to treat a resident's urinary tract infection (UTI) is minor in comparison to failing to protect residents from physical punishments, abuse and isolation.

Staffing must be adequate

Perhaps there is no clearer indicator of the potential for disaster in a care facility than lack of staffing. Even dedicated, hardworking nurses and aides are hamstrung when staffing deficiencies leave them unable to provide their patients with the quality of care they deserve.

Observe staff-patient interactions

Do the staff refer to patients as Mr., Mrs. or Miss and their last names or do they use condescending terms like "honey" or "dear?" Do the residents have an appropriate degree of self-determination and the opportunity to participate in different activities?

What's your gut reaction?

Ask yourself if this would be a facility where you would feel comfortable receiving care. Even bad facilities can have good window-dressing, so pay attention to any nagging doubts you might have about their fitness to meet your elderly parent's needs.

It's wise to allow your parent to have as much input as possible into the admission decision, and this can start with a conversation about long-term care planning prior to need.

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