Unusual questions to ask before choosing a nursing home for someone you love.

This page was written from personal experience with major metropolitan nursing homes considered to have good standards and services. I am not a health care professional. I am not an expert on aging. I am a person who has already been there and done that with parents. You will likely get many standard answers and information on nursing home care, but as with many things, there are a lot of unanswered questions about nursing homes that you won't know to ask about until you actually experience having someone you love in a nursing home.

Considering a Nursing Home
Unusual Questions to Ask Before Choosing a Nursing Home
How a Person can Change when Living in a Nursing Home
Tips for Helping a Person living in a Nursing Home

Important and unusual questions you should ask about a nursing home:

Does the nursing home automatically put the resident in diapers when they begin their stay at the nursing home?

Experience: This seems to be either laziness on the part of the nursing home or lack of staff at the nursing home. One parent who went into an elder care facility was immediately diapered though she was not incontinent and was able to walk to the bathroom on her own when she arrived. She would still have been able to walk to the bathroom with assistance as years went on, but in a short time she became dependent on the diapers. Ask about the nursing home policy on this issue.

Does the nursing home help the resident wash their face every morning?

Experience: We would find mother with "sleep" in her eyes as no one washed her face in the morning. Ask about the nursing home policy on this issue.

Does the nursing home help the resident brush their teeth in the morning and after meals or check that they have done it themselves?

Experience: We found that dental hygiene in a nursing home usually ranks low on the scale of priorities. Ask about the nursing home policy on this issue.

Does the nursing home provide regular dental checkups?

My opinion: same as about dental hygiene in a nursing home.

Does the nursing home have a doctor on staff who will attend a resident who gets the flu or other illness while in the nursing home?
For a nursing home resident who becomes ill or injured while in the nursing home, who calls in the staff doctor, and in what circumstances?

Experience: Though a nursing home may have a doctor on call, they may not actually call the doctor unless someone, such as family, encourages them to do so. We had an incident where mother had congestion, fever, and coughing, but the nursing home did not on its own call for a doctor to check her or get medication. The family had to request a doctor visit. Ask about the nursing home policy on this issue.

Note: Once a person becomes resident in a nursing home, unless the family or friends can take him or her out of the nursing home to the regular family physician,or unless their doctor makes "house calls" to his or her nursing home, you need to rely on the nursing home's medical staff.

Experience: Mother is now wheel chair bound. Overnight mother got a swollen bruise on her forehead that stood out the size of an egg with a scab. (Really more than an inch!) The nursing home could not explain how it got there. Mother lay in bed "sleeping" for several days and eventually awoke. During that time we called in the family fearing the worst. The nursing home told us it would not be fatal. The extended lump remained there for over two weeks. No medical attention was provided. We finally requested a doctor visit with family present. We had to ask the doctor to lance the bump to relieve the pressure. He did so and mother recovered.

What kind of clothing should a nursing home resident wear?

Opinion: What a person usually wore at home may or may not be a good choice of clothing for life in a nursing home. Loose fitting, easy neck opening clothes are good. If an aid helps dress a person in a nursing home, be mindful that they have a lot of people to help dress, and may do it with more haste than you might take in dressing the person yourself. Rips and tears may occur. And if the person who is being dressed has little ability to help in the process, it could hurt to have a tight-necked garment pulled over the head. A shirt or blouse with buttons may need to be a size larger for someone wheel-chair bound.. If the person is diapered, you may need to get them size larger pants, as the diapers are quite bulky. Dresses or even shifts and mu-mus don't seem to work for a ladies day in a wheel chair, though they may work for a lady who uses a walker and has the ability to dress herself. Most nursing homes will attend the residents who need help getting up and dressed each morning - usually no sleeping in or staying in your pajamas all day! Ask about it!

What do the residents do between scheduled activities in a nursing home?

Observation: One of the saddest things to encounter in a nursing home is a hallway lined with wheelchairs and people sitting and staring at the walls. Many older people do not seem to want to make new friends with other residents in the nursing home and though they sit wheel-chair to wheel-chair, they are isolated. Sometimes one does not hear well or the other is not able to speak well so they can't communicate easily. Of course it is hard to have something to do or see all the time for residents, but some options nursing homes of the future should consider would be
  1. A place for residents to look out of the building at trees, nature, traffic, or people in the "outside world".
  2. Provide large-screen really old movies in the cafeteria or dining room.
  3. Provide large-screen travel-logs
  4. Provide large-screen history or nature programs.
  5. Provide music of the 20's, 30's and 40's over the speakers between activities or at certain times during the day.
Ask the nursing home what they do with residents between structured activities. I urge you to suggest these considerations at a nursing home and together we may change the future of nursing home care. If your nursing home does provide continuous visual stimulus, give it a gold star. I don't think all day elevator music counts for much.

Observation and Experience: We have found in our two experiences that the nursing home environment encourages the resident to get lost in thoughts and memories during unstimulated periods during the day. To some extent, it's nice to reminisce, but long periods of reminiscence seems to lead to withdrawal from life today. If the resident is not interested in Bingo, or other programs offered by the nursing home, or refuse to attend the programs, they are usually left on their own. Ask about this too. We provided mother and father (different nursing homes in different years) with a television. We have visited in evenings when mother has been placed in front of her television in her area of a shared room, but the television was not on!

How do nursing home residents get around in the wheel chairs by themselves?

Observation: The wheel-chair shuffle! Older people in nursing homes have found that using the extra wheel-rim for getting around is hard on the arms and many people do not have the strength for it. The practical way to move your wheelchair is to lift up the footplates and do a little foot shuffle to move about. It really works quite well even for folks who really can't walk but have some use of their feet.

Does the nursing home move residents to new rooms at will?

Experience: Now that mother is on Medicare after more than 5 years in the nursing home, the nursing home moves her from room to room when they feel the need. They do not consult us. We do not have a choice. She began in a two-bed room at the window. She has been moved several times (sometimes to a different floor) and we have been surprised when we came to visit. She is now in a 4-bed room with a roommate who appears to be quite disturbed from time to time. Ask about the nursing home policy on this issue.

What is the procedure in a fire?

Experience: We were upset to find that though there are 3 elevators in the building and one fire staircase, the plan is to close the fire doors on each floor and wait. We observed there was no way the staff could get all the people out of the upper floors in case of a fire or other emergency in any reasonable time anyway. Usually elevators are not to be used during a fire.


Skip to our nursing home topics:

When asking nursing home care questions, find out how the nursing homes you are considering handle specific situations:

What can you expect from the person who has moved into a nursing home?

What can you do to help bridge the transition to life in a nursing home? What can I talk about with a person in a nursing home? What can I do for a person in a nursing home?

When you begin thinking about a nursing home for someone you love:

or read it all:

Click here to go to the next page: How a Person can Change when Living in a Nursing Home

Click here to go to the previous page:Choosing and considering nursing home care

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