Best Nursing Homes

If you are scouting living options for a parent who can no longer live alone or whose care requires more than a family member can provide, assisted living might be a good option. Bethany Village offers a comprehensive continuum of care that includes independent cottages, villas, and apartments; assisted living apartments, rehabilitation care, and long-term nursing care.

But all assisted living places are not the same; it pays to visit as many as you can to see everyday life in action. Sometimes what you actually see when you make a scouting visit is more revealing than answers you receive to your questions. Here are a few things to look for:


 

• Do the residents and staff seem happy? Are they smiling?
• Are the grounds nicely landscaped and well kept?
• Are the interiors – living spaces and common spaces – clean and tidy?

If you are visiting a nursing home in anticipation of your parent needing to move from assisted living into a place that offers long-term medical care, you can make the same observations I mentioned above. In addition, look at how the residents live. Yes, they are there for medical reasons, but does the facility look more homelike than clinical? I like to say, "Remember the ‘home’ in nursing home." Do residents’ rooms look inviting? Do residents look "put together" – face clean, hair fixed? (Don’t be disturbed if you see residents sitting in the hall. Chances are they are passing the time by people watching – an activity that you probably enjoy, too!)

Here are some important questions to ask your nursing home tour guide:
 

• Do your employees enjoy working here? Can you show me current employee satisfaction survey results? What is your turnover percent compared to the average?
• What do you do to ensure the facility follows all state and federal regulations? Do you have committees that oversee quality? Do you perform regular audits to ensure quality care?
• Do you have current resident and family satisfaction survey results you can share with me?
• What is the ratio of nurses to patients? How does it compare to other facilities?
• Do you use agency nurses or have your own employees? The organizational commitment and consistency of care that comes with having employee nurses is important.
• What do you do to keep residents as independent as possible?
• How is toileting handled for those who are not mobile on their own?
• Are rooms private or semi-private?
• What furniture and décor items can I bring in to make my parent’s room more like home?
• Can residents select their own meals?
• Do you have an onsite laundry?

As you can see, there is a lot to consider when you are investigating assisted living or long-term care for a loved one. Visit www.medicare.gov/NHCompare for information on nursing homes in your area and to compare facilities using Medicare’s Five-Star Quality Ratings, health inspection results, nursing home staff data, quality measures and fire safety inspection results.

Here is my last piece of advice – and it’s probably the most important of all: look for a facility or community that is based on a "social model," not a "medical model." A social model focuses not on what residents can’t do, but on what they can do. Feeling empowerment, independent and able to make ones own decisions is the best medicine of all.

We welcome your comments and questions about how to find the appropriate level of care for your parent(s).

　

If you are an older person thinking about visiting some retirement communities in anticipation of making a move (or if you are a family member thinking about future living arrangements for a loved one), I have a very important piece of advice for you: Do it when things are going well and you are not in crisis or under any pressure to make a fast decision. Not being in a hurry to make a move gives you the freedom to consider all your options, weigh the pros and cons, and make an informed decision.

I’ve been a senior living counselor at Bethany Village for 11 years, and in that time, I have learned what it takes for prospective residents to glean the most information from their retirement community preview tours. Here are some tips:

Don’t be afraid to make an appointment. Selecting a retirement community can’t be done over the phone. You’ll want to compare at least a couple of similar places. Meeting face-to-face with a counselor is the best way to get a feel for the place and have all your questions answered.

Be prepared. Before you set off for your appointment, take a few minutes to write down your "hot button" issues. What are you looking for? What is less than perfect in your current living situation? Could the community you are visiting solve those problems?

Allow enough time for your appointment. For example, Bethany’s campus is fairly large – ranging from independent living in cottages to long-term nursing home care. We ask our prospective residents to plan on about a 90-minute visit.

Visit during the day. Retirement communities are quieter in the evening and on weekends, so if you want get a realistic impression, come during the day.

Try to set aside preconceived negatives. There are several common preconceived notions about moving into a retirement community. One has to do with loss of control over your lifestyle. A quality retirement community will allow you to make the decisions about how much assistance/care you need. Fear of moving into a nursing home is another common issue. If there is a nursing home associated with the retirement community you are visiting, ask to see it and take a good look around. At Bethany, for example, I think the community and atmosphere would be not at all what you anticipated.

Expect the places you visit to follow-up with you. The counselors you meet with should call you about a week after your visit to see if you have any questions. If you show interest in the community, you should expect the counselor to invite you and perhaps a family member back for another visit.

Let’s face it: people generally don’t like making dramatic changes in how and where they live, especially as they get older. You probably want to see me – a retirement community counselor – about as much as you want to go to the dentist! But taking care of these plans now can make your life a lot easier later. I can assure you that at Bethany Village, your needs and comfort come first. And if you use the tips I’ve outlined above, you will be able to make an informed choice when it’s time to look at retirement living.

Your comments are welcome about your experience with tours of retirement communities.

Bethany Village is located just north of the intersection of Interstate 675 and Far Hills Avenue in Centerville, 10 miles south of Dayton, Ohio. Click here for a map or for Mapquest directions.

It's only natural for parents to want to live independently for as long as possible. As a son or daughter of aging parents, you can help them remain safe while maintaining their dignity and independence. The best defense is a good offense. When visiting your parents, be observant.  If you live far away, ask a neighbor to check in on your parents.

Here are several signs that will help you know when Mom and Dad are having trouble managing by themselves:

• Health changes: shortness of breath, increased pain, unexplained bruises or other injuries, difficulty walking, changes in eating or sleeping habits
• Memory loss: missed appointments, losing or misplacing items, repetitive conversation, missed doses of medications or medications taken at wrong times
• Mood changes: loss of interest in usual activities, being withdrawn, prolonged sadness, increased irritability, unusual fears
• Poor safety judgment: stove burners left on, unexplained dents in the car, getting lost, dressing inappropriately for the weather
• Decline in personal appearance: wearing the same clothing, poor grooming and/or hygiene
• Decline in living conditions: house not being kept up like it used to be, dirty dishes or paperwork piling up, rooms messy
• Difficulty managing finances: unpaid bills, unable to maintain checkbook

There are some simple ways you can help your parents continue to live independently.  If a parent is having trouble managing money, offer to balance their checkbook or help them set up auto-pay for their regular monthly bills. If there is spoiled food in the refrigerator or your parents aren't eating well, help clean out the fridge regularly and take them shopping for groceries for easy-to- fix meals.  Arranging for housekeeping assistance once a month can make a big difference. 

It's important to remember that you aren't alone. There are many resources in the community that can help if you, your siblings or other family members are feeling overwhelmed.

You can start by talking to your parents' physician. Home health services provide nursing care, therapy, medical social services, and home health assistance. Many communities also have a senior companion program  so Mom and Dad won't always be alone at home if you can't be there.

What signs are you seeing in your parents' living situations that concern you? Or do you have suggestions for other daughters and sons caring for aging parents you'd like to share? We'd like to hear from you.

What do you do when you start noticing a decline in your parents' health or living conditions? How do you approach one or both parents when a change in their living situation is inevitable?

Having "the talk" can be awkward for both parents and their children alike.

In a perfect world, plans and wishes have been discussed long before a crisis occurs. But in reality, a crisis such as a hospitalization, a sudden illness or a fall often prompts the discussion about where to go from here - whether it be an Assisted Living facility or a Nursing Home offering 24-hour care. Decisions must now be made under duress, choices may be limited and finances may not be in order.

So the time to have "the talk" is before a crisis occurs.

Before you have "the talk" with your parents, you should speak with other family members, friends or neighbors.  Get some background information from them about one or both parents' behavior and come to a better understanding of the situation so you can present a unified front. You want to make sure everyone is on the same page before approaching Mom and Dad. Review information about various senior living options and resources for family members so that you will be armed with the confidence that comes with knowledge.


You could lead into the conversation by talking about  specific examples as a springboard for "the talk" - you could say, "Mom and Dad, I'm concerned about your health and your ability to continue to live at home. I think its time to discuss your living options." Continue with "This is what I've noticed the last several times I've been to visit." Then give observations pertaining to either a specific health ailment or a general decline in health reflected in poor housekeeping or hygiene.

Validate their strengths, all the things that they are still doing well that do not concern you. That way the conversation is not all about "You're failing this, you're failing that." Instead say, "I think you may need specific help with this." For example, "When I come over I notice the carpet isn't as clean as it used to be. It doesn't appear to have been vacuumed in a while." This works well if there are a few specific issues that need to be addressed.

Don't make "the talk" bigger or more dramatic than it needs to be. You don't necessarily need to have the whole family show up; that could seem like an "us versus them" confrontation. It could be very overwhelming and intimidating for the parent. 

If there are a series of small problems that are mounting then perhaps you need to have a more serious conversation with Mom and Dad.

If you'd like to share some advice, or have a question about caring for your aging parent, please write a comment to me below.