The tour guide is cheery. The entrance is pristine. There’s classical music softly playing in the background. Everything looks great, right? Wrong. Families who’ve gone through the process know that everything a facility puts on display for your honor does not tell the whole story. The story of any nursing home comes from those unscripted, spontaneous moments that occur when no one believes you’re watching.
Where Are the Signs of Nursing Aides Addressing Residents?
The details come in the corridors and doorways. Pay attention to how nursing aides speak to residents when there’s no formalized tour instruction taking place. Do they make eye contact? Do they treat older adults like adults, or do their voices go high, and their tones aggressive? These micro-interactions communicate much more about life there than a presentation ever could.
Genuine nursing aides will acknowledge residents on their journey, even if they’re busy. They’ll stop in their tracks if someone calls out to them. These are things families should note when exploring potential placements and acknowledging red flags when choosing a nursing home, so they know what’s legit and what’s only pretending on the tours.
Is There a Smell?
It’s highly likely that a facility will smell good. If it’s covering up a smell, it’s not good. New facilities will have a neutral smell (maybe a hint of whatever’s cooking) old facilities will have floral or chemical scents that cover up subpar bathing/toileting opportunities.
The same goes for cleanliness in general. Look in the corners of rooms. Look at door frames, underneath furniture, and along baseboards. Facilities that take their time to ensure cleanliness don’t just clean the areas that show up on tours.
What Do Residents Say (and Don’t Say)?
The tour guide will introduce prospective families to a handful of residents who love where they are—and it’s expected and appropriate. Still, look for residents who aren’t part of the brief interaction and engage or observe them. Are most residents alone in their rooms without anything going on? Do residents seem comfortable enough approaching aides with questions or requests?
The demeanor of current residents is enough to tell an interested party whether this is a place for their loved one. A good place will have people who feel empowered to speak up, ask for what they need, and go about their day as they see fit.
What’s the Turnover Rate?
If turnover is too high, there’s a problem. Whether the nursing aides are overworked or underpaid or management is subpar, something causes nursing aides to change places frequently.
Good management will acknowledge retention statistics and inform interested parties how long their average CNA has been employed, and they won’t bite when you ask. If you get stonewalled or vague answers, remember this red flag for your decision-making process.
When Are Call Buttons Answered?
It’s unlikely you can assess this during a tour, but if you’re there long enough, you might hear a call button. Then it’s noteworthy to see how long it takes for someone to respond, or if anyone responds at all. Call buttons are life or death for many residents who need immediate attention due to safety concerns.
Some families come and visit a second time instead of once, during the pre-tour announcement, they drop in. Sometimes families come in when administrative staff are gone, and weekends are typically understaffed but might show another side of operations.
Get a Copy of the Activities Schedule And Look Closely
Most nursing homes love showing off their activities program. Take a picture of the calendar and review it later for detail. How often are activities listed every day? Is it once per day or multiple times per day? What activities are listed? Bingo and TV? Or something more varied? Is there something for every ability/interested level?
Residents need mental stimulation as much as physical wellness care; therefore, if their quality of life cannot be supported because no one cares about activities, this isn’t an ideal placement.
If It Doesn’t Feel Right – Trust Your Gut
Sometimes families can’t put their fingers on it, but something feels wrong. People who seem too stressed or additional residents that seem far too quiet can make a place feel gorgeous but warm.
Choosing a nursing home shouldn’t only include checking off boxes. It should mean selecting a place where your loved one feels respected and loved every single day, and sometimes those things come across when those tour-worthy scripted moments are revealed as less than so.
