What Are Quality-of-Life Considerations in Choosing a Nursing Home?

The basic function of any long-term care setting is to provide for your loved one the things they can no longer do for themselves. To this basic function a skilled nursing facility adds medical care from registered nurses (RNs) and licensed practical or vocational nurses (LPNs or LVNs) who are on staff around the clock. However, medical care and assistance with daily living are merely the most fundamental and minimal standards. The overall quality of life provided should be a substantial consideration in comparing available facilities and making a final selection.

The first element of quality-of-life relates to basic needs such as food and sanitation. The facility should have a dietician on staff to address any special dietary needs, but food service issues go far beyond this. A menu of high-quality, well-prepared food; a menu rotation that offers variety; and choices of foods at each meal are important for a resident who will be eating every or nearly every meal at the facility. Providing variety and appetizing options can be even more challenging for special diets. In any institutional setting, quality and variety of meals take on a much greater importance due to the absence of other options, much like a school cafeteria setting. For a nursing home patient food quality is even more important, since good nutrition is vital to improving and maintaining health.

The cleanliness of the facility obviously matters from a health and safety standpoint. A high level of cleanliness will go far toward preventing the spread of infection, crucial for those who may have weakened immune systems. A clean, orderly environment also has a positive impact on patient morale; it's hard to be positive or happy about living in an environment that is dirty, disorderly, or smelly. For older facilities cleanliness and appearance may present more of a challenge, but the housekeeping in a nursing home speaks volumes about the priorities and dedication of both management and staff.

The next issue is the opportunity for residents to remain active and engaged. Isolation is often a key factor in declining health in seniors, so a program of social and recreational activities can play an important role in not only the happiness but also the health of patients. In addition to a regular program managed by the facility, there should be opportunities for service and religious volunteer groups from the community to offer activities.

In many cases, the facility may transport residents, whose physical condition permits, to activities at other locations. Local churches may also offer transportation to services and other events that they hold. The ability to get out into the community occasionally can be a great morale booster.

Finally, it is important to know whether residents will have the option to leave the facility and spend time with family for part of a day or even a few days. In addition to the "change of scenery" that this offers, it provides the chance to spend more time with loved ones than visits at the facility typically allow. Of course, the patient's specific medical needs or prescribed course of treatment (such as a rehabilitation program) may limit the amount of time they can spend away from the facility in this manner.

When choosing a long-term care setting, remember that quality of life is just as important as quality of medical care. Unlike a hospital where the patient will typically remain for only a few days, a stay in a skilled nursing facility will last for weeks, months, or possibly even years. Think about the various factors that affect your happiness in day-to-day life and find out how the facility that you're considering meets each of those needs.