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What to Look For in a Long-Term Care Facility

Deciding to place a loved one in a long-term care facility can be an agonizing decision. In addition to all of the emotional aspects, you want to be sure that the place you choose will be a good fit for your loved one, while providing the best possible care. According to Robin Bromberg, LICSW, Social Services Leader at Hebrew Rehabilitation Center in Boston, there are several things to consider.

"A long term care facility should provide the most overall, optimal living environment for a family's loved one," Ms. Bromberg says. "Both top quality medical care and nursing care is a must. You can actually review a facility's survey report, which is available through the state Department of Public Health."

One of the most important things, and usually an early step in the process, is to visit the facility. According to Ms. Bromberg, a personalized, scheduled tour of the facility can be arranged by contacting the facility's Admission Department.

"It's important to note if the place has a feeling of life to it," Ms. Bromberg says. "The 'air' of the facility should be on life enhancement. In addition to any necessary medical care and assistance, the facility should emulate a high quality of living - demonstrated through center-wide enriching programs, unit group activities, and individualized motivational plans."

The next step is to talk to people — from the administrators to staff on the floor. Ask the nurses and the aides what a resident's day is like. Talk about your relative's daily schedule: when are meals, showers, etc.? Does the resident have a choice about when to do these things?

Find out if the same staff members will be assigned to care for the resident each day (which means they'll be able to build a relationship with your loved one), or if the staff rotates frequently. Confirm that you (and other relatives and friends) are able to visit your loved one anytime you choose, as opposed to being limited to set visiting hours.

Next, find out what is available to keep the resident active and engaged.

"Activities should be varied to match your loved one's interests and abilities — a range including more active groups to those more sensory and individualized focused," Ms. Bromberg says. "A good facility has sufficient resources and demonstrates creativity with program planning."

Some facilities offer intergenerational programs in conjunction with schools or community groups in the area. And some facilities even allow visits from family pets.

"At Hebrew Rehabilitation Center, we have lots of animals that visit for 'pet therapy.' The residents really enjoy these visits," Ms. Bromberg says.

Ms. Bromberg stresses the importance of matching a loved one's needs to what the facility has to offer.

"Entering a long term care facility, one of the biggest losses that a resident may fear is giving up the social routines of his/her life. A loved one who moves into a facility is adjusting to the new surroundings and people. It naturally can take time to build new relationships," she says. "A good facility should support this adjustment process, with introductions and inclusion, both in activities and in the overall environment. This assistance by the staff is a key valued point for many families."

Finally, once a loved-one has moved into a facility, Ms. Bromberg recommends, "Be actively involved in the best care plan possible for your loved one. Being involved and asking any questions you may have — about the care, about the resident's daily routines, about the environment, etc. — is most important. Attend Family Meetings with the entire Care Plan Team — becoming an active participant of the team yourself in the overall care of your relative. You will be developing relationships with the staff, and they will value your input.

"When you visit, let the staff on the floor know that you're there," Ms. Bromberg says. "Ask the aides how your loved one is doing that day, and include any of your questions and observations. The staff wants to build a relationship with you so they can learn about the resident's likes, dislikes and habits. You have known your loved one best!

"Bottom line, trust your instincts. At a good facility, you will be made to feel welcome. You will sense a spirit of vitality. The key message here is to really ask questions and be upfront with what your loved one's needs are," Ms. Bromberg says. "You are putting in the effort for your loved one, to make the most informed decision in his/her best interests. You want your loved one to be comfortable; and a good facility will want you to feel that same level of comfort about your choice, as well."

Hebrew SeniorLife offers a free long-term planning guide, which offers support to help you think about your loved one's needs in advance, to understand options and to feel more confident in your decisions.

For more information on long-term care facilities, visit or see the Guide to Choosing a Nursing Home , published by the U.S. Department of Health & Human Services' Centers for Medicare and Medicaid Services.

Above content provided by Beth Israel Deaconess Medical Center in partnership with Hebrew SeniorLife. For advice about your medical care, consult your doctor.

December 2014

Contact Information

Division of Gerontology
Department of Medicine
Beth Israel Deaconess Medical Center
Lowry Medical Office Building #1B (West Campus)
110 Francis Street
Boston, MA 02215

Contact Information

Hebrew Senior Life
1200 Centre Street
Boston, MA 02131