If your loved one is no longer able to safely live on his or her own — whether it’s your mother, your father or your spouse — trusting his care to strangers isn’t easy. How can you be sure that his needs are being met and that he is safe?

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It is important for family members to stay involved to ensure their loved one receives the best nursing home care. — Photo by Alexandra Boulat/VII/Corbis

The answer, says experts, is simple: You must stay vigilant to make sure that he is getting the kind of care you want him to get.

“Every person in a nursing home needs an advocate,” says Maryglenn Boals, a former nursing home administrator in Arizona. “When you are serving that many people, there are going to be mistakes. There is always going to be little things that happen. So every resident needs his own ‘squeaky wheel.’ ”

A panel of experts and former nursing home workers offers these 10 questions to ask to detect signs of improper care.

1. How does the food look and taste?

Dining with your parent in the nursing home cafeteria is a great way not only to bolster your parent’s spirits, but also to give you an idea of how well he or she is eating. “When people are aging and losing a lot of sensory sensitivity, food is a huge issue,” says Boals. “The meal might meet the dietary requirements, but is it palatable? Is it visually encouraging, especially to someone who doesn’t have much interest in eating?”

Standard protocol is to record how much food a resident eats at each meal, Boals says. If you see that your parent is not eating much of the home’s food but will heartily eat food you bring in for him or her, mention that to the staff. Changes to their meal restrictions might be possible. Keep in mind that if your parent is on a special diet, such as low-salt or pureed foods only, you might not have much say over taste and appearance. But if someone can’t eat because the food is unpalatable, it’s not necessarily worth maintaining a special diet.

2. What sounds do you hear?

Residents moaning or yelling “help” might be unsettling, but they are rarely signs of poor treatment, says Boals. More likely it’s part of the dementia spiral. Instead, listen for how staff members address their residents.

Staff should address residents by their names, instead of “Mama” or “Grandpa,” says Marion Somers, an elder-care advocate and former nursing home administrator. “You’re talking about a generation that is used to being called Mrs. So-and-So,” Somers says. “Staff should ask a resident how they want to be addressed. If they’re not taking into consideration what the resident needs to feel respected, then they are diminishing that client and they are going to have problems with that client.”

3. What does it smell like?

Nursing homes can foster some funky odors, says Boals. There are unavoidable reasons for this: certain medications and diets make residents more gassy. And as people age, they’re more likely to lose control of their bladder and bowels. So a faint whiff of something unpleasant isn’t something to complain about. However, if the home reeks of stale urine, it could be a sign that the facility is not cleaned properly. “Urine can penetrate into floor wax, and if someone is having a lot of accidents on the floor a room can get a very intensive smell if they’re not stripping and rewaxing the floors regularly,” says Boals.

Next: Beware of an overworked staff. »