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Living in a Nursing Home

Understanding how these facilities work can mean the difference in the quality of your loved one's care

AARP offers tips how to pick a good nursing home and keep a good relationship with it- nursing home resident waits patiently while her bed is made by a nurse

Photo by Whisson/Jordan/Corbis

Understanding how nursing homes operate can help your loved one receive the best care possible.

To receive the best care in a nursing home, it’s important to know how such facilities operate. If you understand the residents’ rights and the best ways to communicate, you are more likely to be able to resolve problems and ensure that your parents and loved ones have a good experience.

See also: How to find the right nursing home. 


Be proactive

Friendly, open communication and relationships with nurses, the social worker, the administrator and other staff can often help keep small problems from becoming serious.

Family councils

Medicaid and Medicare nursing homes are required to allow families to form family councils that can meet privately in the facility. Ideally, the family council is a place for families to talk freely and present concerns to the staff. Find out whether there is an established family council already meeting. If not, think about starting one.

Care planning meetings

Periodically, nursing homes must hold care planning meetings with a team of staff members to discuss residents’ needs and possible changes in care. Residents and their family members can participate in these meetings. Ask about the next meeting and who will be attending, and feel free to request that other staff members attend. You can also invite the long-term care ombudsman, a member of the clergy or a close friend to provide support.

Solving problems

Often families won't bring up complaints about subpar care for fear that someone will take it out on their loved one. However, nursing home workers themselves say that families who call attention to problems get results.

Try the following suggestions to confront problems:

  • Use the care planning conference to discuss problems with staff. This meeting creates a natural setting to address concerns without raising them to the level of a complaint. 
  • When making a complaint about a staff member to a supervisor, share any concerns about retaliation.
  • Work with the family council to address problems in the nursing home. 
  • Solving problems can be more effective when working in a group.

If the nursing home is poorly staffed or managed, you may need to take your complaint to a higher level. Don’t hesitate to take a complaint outside the facility if the nursing home is not responsive. Keep a written record of when the problem(s) occurred and who was involved to help in filing your complaint.

You can contact the following for advice or investigation of complaints dealing with nursing homes:

Protecting rights and dignity  

Too often, people lose even the simplest rights when they become nursing home residents, such as privacy when they bathe, freedom to visit with friends, or choice of what to wear. The Nursing Home Residents’ Bill of Rights was designed to help make sure people can keep their privacy and dignity. It protects rights as basic as whether staff members knock before entering a resident’s room. These rights apply to all residents who live in Medicare-  and Medicaid-certified nursing homes.

Expecting good care from the nursing home system

When care is poor, it usually is because the nursing home fails to hire or keep enough qualified licensed nurses and nursing assistants. It is understandable to sympathize with overworked nursing staff, but good care should be expected.

Sometimes neglect can result in dangerous medical conditions. Here are serious signs to watch for:

  • Dehydration;
  • Malnutrition;
  • Bedsores
  • Physical restraints;
  • Chemical restraints (drugs used to control a resident’s behavior);
  • Contractures (muscles that are becoming too stiff to move easily).

Do not accept behavior toward a loved one that is abusive, including rough treatment or unkind words. If supervisory staff members do not act immediately to fix a problem, contact one or more of the following authorities:

  • The long-term care ombudsman; 
  • The local adult protective services agency;
  • The police.

You may also like: Speak out on the future of Medicaid and Social Security. 

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