by Stan Goldberg. Originally published by, January 23, 2016
There may come a time when, despite wanting to care for your loved one, it may not be possible. Either you’re physically unable or the emotional strain on you has become unbearable. Placing a loved one in a nursing home is difficult, especially when a loved one pleads to remain at home. But allowing him to remain at home might endanger him or be so punishing for you that you are no longer able to competently serve him.

Which Nursing Home and When?

One of the most painful decisions a caregiver may have to make is when and where to place a loved one when home care is no longer possible. Unfortunately, the decision is often made during a health crisis when bed availability rather than the nursing home’s quality becomes the most important selection criteria.

In some cases, the stars are aligned and the selection of a nursing home is ideal. What your loved one needs and what’s available matches perfectly. But that happens more often are instances were caregivers are faced with the immediate necessity of an out-of-home placement? In too many of these situations, the nursing home selected is one with an available bed or affordable fees. Rarely do the stars align, and the results are guilt over a less than ideal placement.

Avoid Making a Crisis Decision

To avoid making a crisis decision, you can do two things. The first is explore what’s available in your area long before you need to make a decision, even if you’re convinced you’ll never place your loved a nursing home. What is unimaginable today may be a necessity tomorrow. Second, ask specific questions of the facilities you might consider.

An excellent source of general questions relating to quality and safety can be found at Although the site specifically discusses nursing homes, I believe most of the questions are appropriate for all care facilities. Below is a list of questions suggested to me by professionals, family caregivers, managers of reputable facilities, and patients who experienced both great and less than adequate care.

1. Are you licensed by the state/or a national association?

2. Are your employees bonded?

3. Has a background check been run on every employee?

4. Can I see the background check of the person(s) who will be assigned to my loved one?

5. How much training do your caregivers have?

6. Have there been any complaints against your agency or employees, and if so, how were they resolved? (available from you state-licensing agency).

7. Are your employees required to seek continuing education?

8. What services can my loved one expect, and how often will they be given?

9.What is the total monthly cost?

10. Do you have special certifications (i.e., Alzheimer’s)

11. What is your staff turnover rate?

12. What is your ratio of caregiving staff to patients?

13. Do you have any formal relationships with hospice organizations?

14. What is it about your facility that makes it stand out from others?

You may find it uncomfortable asking these questions. But reputable agencies and facilities will understand why you’re asking them. If you meet resistance, the resistance itself may indicate problems the agency or facility might not want to disclose.

Concluding Thoughts

The future is always in a state of flux. What you may now believe to be unthinkable may be a necessity in the future, especially when it concerns the placement of a loved one. The earlier you prepare for the worst, the more comfortable you’ll be if it happens, and the more delighted you’ll be if it doesn’t.


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Family Conflicts During Health Crises: 13 Best Strategies To Prevent Them