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.

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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.


12 Responses

  1. Ashley Maxwell

    I like how you said that you should look for a nursing home that is licensed. I also like how you said that the caregivers should be experienced and well trained. My mother will soon need to go to a nursing home, so I am trying to help her find one with skilled workers.

  2. Jordan Curry

    Moving loved ones to a nursing home can be a process. I liked how you said that it’s important to trust the staff and to have a relationship with the staff and what makes it stand out from others in terms of hospice. Hospital care is so important for loved ones if we ever need to look into this in the future we will be giving a great assisted living facility a call!

  3. Ernest London

    I like that you mentioned to ensure the nursing home you choose does a background check on all of their employees. We are trying to find the right nursing home for my grandmother, because she can’t live on her own any longer. I want to be completely sure that the people caring for her are reputable and respectable, so this is definitely something I will ask about. Thanks for sharing!

  4. Finley Moreira

    I thought the questions you provided were all very helpful for finding a good nursing home. My wife and I have been talking lately since her mother might need to move into an assisted living facility in the near future. Your questions about proper training and licensing of employees will definitely be something we’ll focus on when finding a good home for my mother-in-law.

    • Stan Goldberg

      Hi Finley,

      I’m delighted to hear that my article is helpful. I know how difficult and stressful it is to find an appropriate place for a relative.

      take Care,

  5. Lauren Jones

    My great aunt just had a stroke and is having a hard time getting along on her own. We think that a nursing home would be a great option for her. It is good to know that one should ask the facility if a background check has been run on each employee before committing to their work. I also like what was mentioned about asking if they are licensed by the state. Thanks for the information.


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