5 criteria to consider when picking the right nursing home for your parents

Of all the issues facing Singapore, the biggest elephant in the room is the rapidly ageing population. Almost 20 per cent of the populace will be 65 and over by 2030, with that number doubling to nearly 40 per cent by 2050. At the national level, it's a concern that will gradually reduce economic output and raise eldercare costs.

At the individual level, however, this issue brings up another tough question - how will you care for your ageing parent(s) once they need living assistance?

Depending on your situation, a nursing home may be the only way to ensure your parent(s) receive the attention and care they need. Unfortunately, bad headlines and abuse cases have tarnished their image.

So how can you be sure you're sending your parent(s) to a good nursing home? Look at the below 5 criteria:

1. ACCESSIBILITY OF THE NURSING HOME

Accessibility means choosing a nursing home that's conveniently located close to where you live so you can visit your parent(s) quickly and easily. Just imagine how difficult visiting would be if you lived in Bedok while your parent(s) stayed at a nursing home in Woodlands or Johor Bahru.

Accessibility is also about selecting a place with longer visiting hours, allowing you the flexibility to visit in the early hours of the morning or late at night. But there's another reason why accessibility is so important - visiting regularly (especially unannounced) can impact on the quality of care your parents receive. Why?

Two reasons:

- Staff notice that you visit frequently and are more conscious of the care given to your parent(s)

- You can directly observe your parent(s) treatment and point out any shortfalls in care provided by staff (ex. calls for assistance go unanswered)

You can use the Silver Pages Eldercare Locator to find the closest nursing home to your residence. Shortlist a few near you and schedule a tour/visit so you can see the place for yourself.

2. CONDITION AND ATMOSPHERE OF THE NURSING HOME

Open your eyes and your ears when you visit the nursing home for the first time. Be like Sherlock Holmes and pay close attention to cleanliness, condition and atmosphere of the nursing home.

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Does the place look like a clean and tidy home, or a hospital? Does the place smell pleasant? Does it have natural light?

Is it elderly friendly with handrails and wheelchair accessibility? What kinds of recreational activities does the facility provide to enhance their quality of life? Are the security measures sufficient? An atmosphere that is warm, social, and welcoming will help your parent(s) adjust to their new home.

Make sure you don't leave without viewing the rooms! Are the rooms tidy and well-maintained, with elderly-proof features like handrails? Some facilities may have different rooms available ranging from private rooms to rooms housing 2, 4, or 8 residents. Observe if there's enough space for each person in shared rooms, or if they're overcrowded and unclean.

3. SOUND LEVELS OF THE NURSING HOME

At first glance, everything may seem fine and dandy, but you may also want to stop and listen to the sounds of the nursing home. Sounds don't affect visitors who're just taking a look for 15 minutes, but if you're staying in that place for a long time, they will affect the quality of life.

Is the nursing home quiet and peaceful, or are you bombarded with noise from loud televisions, radios, or residents constantly crying out for staff assistance? Do you hear staff regularly interacting with patients, or gossiping loudly with each other? If your parent(s) are social, selecting a nursing home with more engaging staff is preferable. If your parent(s) favour peace and quiet, a more tranquil place (or a private room) would be better.

4. QUALITY OF THE FOOD

Food is a big creature comfort so it is important to ensure that the nursing home that you have shortlisted are able to serve food that is palatable your parents.

The mealtime environment is also a clue into the social dynamics of the place. If you can, you can request to take time to eat with them.

Observe these things: Does everyone eat together at the same time, or at their leisure? Do people eat in peace, talk with other residents, or argue with each other? Is the food comparable to something you'd eat at home, or is it something a prisoner locked in solitary confinement at Changi Prison wouldn't touch? Also, ask whether they can provide for special diets based on religious, health, or ideological preferences.

5. ARE THE STAFF HAPPY?

If a nursing home is understaffed, you can quickly see it on the faces of the staff. Are the staff members overworked, do they smile when they greet the elderly? Are able to remember the names of the elderly they care for?

Don't simply look to the people in admissions or the person who is giving you the tour. These people already want to impress you. See if you can talk to the nurses, the caretakers and the cleaners who deal with the residents on a daily basis to check about their experience working there.

If there is hesitation, it's probably a warning sign that they're hiding something.

Some questions to ask include:

• How long have you worked here?
• What credentials or training do you have?
• Do you take time to get to know each resident personally?
• Can you tell me a little bit about some of the residents?
• How do you handle medical emergencies?
• How do you handle residents with special conditions like dementia?

STAFF-TO-PATIENT RATIO

During the tour, observe if there are enough staff members to manage the residents living there. A horrible staff-to-patient ratio will be pretty obvious if there are multiple residents asking for assistance but not enough caretakers/nurses to help. Even if the place looks well-staffed, ask if the staffing levels are always constant or change during the evenings and weekends.

STAFF TURNOVER

While nursing homes generally have a high turnover rate (hey, it's a tough job), a turnover rate that's too high (50 per cent and above) almost always means that residents will suffer as a result. Because no matter how dedicated the experienced staff are, there's not enough of them to care for everyone. And inexperienced staff are more prone to making harmful mistakes (i.e. giving the wrong medication, not recognising illness symptoms, etc.).

FINAL NOTES

The cost of sending your parent(s) to a nursing home can be steep, ranging from $1,200 to $4,500 per month without government subsidies. Many factors such as room type (private room vs. 4-person room, etc.) and special medical needs (dementia, Alzheimer's disease, etc.) contribute to the cost.

Depending on your income, you can apply for and receive subsidies under Medifund and Eldershield that will cover 10 per cent - 75 per cent of nursing home fees. For more information, you can visit the Silver Pages website to speak with a client relations associate on their Online Helpdesk.

Making the choice to place your parent(s) in a nursing home is never an easy decision. Remember that there are some alternatives to putting your parents in a nursing home, and the ultimate choice falls on you and your parents.

This article was first published in MoneySmart.