What Questions Should I Ask?

Assessing a Nursing Home or Assisted Living for Person-Directed Care

Finding a place which implements person-directed care can be difficult. Here is a set of questions that we have developed to help families determine whether or not a nursing home is engaged in person-directed care.

Person-directed care allows the elder to make their own choices, continue familiar routines and maintain their dignity after moving into the new setting — or in other words, be at home wherever home may be.  Below are some questions you should ask when visiting a nursing home or an assisted living care community.  Just click on the down arrow to the left of each question to read the answer.

Key Questions to Ask the Staff in Nursing Homes to Find Out If They Provide Person Directed Care

Download a copy of Key Questions to Ask Nursing Home Staff.

What should I look for on a tour?

To get a feel of the tone of the nursing home during your “walk-about,” look at the colors (furniture, walls, floors), lighting, real or artificial plants, bird cages and fish tanks, other animals, smells, lighting, signs, elements of privacy, options for sitting alone, conversation areas, and individuals’ facial expressions. Are staff and individuals interacting in what looks like interest and kindness?

How can I assess activities, services, and quality of care?

Look at the types of activities that are posted. Check to see if Resident Council and Family Council materials, and ombudsman contact information, are posted in obvious places and at a level where a person in a wheelchair could read them. The last report of the state survey should be available for you to review. Talk to individuals and families when you are visiting. Ask them how they feel about the place and if they would recommend it. Remember that if you ask this in the presence of a staff person, individuals may fear sharing negative comments and so may give you an inaccurate impression.

Key Questions to Ask the Staff in Assisted Living to Find Out If They Provide Person Directed Care

There is a need to ask more specific questions about person-directed care and what the assisted living community is doing, if anything, with person-directed care. Listed below are some general and specific things to ask and to listen for in the response. These are not the only “correct” responses, but they will give you a general idea of what you might hear that indicates work toward creating home for individuals.

Download a copy of Key Questions to Ask Assisted Living Staff.

What should I do on a tour?

Show up 10 minutes early for the tour and sit and wait patiently and observe general feel of place and environment. Talk to individuals and families when you are visiting. Ask them how they feel about the home and if they would recommend it. Remember that if you ask in the presence of a staff person, individuals may fear sharing negative comments and so may give you an inaccurate impression. Ask to see the assisted living community’s most recent state survey–even if you have already seen it online.

What should I look for in a surprise visit?

If after the tour, you are sincerely interested in the home, return for an unannounced visit preferably during a meal or scheduled activity. How does the staff handle your surprise visit? Do things look different than they did during the tour? Talk to individuals and family members without staff present to find out how they like the home.

Developed through the support of the Picker Institute, adapted with permission from the work of David Farrell and the California Culture Change Coalition.