Choosing a nursing home

If the person in your care is no longer able to function independently, you'll need to consider the options, including a nursing home. What makes a nursing home different from other eldercare choices is the fact that a patient will be under the 24-hour care of licensed or registered nursing staff (in a skilled nursing facility) or of certified nursing assistants (in an intermediate care facility).

In addition to nursing care and room and board, a nursing home also provides assistance with what's known as "activities of daily living" -- dressing, bathing, grooming, toileting, walking, and so on. Physical therapy and activities are usually included. But make sure you're clear on exactly what services are provided before signing the contract.

Decide what kind of nursing home fits your needs

If the person you're caring for has a medical condition that requires continuous monitoring -- anything from a feeding tube or respirator to an ongoing need for physical or occupational therapy -- he'll likely need to be in a skilled nursing facility. If his main need is for ongoing help with activities of daily living, then an intermediate rather than a skilled facility may suffice.

Sometimes patients transition from the hospital to skilled nursing and later to intermediate care. Some facilities have both skilled and intermediate wings. Each facility will have intake planners who can help you evaluate his needs and find the right level of care.

Narrow down your nursing home choices

If a patient is going to a nursing home after a hospitalization, the hospital will have a social worker known as a discharge planner who can help you find a facility. But there's no substitute for doing your own legwork.

One quick way to find nursing homes in your area is through Caring.com's local resources tool or through HealthGrades.com's nursing home ratings tool. (You'll pay a fee to use Healthgrades' service.) By analyzing information from state inspections and consumer complaints, HealthGrades ranks nursing homes on a five-star system and offers a detailed report on everything from cleanliness and diet to "dignity and respect of each resident" to how often patients typically get bedsores.

Check out a nursing home's reports

Each nursing home is required to keep copies of state licensing reports on-site and to show them to you at your request. Once you think a home is a good possibility, take a close look at it. You can also call your state or local long-term care ombudsperson and ask if there have been any substantiated complaints against the home you are considering. (An unsubstantiated complaint in itself, with no other red flags, may not be reason enough to steer you away, as complaints are fairly common.)