8 Common Mistakes When Selecting a Nursing Home (and How to Avoid Them)
If you’re in the process of selecting a nursing home for an aging loved one, the decision is often emotional. This decision-making process can impact every aspect of the senior’s life, from their health to their ability to socialize and their comfort level and dignity. It’s a process filled with uncertainty, stress, and sometimes guilt. I know how overwhelming it can be. In fact, I’ve walked with many family caregivers through this process and helped them navigate questions and uncertainties.
In the process of listening to and helping my clients and their families, I learned a lot. Now, I want to share those lessons with you to help you avoid the common pitfalls families often encounter.
1. Rushing Care Decisions
Many families first consider nursing home care for a parent or aging loved one when a doctor diagnoses a chronic medical condition or their health status makes it unsafe to stay at home any longer. Pressure mounts when the clock is ticking. Maybe your loved one experienced a fall, which is the leading cause of injury among older adults. Or maybe they suffered a stroke and had to be hospitalized. Whatever the case, that incident probably made you realize that home is no longer safe. The urgency you feel makes it tempting to go with the first facility with an available bed. Try not to make that mistake.
Nursing home care is a long-term decision. Making a quick choice without thorough research can place your your loved one in a less-than-suitable situation. A poor choice can cause regret, stress, and anger. Worse still, it can even disrupt family harmony!
Tip for Avoiding this Mistake:
Proactively planning for nursing home care is the best way to avoid this problem. Even if you don’t feel like you’ll need nursing home care anytime soon, start researching facilities in your area. Tour a couple. Check reviews. Ask friends and neighbors what facilities they’ve chosen. If you’re in a crisis and don’t have the luxury of time, ask the hospital discharge planner for multiple recommendations and enlist help from family and friends to visit each of them before deciding.
2. Limited Visits to Tour the Facility
A nursing home might seem perfect for your senior loved one when you visit for a scheduled tour, but what happens in the evening and after shift change? Are there enough nurses and nursing assistants on staff? Do residents receive proper assistance and care during mealtimes? What about when they need a nighttime bathroom break? Are there appropriate evening activities for seniors who prefer to keep later hours? You can’t get the full picture of living in a facility with just an hour-long visit and tour, especially when it’s scheduled and the staff is waiting for you. Those after-hours and unscheduled visits are essential to get the complete picture.
Tip for Avoiding this Mistake:
Schedule a couple of visits—morning, afternoon, or evening. Then, plan to drop by once or twice unannounced. Start by gauging how welcome you feel by the receptionist and other staff during those unplanned visits.
Watch closely to see how the staff interacts with residents when they aren’t expecting visitors. Are they calling residents by name? Are their responses attentive and friendly? What does the posted activities schedule look like in the evening hours? Is the facility maintained properly, with dishes removed and trash picked up? Observations during several visits can give you a clearer idea of what day-to-day life will be like if your aging loved one is in the facility.
3. Misunderstandings About Staff-to-Resident Ratio
One of the biggest complaints in nursing homes is understaffing. If each caregiver is responsible for more residents, seniors in the facility are less likely to receive proper care promptly. This can lead to missed meals, medication errors, an increased risk of slips and falls, or neglected hygiene. Unfortunately, staffing issues are a big concern in nursing homes, and turnover rates can be high.
Tip for Avoiding this Mistake:
When you visit a facility, ask about the staff-to-resident ratio, especially on nights and weekends. A good rule of thumb is that lower numbers mean better care. The Centers for Medicare and Medicaid Services’ federal minimum requirement is one nurse for every 20 residents, and an RN must be on-site 24 hours a day. The best facilities often exceed this standard.
4. Focusing Solely on Appearance
Some of the best nursing homes I’ve visited aren’t the fanciest, but they have low patient-to-staff ratios and dedicated, compassionate staff who genuinely care about their residents. While fancy furniture, a new building, and top-of-the-line technology make a nursing home look stunning, focus on the overall picture and the care your loved one will receive. It’s far more important than how new the couches are or how fancy the artwork is.
Tip for Avoiding this Mistake:
Instead of judging the senior living facility by looks, focus on how residents and staff interact. Are residents engaged and happy? Does the staff seem committed to care or rushed and irritated by their jobs? Do nurses and caregivers address residents by name?
Is the social worker ready to speak with families and interested in hearing about your loved one’s needs and goals? If there’s a memory care unit, does it feel home-like and comfortable? These signs are much more important than a modern reception desk or intricate tiled or hardwood floors.
5. Failing to Consider Activities and Social Life
A nursing home isn’t just a place for receiving medical care and managing activities of daily living (ADLs) —it’s your loved one’s home! It must feel comfortable and engaging to create a higher quality of life for residents. Social isolation is a significant issue in some nursing homes, and if residents aren’t provided with engaging activities, their mental, emotional, and physical health can decline quickly.
Tip for Avoiding this Mistake:
Research teaches us that there are three pillars to preventing loneliness and isolation in a nursing home. They include maintaining ties to one’s earlier life, engaging in activities, and building social ties in the facility. Help your loved one to realize the advantages of doing these three things.
Ask about visitation hours to ensure they work with your family’s schedule. Discuss strategies that are in place to help residents make friends and interact with each other. Request to see the activity calendar. Are there daily interactive events? Is there a comfortable and inviting common area where residents gather? Does the facility offer outings, music, art, or games? The best facilities provide a variety of activities that cater to different interests.
6. Forgetting About Nutrition and Food Quality
Meals are essential and oftentimes joyful. Poor-quality food can make your loved one’s life in a facility miserable. Some facilities try to meet residents’ health and dietary needs for low-fat or no-salt foods by serving bland, repetitive meals. The choices might not be appealing or nutritious.
We all need variety and flavor in our diet. If your aging loved one doesn’t have those two things, they might stop eating because they don’t like the food. This can quickly lead to mental and physical decline and other serious health problems.
Tip for Avoiding this Mistake:
Visit the facility during mealtime and request to spend time in the dining room and be served a meal. Is the food appetizing? Are your requests for seasoning or other choices honored? Are there options for different dietary needs, such as a vegetarian, kosher, heart-healthy, or diabetic diet?
Ask residents if they enjoy their food. A quality nursing home will welcome the opportunity to showcase its dining experience and prioritize nutrition and taste.
7. Not Understanding All Costs and Fees
According to Statista, in 2024, US nursing homes had an average cost of $10,000 a month for a private room and $8,929 for a semi-private room. Prices varied greatly by area and state, but the bottom line is that nursing home costs can be staggering. Many families aren’t prepared to tackle their complex nature or the associated financial burden of receiving long-term care.
Some facilities aren’t transparent about their fees, and families end up shocked by unexpected charges. Medicaid and Medicare may not cover everything, and some facilities may not accept one government health payment program or another. This can quickly leave families scrambling to figure out how to come up with funds and pay out of pocket.
Tips for Avoiding this Mistake:
Spend some time in the admissions office when you visit a nursing home and get a detailed breakdown of costs in writing before making any decisions. Speak with the social worker about applying for Medicaid coverage if that’s applicable. Some facilities assist families through this process.
Ask what’s included in the base price and what, if any, services require extra fees. Find out about any specific policies related to costs if your loved one is sent to the hospital or needs hospice care. Even if these aren’t immediate needs, it’s best to prepare yourself for any situation.
8. Forgetting to Let Your Gut Guide You
At the end of the day, choosing a nursing home is a deeply personal decision for every family to make. A facility that is perfect for one senior may not be the right choice for another. Spend some time meeting with staff and touring the nursing homes, and if something feels off—whether it’s the age of the furnishings, how nurses interact with seniors, or even just a bad feeling—pay attention to your gut. I’ve learned that instincts are usually right, and you can end up with some big regrets if you try to ignore them.
Tips for Avoiding this Mistake:
Hesitations can be related to a lot of things, from genuine concern to the stress of having to move your loved one into a facility. If you experience them, step back for a moment and reassess. Ask the senior or another family member how they are feeling.
There’s no harm in checking out a different facility if something doesn’t sit well with you. Your loved one’s well-being is too important to quickly write off negative thoughts or settle for anything less than the best possible care and quality of life.
Takeaway
Moving your aging loved one to a nursing home is never easy. Fortunately, awareness of these common mistakes can help you make an informed and confident decision. If you have the time to tour multiple facilities, do so. If you don’t, ask the hospital discharge planner and trusted neighbors and friends for advice. Visit the facilities and ask plenty of questions. The best nursing home is one where your loved one will feel safe, respected, and cared for, and finding it isn’t impossible if you do your homework and trust your gut.
Image Credit: PixelsEffect @ Getty Images | Getty Images | Shutterstock
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Originally published March 25, 2025
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