Earlier, sending parents to the nursing home or elderly care home has been seen as an almost sinful act by society. But now the time has changed. It has turned a crucial need in the current society. Children working abroad or migrated abroad; the need for nursing care; children busy with work and some other societal and economic changes have contributed to the demand for elderly care or nursing homes. It is good news to children that it is no more perceived as an act of abandoning your loved one rather an act of care to seek for better care and environment for the loved one.
But how sure are we giving better care at the facilities?
We do visit and consider a few homes before choosing one out of our list. But most of the times, we are deceived by the exterior look of the home or friendly staffs/owners. We only start to realize poor service after our elderly started to stay in the home. It is not an easy process anyway to shift from one home to another after realizing poor services.
Here are 7 things recommended to consider when you are choosing a nursing home or elderly care home for your loved one:
- Licensed home
There are plenty of elderly care homes blooming in the market.
Official records in the Health Ministry only show that 268 nursing homes in the country are registered compared with some 1,000 that are operating unlicensed . Majority of us do not look into this criteria but we need to understand that it makes a lot of difference in the deliverance of safe care for the elderly as the licensing requirements include crucial elements such as infrastructure safety, emergency plans, nursing requirements, facilities occupancy and staff to resident ratio. Find the link below to anticipate what could happen if a home operates without licensing:
Licensing is the best way to ensure that the residents are receiving the best kind of care. In regards, we need to understand the licensing/ registration difference between the old folk’s home and nursing home.
Old folks home: Need to be registered with Jabatan Kebajikan Masyarakat (should not admit residents requiring nursing care of any extent)
Nursing home: Need to be registered with Kementerian Kesihatan Malaysia (suitable for patients requiring nursing care)
Be aware to ask the right questions to get to know the facts.
- Qualified nurse
Most of the homes claim to provide 24hour nursing care but in fact, they do not even have a qualified nurse in the team to provide the service. They just provide the required nursing care using caregivers (sometimes untrained maids) and claim to provide 24-hour nursing care in their advertisements. Therefore, as consumers, we need to be aware of the reliability of the service that we are receiving.
- Trained caregivers
Currently, the country is flooded with foreign workers as all of us are aware of. Nursing home industry is not exceptional to rely on the need for foreign maids to serve the elderly. But we need to ensure that they are properly trained to do the job. We need to be aware that caring for the elderly is a skillful job and it could not be done professionally without proper training. For instance, it involves the right method to carry a patient, giving medication, hourly turning for bed sore patients, fall prevention and emergency management. Most nursing homes claim to have certified nurses but again we need to ask the right questions to know the facts
- Activities incorporated into the daily routine
This aspect is often overlooked. Maybe afternoon/ evening would be the right time to visit the homes you are having on your list. It is common to see the crowd of residents circling just watching people coming and going through the front door, just being parked on a wheelchair in front of the television or being tucked in the room alone. Though it is common, it is not a good quality of a quality nursing home. Nursing homes of good quality have a daily schedule of activities which the elderlies can participate as productive daily routine contributes to the mental health of the loved ones staying in a long term care setting.
In the case of room bound, the activities need to be brought to the room to ensure participation because study has proven that social isolation and exclusion are associated with an increased rate of poorer chances of survival after a heart attack and people who get less social and emotional support from others are more likely to experience less well- being, more depression and high levels of disability from chronic disease.  Therefore, as children we need to ensure to pay a visit to the loved ones in the long term care setting as much as possible.
- Staffing ratio
Definitely, most of the current nursing home/ old folk’s home operators are profit concerned therefore the element of the operation mainly chosen to cut cost is staffing. Therefore it is our responsibility towards our loved one to ensure proper staffing at the facility which we are admitting them as staffing ratio has a linear relationship with the care provided. Find the ratio guide below for your reference:
- Ratio for acute cases 1 Staff Nurse: 1 patient (Sufficient number of registered nurses on duty at all times) 
- Ratio ≥ 1 nursing staff (plus personal aide) to 4 chronic patients (long-stay, geriatric, rehabilitation, psychiatric or convalescent care or service) 
- 1 personal care aide: 14 patients 
A good diet and adequate food supply are central for promoting health and well-being.  Therefore ensure to observe this factor when you do your visitation. Make a second visit without calling ahead during meal time. Most of the nursing home websites upload food and mealtime pictures from the internet to deceive the clients, so trust only what you see before your eyes.
- Bedsore and infections management
This is a crucial box that you need to tick before admitting your loved one to a nursing home.
Bedsores are often inevitable, especially for bedridden and frail residents as they become older. Be sure to ask about the procedures for rotation, fall prevention care procedure and other basic infection management.
“Scabies can be a problem, particularly in nursing homes. Many may not regularly screen or check patients, staff, and visitors for scabies or clean bedding, towels, furniture, clothing, carpets, or other items. One scabies case in a nursing home can soon lead to dozens or hundreds of scabies cases. Therefore, when you are considering nursing homes, ask about their scabies screening procedures.”
It is recommended to speak to the existing residents at the homes to get the real picture. Do all you can to get the assurance that a nursing home is really taking care of its residents as crucial things can’t be seen quite as readily. This is the only way to prevent any loss or regret in the future.
Wilkinson, R.G. and Marmot, M. eds., 2003. Social determinants of health: the solid facts. World Health Organization.
Standard On General Requirement [Pdf]. (n.d.). CKAPS-ICL-General Requirement (Ver. Oct 2016).
Before You Use A Nursing Home, Make Sure It Does Not Have Scabies-Bruce Lee - https://www.forbes.com/sites/brucelee/2018/04/28/before-you-use-a-nursing-home-make-sure-it-does-not-have-scabies/#2bd5901c6418