Denver, CO 

Quality of life is one of the most important factors to consider when choosing a nursing home. Quality of life has many different definitions but should include such things as resident respect and dignity, individual control of one's own life, homelike atmosphere, sensitivity to resident individuality, stable staff, and adequate training and career advancement for staff.

Experts tell us that your first impression of a long term care facility is the most important. The facility may meet your needs if you feel comfortable and there is a feeling the nursing home is under control, rather than disorganized and chaotic. When searching for a long term care facility, individuals should be aware of halls cluttered with laundry bins and medicine carts, as well as loud noises throughout the building. If these are bothersome to your family member or you, they probably will not "go away."

Institutions usually are very routinized -- there are set schedules for meals, naps, wake up times, bathing and going to sleep. Check with staff about individual choice at varying these daily routines. Ask other residents if they are able to make choices about the meals they eat and when they dress themselves. Most nursing homes encourage residents to bring personal items in an attempt to make the room a more homelike atmosphere.

Individuals who live in long term care facilities often are able to control very few activities in their lives. Food and meal times become very important social times. Families should look at the type of dishes; the variety of the menu, including ethnic foods; and the dining room atmosphere when selecting a nursing home.

In long term care facilities, the capacity to provide for special needs of the residents is important. Staff should respect the privacy and knock before entering a resident's room. Privacy becomes an extremely important issue for many residents in nursing homes. Sharing space including a bathroom, sinks, and bureau space often becomes very challenging in a nursing home. Older adults do not feel at home because they are unable to "claim private space" for themselves. This is especially difficult because nurses enter the room to provide medical services and medications; aides and orderlies enter the room to clean the bed, scrub the floors, put away the laundry and clean the bathrooms. Social workers and activity directors enter the area to invite the resident to join in activities or to ask lots of questions.

Although all of these individuals are "just doing their job," these intrusions into private space can be very annoying to an older person, especially someone who has lived alone for many years and is very set in their personal routines.

Staff attitudes in long term care facilities are critical. As you are touring the facility, observe how the staff interact with other residents, staff and visitors. As you visit, determine if staff are happy to be working in the facility. And lastly, look to see if the administrator is visible and involved in the facility. The administrator sets the tone for the rest of the staff and residents!

For a questionnaire on what to ask about quality of life issues when visiting a nursing home, call 303-333-3482 or send a self-addressed stamped envelope to have your personal copy of "The New Image in Long Term Care Facilities -- A Guide for Visiting" mailed to you. For detailed information regarding nursing homes licensed in the state of Colorado, see the Colorado State Health Facilities Information website.

Eileen Doherty is the Executive Director of the Colorado Gerontological Society and Senior Answers and Services. She has worked in the areas of policy, clinical practice and education in gerontology for more than 20 years. She can be reached at 303-333-3482.