Dear Savvy Senior,

Can you give me some tips on picking a good nursing home for my mother who has Alzheimer’s disease? I’ve been taking care of her at home, but she’s gotten to the point where she’s too much for me to handle.

Overwhelmed Daughter

Dear Overwhelmed,

Choosing a good nursing home for a loved one with Alzheimer’s disease is a very important decision that requires careful evaluation and some homework. Here are some steps that can help you find a good facility and avoid a bad one.

Make a list: There are several sources you can turn to for referrals to nursing homes in your area: Your Area Agency on Aging (call 800-677-1116 for contact information); your mom’s doctor or nearby hospital discharge planner; or friends, family or neighbors who may have had a loved one in a nursing home. Ideally, the nursing homes should be close to family members and friends who can visit often, because residents with frequent visitors usually get better care.

Compare nursing homes: To research and compare the nursing homes on your list, use Medicare’s nursing home compare tool at medicare.gov/nursinghomecompare. This tool provides a 5-star rating system on recent health inspections, staffing, quality of care, and overall rating.

You should also contact your local long-term care ombudsman. This is a government official who investigates nursing home complaints and can tell you which ones have had problems in the past. To find your local ombudsman, call your Area Agency on Aging or see ltcombudsman.org.

Contact the facilities: Once you’ve narrowed your search, call the nursing homes you’re interested in to verify that they have a dementia unit that can facilitate your mom’s needs. Also, find out if they have any vacancies, what they charge, and if they accept Medicaid.

Tour your top choices: During your nursing home visit, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the residents and their family members, if available. It’s also a good idea to visit several times at different times of the day and different days of the week to get a broader perspective.

Also, find out about their staff screening (do they do background checks) and training procedures, staff-to-patient ratio, and the staff turnover rate.

To help you rate your visit, Medicare offers a helpful checklist of questions to ask at medicare.gov/nursinghomecompare/checklist.pdf, as does the Alzheimer’s Association at alz.org/visitinganursinghome.pdf. Print these lists from your computer and take them with you on your visit.

Paying for care: With nursing home costs now averaging $250 per day nationally for a private room, paying for care is another area you may have questions about or need assistance with. Medicare only helps pay up to 100 days of rehabilitative nursing home care, which must occur after a hospital stay.

Most nursing home residents pay for care from either personal savings, a long-term care insurance policy, or through Medicaid once their savings are depleted.

The National Clearinghouse for Long-Term Care Information website (longtermcare.gov) is a good resource that can help you understand and research your financial options. You can also get help from your State Health Insurance Assistance Program (SHIP), which provides free counseling on all Medicare and Medicaid issues. To find a local SHIP counselor visit shiptacenter.org, or call 800-677-1116.

For more information, see Medicare’s online booklet “Your Guide to Choosing a Nursing Home” at medicare.gov/publications/pubs/pdf/02174.pdf.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of The Savvy Senior book.