"I'm sorry, your mom really needs to go to a nursing home …"

Those are tough words for a daughter or son to hear, and tough words for a health care provider to say. The look of panic on the faces of family members and patients often leaves nurses reaching out to comfort and wondering how to help.

Lori Popejoy, GCNS,RN, Mary Zwygart-Stauffacher, Ph.D., RN, and I-researchers at the University of Missouri-Columbia and the University of Wisconsin-Eau Claire-have written The New Nursing Homes: A 20-Minute Way to Find Great Long-Term Care that lists features to look for when choosing long-term care for loved ones.

We have summarized this information in an observation guide for consumers to use as they walk through facilities. The guide includes questions to ask residents, their family members and staff, and comes with "correct" answers.

Families are advised to visit several facilities, take a quick 20-minute walk through each one, and use the observation guide to determine the quality of care. Decisions about long-term care are best made based on the quality of care, not just bed availability or location.

We list seven signs of high-quality nursing facilities (nursing homes, assisted living, residential care):

A homelike setting. A nursing facility should feel like a home, not an institution or hospital. Residents' rooms should have plants and personal items from their previous homes so each resident can identify the room as his or her own.

Excellent care. In a quality nursing facility, staff stay on top of the fundamentals of care, helping residents to bathe, eat, dress and go to the bathroom. Residents should have a variety of activities to engage in, such as discussion, Bible study groups and games. Meals should look appetizing and smell good.

Family involvement. Good facilities encourage families to get involved with the care of their loved ones. Families who work closely with staff members feel more confident that their loved ones are receiving the personalized care they want and need.

A pleasant environment. A nursing facility should be clean, spacious, not too noisy and odor-free. Furnishings and equipment should be functional and well-maintained.

Good communication. There should be positive verbal and nonverbal communication between staff and residents. Quality staff members will talk with and listen to residents. It should be obvious to someone walking through a facility that residents are comfortable with the staff caring for them.

A committed staff. Staff members should be responsive, compassionate, clean and well-groomed. They also should remain employed at a facility for several years. Registered nurses should be closely involved in monitoring health conditions of the residents, and nurses who specialize in geriatric care should supervise their care.

A central focus. Good nursing facilities not only focus on residents and their family members but also on the community by participating in local events, soliciting community support or sponsoring educational programs, such as those about healthy aging.

The options available for people needing long-term care today range from skilled rehabilitation, to traditional nursing home care, to assisted living, to in-home services.

Making decisions about long-term care is stressful for families, but it can be made much easier armed with the right information. Knowing what to look for helps make this emotionally charged decision more objective.

For more details about The New Nursing Homes: A 20-Minute Way to Find Great Long-Term Care, visit nursinghomebook.com.
The book is available for $14.95 in bookstores or can be ordered from Fairview Press at (800) 544-8207.

Contact Marilyn Rantz at rantzm@health.missouri.edu.