Goal: A community that cares
Are aides assigned to the same residents each day?
How much staff turnover is there among aides?
Does the nursing home use staff from temporary agencies?
How long have the Administrator and the Director of Nursing been there?
Does staff spend time one-on-one with residents, talking, joking, being friends?
Goal: Autonomy and privacy
Are residents free to get up when they wish?
If they do sleep in, will there be breakfast available?
How much choice in food will they have?
If someone is hungry at midnight, will they have something to eat?
Can they choose when and how they are bathed?
How much privacy do they have in their rooms?
Is it customary for staff to knock on a resident's door, or do they just walk in?
Goal: A rich environment of home
Is there open visitation, day and night, so that family members are encouraged to visit?
Is there any place families can congregate that affords privacy?
Is there a place for kids to play, inside and out? Are there boxes of toys?
Are pets allowed?
Are there houseplants and outdoor gardens?
Are there shelves or bookcases for residents to display belongings or photos that have meaning to them? Is there artwork on the walls, selected or made by residents?
Is there normal household furniture? How about a family-size kitchen that is easily accessible, 24 hours a day?
Goal: A life of meaning
Can residents help around the household to the best of their abilities?
Are there chances for creativity - art, dance, singing, cooking, story-telling?
How does the nursing home learn about the resident - their hobbies, past career, religion, interests, daily pleasures? Is it written down so that new staff or volunteers can get to know something about the person? How are these desires met?
How much interaction is there with the outside world? Are residents included in outings to restaurants, church, shopping, museums, picnics, fishing trips or sports events?
Is there an on-site day care center or other regular interaction with children?
Are there plenty of volunteers to help out and provide companionship?
Do residents have opportunities to serve others?
Goal: Individualized care for people with dementia
Do people who have dementia have the chance to mix with others?
How much individual attention do people with dementia have? Are anti-psychotic medications heavily prescribed?
If the household they live in is kept locked, do they have access to secure areas outdoors?
Do they appear engaged or are they wandering aimlessly or restrained in wheelchairs?
Do they appear to be contented, or do they look fearful or anxious?
Goal: A death with dignity and love
Is expert, pain-free end-of-life care provided, either by specially-trained staff or by hospice agencies?
Are any staff assigned to be with a resident when death is near? Are families notified in a timely way?
When someone passes, what is the procedure? Are there meaningful rituals? Are staff and families given time to express their grief or to honor the person who died?
Do families choose to hold memorial services inside the nursing home?