If you have ever contributed to a savings account, worked hard in a degree or training program, or taken your car in for an oil change, you know what it is like to make a small sacrifice now with the expectation that it will pay off later.

It's the same with touring nursing homes in advance. If you are 75 or older, your chances of needing a short stay in a nursing home in the next five to seven years are pretty good. There are lots of reasons people receive a recommendation for subacute care in a nursing home. Patients use nursing homes for a few days to a few weeks to recover from operations, regain control of a chronic illness, or rebuild their strength. Only about half of people using skilled nursing facilities are there to live out their final years.

In many cases, skilled nursing facilities are the best way to recover, especially for those recovering from an operation or building strength. The reason is therapy. You might envision patients sitting around watching television or reading. That vision is flawed. Short-term patients are working hard to regain their maximum capabilities. Many receive therapy—physical therapy, occupational therapy, or speech therapy—as often as three times per day seven days a week.

This level of attention is simply not available in an in-home situation. Once you are ready, the therapists practice the skills you will need at home, like getting dressed and cooking meals. Therapists even travel to your home to evaluate your "real life" environment and abilities. Those who receive intense therapy return home faster and are more likely to make a full recovery. Really, the quicker you receive the therapy you need, the faster you improve.


That's why it makes good sense to tour nursing homes in advance. Those who tour in advance, are in a much stronger position to make their own decision about where they want to go. Here's a quick list of things to look for and questions to ask.

• Call two or three nursing homes to schedule a tour in advance. This is the best way to ensure that you will be able to meet with all of the most important team members, including admissions, nursing, and rehabilitation staff.

• When you arrive, take a deep breath through your nose. It should smell clean, without smelling antiseptic or overly flowery. If the facility is clean, there is no need to cover smells.

• A facility might be attractively decorated, but that is not the most important thing. Look instead to see if the staff and patients look happy and relaxed. Pay attention to their interactions with one another.

• Ask about the most recent Centers for Medicare and Medicaid Services State Licensing and Protection Survey. You might not understand everything about this survey, but you will be able to tell if the staff is proud of the outcome and eager to share what they learned.

• Share your food preferences and other things that are important to you, so that the staff can be prepared and explain what adjustments might be necessary.

• After two or three tours, it should be easy to determine where you felt the greatest connection. Put the phone number where you keep your important contacts. If you are having an elective surgery, you can sometimes pre-book the room of your choice in advance. If you do end up needing care unexpectedly, you can speak with authority about which nursing home you feel would be best for you.

Looking at nursing homes in advance doesn't make you more likely to need nursing care any more than having a will increases your likelihood of death. It makes you a well-prepared adult. Touring nursing homes while you are healthy is a small investment in time and the best way to ensure a stress-free experience when you need it.

— Suzanne Anair is the administrator of the Centers for Living and Rehabilitation, a part of the Southwestern Vermont Health Care system. To reach her, e-mail Suzanne.Anair@svhealthcare.org.