As we age, we begin to wonder what life will be like when we are physically or mentally unable to take care of ourselves. Where will I live? Will I have access to quality medical or nursing care when I need it? Naturally, we would prefer to avoid these questions. However, right now, many of us are dealing with these issues in making life-care decisions for our elderly family members. Often the answer is a nursing home or assisted living facility (ALF).

What must we do to ensure that we choose a clean, safe, and high-quality living arrangement for our parents and grandparents? First, we should find a location that is close to a hospital or medical office complex because there will be frequent trips for procedures and follow-up visits. Commonly, geriatric physicians will recommend a convenient facility. Sometimes, private health insurers or Medicare/Medicaid will require that we chose from their lists. The Agency for Health Care Administration (1-888-419-3456) is also a good resource for this information.

Second, once we have narrowed down the list, we should inspect each facility. Make an appointment with the Head Administrator for a tour. Talk with the Medical Director. Find out how many hours a week he or she is there treating the residents. Speak with the Head Nurse. Get a good idea about the number of residents the facility serves. Talk with the nurses on staff. Take note of the number of nurses per resident. Request brochures. Also, ask to speak with some of the residents and their visiting family members. Encourage these folks to be candid about the facility's quality of care.

Third, before choosing, we should read at least a few of the inspection reports and surveys that are published by governmental agencies. Federal and state regulations mandate that certain standards of care be provided. Not all facilities provide the quality of care required. To find the law-breakers, inspectors thoroughly assess the condition of the residents and the sterility and safety of the nursing equipment. They review personnel files, staffing schedules, and incident reports. Most importantly, they analyze the frequency of certain types of injuries. Their reports may show that a particular nursing home has many residents with seriously infected bed sores (a/k/a "decubitus ulcers") that are often caused by the nursing staff's neglect of its residents. Unfortunately, there are also statistics indicating serious patterns of staff-inflicted abuse. These reports may be obtained from governmental sources such as www.fdhc.state.fl.us as well as private sources such as www.NursingHomeReports.com.

Finally, another useful website is www.doh.state.fl.us. This is the website for the Florida Department of Health and it provides background information about the qualifications of doctors and nurses who are affiliated with or employed by the facility. There is also information about which doctors and nurses: 1) are licensed, 2) carry liability insurance and 3) have settled any malpractice actions.

Remember: Be patient. Be thorough. Hopefully, the new home will exceed expectation.