Once at Activities Department, observe what is going on each time you pass by. Make it a point to stop for a few minutes and observe residents and don’t be surprised if not every resident in activities room, is not doing something. Are at least 25% of residents doing something like reading, watching TV, or doing activity that is going on at time? Ask to see or have a copy of activities calendar. Observe interactions.

The dining areas are a very important area to make observations. Check to see if they have more that one dining room or area? If nursing home that you are at has 120 beds and is not specific to only Alzheimer’s/dementia residents, then there is a mix of residents functioning at different levels. There are usually three functional levels of dining: residents that can dine independently, residents that require cueing, and residents that need to be fed. Observe for different types of dinning rooms or areas. If residents are dining observe for a few moments. Are they socializing, smiling, having a difficult time with food? This is important because as your loved one’s functional ability may decline and they may need cueing or to be fed from time to time. What is facilities policy about reidents dining in their room?

The tour guide (admissions coordinator) will show you a few resident rooms. Most of time they will show you rooms of clean, fairly independent, and continent residents with good family support, a well decorated room, not room they would be admitting your loved one into. Facilities are limited to number of private rooms they have. Most of rooms are semi private with a private bathroom for two sharing room or a bathroom that is shared with adjoining room. Look in bathroom if you can. There is much to consider.

During tour they will hopefully show you outdoor areas for residents. Is it shaded from sun? Is it partially protected from weather like rain, snow, and wind? Do they have an area outdoors for residents who smoke? Are there seating areas? Is it visually appealing?

This is usually what happens during”THEIR.PITCH”. They ask you for information and you ask questions and make observations. Just like when you are with a salesman they want you to get emotionally connected with their facility.

At closing be sure to thank them for their time and let them know that you will be in touch with them soon.

Before your second visit, try and read information related specifically to nursing home and what their expectations are of you and resident from information packet or a pre-admission packet you recieved. Then make a list of questions for next visit. If you can’t think of any questions, Medicare’s publication Guide to Choosing a Nursing Home has questions on several pages that you can tear out and take along with you to what I call “YOUR Q&A VISIT”.

Try to make “YOUR Q&A VISIT” unexpected on a weekday. Ask to speak to admissions coordinator or some one who can answer some questions that came up. I will just tell you now, that if they respond timely to you at this visit that’s how you will be responded to if your family member was in nursing home. This is your opportunity to get your questions answered and to get any additional information that will help you make best choice.

If you live in a small town this nursing home may be your only choice and you will learn to be a good advocate. However, if you live in a large town or metropolitan area you will have a choice of several nursing homes, pick one that suits your loved ones needs and not your convenience. I wish you best of luck on your search. Thank you.

Here are valuable Resource Links that I promised. Just click on title.

Nursing Home Compare – Will provide you data about a nursing homes most recent survey and compare it with other nursing homes you select for free. http://www.medicare.gov/NHCompare/Include/DataSection/Questions/SearchCriteria.asp

Home Health Compare – Will provide you data about home health agencies most recent survey and compare it to others you select for free. http://www.medicare.gov/HHCompare/Home.asp

Long-Term Care Counselor – Will help you make a determination of type care and where care can best be provided for you or for some that needs help or supervision. http://www.medicare.gov/LongTermCare/Static/LTCCounselor.asp

Publications - Guide to Choosing a Nursing Home, Medicare and You 2004, and Medicare Coverage & Skilled Nursing Facility Care http://www.medicare.gov/Publications/Search/SearchCriteria.asp

Tammy Gonzales, Life Coach, her current project, Caregiver & Aging Awareness Campaign to direct caregivers and the aging to resources to complete their life planning.

A host of research efforts both in America and Europe sought to ascertain if in fact nail biting was linked to mental illness in one form or another. Most people would have anticipated they found a high prevalence of nail biting among mentally disordered; however, they found that nail biting, in and of itself, is not systematic of any form of mental disorder or maladjustment.

Nail biting crosses all national borders, genders, and both social and economic lines and may also originate from a primal need for self-grooming. It affects both nails and cuticles; with greater potential harm caused via infection to cuticle and nail biting tends to be a private affair, and is a relatively isolated form of self-indulgence.

Nail biting may be treated addressing symptom rather than cause; it is a habit, not a disease.