To narrow down your choice between two or three nursing homes or just considering only available nursing home to place your family member or friend, it takes two visits. Take someone with you and if at all possible take person who will be moving into nursing home.

Your first visit to nursing home is what I call “THEIR PITCH”. Set it up for morning anytime before 11:00 AM on a Saturday and plan to be there at least an hour. Get there 15 to 20 minutes early with a magazine or a newspaper and let receptionist know you are there. Take a seat in lobby and wait. This is not waisted time. Open up your newspaper or magazine and eaves drop without calling attention to yourself. Let your senses lead way. Have you been offered refreshments? Does facility smell? Does interaction of others sound pleasant?

When you opened front door into nursing home did you smell urine, bowel movement, vomit or body odor? Did it to smell like flowers or antiseptic? Or like bad odors are being covered up by good odors. Broccoli, cabbage and brussels sprouts are only offensive smells that come from kitchen when they are being prepared.

After a short while close up your magazine or paper and reseptive to your visual surroundings. If there is someone else sitting there try to start a conversation about nursing home and find out what they think. Listen to tone of their voice, watch facial expression and body language. By now admissions coordinator or someone is going to invite you into their office or take you for a tour and give you “THEIR PITCH”.

When they take you into office they are going to ask you questions. Names, name of potential resident, age, diagnosis, who their doctor is, where are they now, do they have Medicare, insurance, are you health care power of attorney, do they have a living will, have you applied for assistance, how soon do you plan to place them here, etc. They are going to try to emotional connect with you as well. They are looking for potential problems too. Pleasantly answer their questions. If you have a few questions ask and be sure to ask if you can have a copy of an information packet or pre-admission packet.

So on to tour. The tour is about showing you best of what they have to offer. They will introduce you to everyone and show you facility. Let “THEIR PITCH” happen and go along with it. Don’t ask too many questions now because you will distract yourself from observations that you need in order to make a sound choice.

During tour you will be introduced to different department managers and shown their offices. You won’t be expected to remember names and it is more important how they respond and take an interest in you. Also, during this tour pay attention to interaction between staff and residents in every area you are toured through. This is important.

Observe residents. Are their clothes clean and in good repair? Are they wearing footwear? Do men look clean and shaved? Does their hair look cared for or is it a mess? Do women have appropriate hairstyles (I have seen them put pigtails on top of balding 90 year olds)? Do they still have bibs on from their last meal? Does any one look cold and not have a sweater? Do you see a number of residents that are wet or smell of urine or BM? Do hands look clean especially under nails? Do wheel chairs look clean and cared for with no sharp edges or tatters? Do residents in wheel chairs look comfortable? Are residents in wheel chairs being pushed too fast or backwards? Are residents that are being walked rushed or are they allowed to walk at their own pace? Is a resident yelling out whole time you are there?

The flooring should be clean and free from any debris. The walls should be clean. The lighting should be good. Carpets free from spots. Decorative items should look well kept. Drapery should be open to allow natural sunlight in.

You will be taken to nurse’s station. The nurses should be pleasant and responsive to residents and family members. Listen to their tone and responsiveness in their voice. Watch their body language as they acknowledge you or others at nursing station. Is this representative of how you would like your loved one to be responded to?

Nail biting typically begins between ages of five and 10 and is common among children as well as adults. As many as one in three Americans bite their nails.

One of more noteworthy and generally surprising things about nail biting is its high instance. It crosses every social and economic barrier. Prevalence figures for children are much higher than for adults.

Results of nail biting can result in short, ragged nails. It may also lead to damaged cuticles as well as bleeding around edges of nails. Infections can also develop if nails are not properly attended to.

Most relevant studies have found that nail biting tends to peak out around puberty.

A study by Malon and Massmer studied behavior in Chicago school systems and reported that nail biting is prevalent in about 60 percent of children age eight to eleven. Most people agree it is a learned habit, perhaps picked up by watching a parent or someone else biting their nails.