The Dark Secrets Your Nursing Home Doesn’t Want You to Know

As you age, you might consider care in a nursing home — an excellent choice for many seniors. MedlinePlus notes most homes have skilled nurses and workers capable of looking after all of its residents 24 hours a day. And many homes even have a communal, neighborhood-like feel complete with scheduled activities so you can develop close relationships with others.

Nursing homes aren’t perfect, however — and there are some secrets the homes keep closely under wraps. Here’s what yours may be keeping from you.

1. Some contracts don’t allow you to sue if something goes wrong

signing a contract

Read the fine print. | BernardaSv/iStock/Getty Images

  • Watch for “binding arbitration agreements” in the contract.

As with any contract, it’s vital to look at the fine print. Knapp & Roberts notes you should review all of the print in your paperwork, and keep a watchful eye out for anything noting “binding arbitration agreements.” Essentially, this agreement means you must settle your differences outside of court, removing your right to sue. If anything serious happens, you certainly don’t want to be bound by this clause.

Next: Many residents find their depression stems from this issue.

2. Residents don’t always have as much freedom as they want

Senior couple

Residents aren’t always able to do what they want. | Wavebreakmedia/iStock/Getty Images

  • Look for a home where residents aren’t isolated from each other.

It’s important to tour a number of homes before deciding on which one’s the perfect fit. And good homes should allow residents to roam freely as they wish.

Unfortunately, not all facilities allow for such freedom. One study found out of 65 nursing home residents interviewed, about half felt depressed due to a lack of independence and freedom, as well as loneliness. The interviewees also seemed to prefer homes that had programs designed to reduce their sense of isolation from others.

Next: This shocking issue is more common than you think.

3. Residents don’t always get enough to eat

Salisbury steak dinner with mixed vegetables

No one should be hungry or malnourished. |

  • Ask the home how they handle meals 

It’s true that many older folks experience a severe loss in appetite. For this reason, a good nursing home should be aware of this and ensure no one goes hungry or malnourished.

A 2015 overview from Nursing Older People found nursing home residents are among those who have higher rates of “anorexia of aging,” and over 50% of residents studied also complained of constipation. Your home of choice should have a plan in place to combat these issues.

Next: You’ll be shocked to know who some of the “nurses” really are. 

4. Some of the ‘nurses’ aren’t nurses at all

nurse and patient home care (focus on man)

Find a home with permanent nurses. | Mandygodbehear/iStock/Getty Images

  • Ask how many agency nurses your home of choice uses. 

Every nursing home has some number of permanent nurses — but not everyone working is a staff member you’ll see again. Bottom Line Inc. explains “agency nurses” are often employed when a home is low on permanent staff. These temporary nurses work for staffing agencies and rarely form bonds with residents because of their position.

For your comfort, it’s wise to choose a home with a staff that’s at least 80% permanent nurses.

Next: Love your current doctor? This could be bad news if you’re entering a new nursing home.

5. Residents often have to leave the doctors they’re used to behind

couple on consultation with a doctor

Many homes have assigned physicians. | Didesign021/iStock/Getty Images

  • Ask your nursing home if you can keep your current doctor.

Knapp & Roberts explains most nursing homes have assigned physicians, which makes it difficult for residents to keep the doctors they’re used to seeing. If you’re really attached to your current doctor, it’s best to ask a potential home about their rules regarding this. You should also ask the home how often the physicians see their residents and what the health care plans may look like before committing.

Next: Think there’s enough staff at your potential nursing home? Think again.

6. Low staffing levels are a huge issue

The right staff-to-patient ratio is key. | Katarzyna Bialasiewicz/iStock/Getty Images

  • Up to 95% of American nursing homes may be understaffed.

Some homes have a difficult time finding enough staff, but other homes purposely understaff to cut costs, says attorneys Jason Paul and Paul C. Perkins Jr. Having a bad patient to staff ratio is stressful for the staff and bad for your care. It may also leave you vulnerable to neglect and abuse. Be sure to ask what the patient to staff ratio is in your chosen home so you can ensure you’re getting the care you’re promised.

Next: If you can no longer pay your nursing home fees, do you know who does?

7. Nursing homes may send a bill to relatives for the resident’s care

senior mom with daughter

Know how you’ll pay. | YakobchukOlena/iStock/Getty Images

  • Know the laws regarding billing in your state. 

According to Mass Mutual, the average amount paid for assisted living in 2017 was $3,750 per month. While you may have multiple ways of taking care of these costs, you should ensure none of the expenses accidentally get sent out to relatives. This happened in 2012 to a man who was forced to pay nearly $100,000 of his mother’s care without realizing it.

Know what your state laws are regarding billing, and as always, have both you and your family members read the fine print.

Next: Hand-washing amongst staff members isn’t as prevalent as it should be. 

8. The staff isn’t always clean

Person washing their hands

Sometimes, staff members don’t wash their hands. | iStock/Getty Images

  • Michigan nursing home staff members have some of the worst hand-washing hygiene. 

Nursing home staff are careful with washing their hands, right? While this may seem like an obvious practice of personal hygiene, not all staff members participate. The New York Times reports many nursing homes are being cited for “hand hygiene” deficiencies.

Unsurprisingly, the nursing homes that were understaffed found the most hand-washing issues. Finding a well-staffed home may be key to your overall health.

Next: Your closest assistants may not be as well-trained as you think. 

9. Nursing assistants don’t need as much training as you think

nurse checks blood pressure

Many have no formal training at all. | Zinkevych/iStock/Getty Images

  • Certified nursing assistants have an extremely high turnover rate. 

They may seem official, but many nursing assistants have no formal training at all to take care of you. explains some clinics will hire untrained workers and train them to be nursing assistants at the facility. Even for those who have a degree as a CNA, that can be acquired online with no hands-on experience. And many CNAs start at nursing homes and then move on to jobs with better pay, making the turnover rate incredibly high.

Next: This form of abuse is extremely common in nursing homes. 

10. Neglect is a common issue in the homes

a nurse takes notes as senior patients sit

Take a look at the other residents. | Carsten Koall/Getty Images

  • Look for signs of neglect in the patients and facilities. 

Next Avenue explains out of all the cases of nursing home abuse, neglect is the most common. While there are times when neglect is intentional, it isn’t always this malicious. Inadequate staffing and high turnover rates can also lead to this issue.

When choosing a nursing home, take a look at the other residents. Do they seem clean and well taken care of? The living quarters should also be clean and safe, with little wear and tear.

Next: If a nursing home ever tells you this, it’s a major red flag. 

11. Some nursing homes may tell you to get extra aid outside of their care

a female nurse in blue scrubs from the neck down, with a stethoscope around her neck, holding a piece of paper and a pen

The home should have all you need. | Christopher Furlong/Getty Images

  • Your home should provide everything you need. 

Staff in your chosen home are required to provide you with the care you need. If you’re ever told you need an outside aid to assist you for additional costs, Knapp & Roberts says to take note. This is negligence on the part of the nursing home.

Next: Don’t forget to ask for a tour of this area of your chosen facility.  

12. The physical therapy units aren’t always up to snuff

Nurse helping elderly patient

Make sure it will meet your needs now and in the future. | iStock/Getty Images

  • Tour the physical therapy unit before committing. 

While you may be more concerned with what the rooms and eating areas look like, don’t forget to tour the physical therapy unit. Bottom Line Inc. explains if you require rehab of any kind, this is particularly important. Take a look at the machinery and ask if physical therapists are on the staff itself or just doing contractual work. If your nursing home is staffed with physical therapists, it’s likely to give you better service.

Next: You’ll need to make sure there’s plenty to do at your new home. 

13. The ‘activities schedule’ might be a total bust

Bored senior man watching tv

It should have a variety of activities. | littlebee80/iStock/Getty Images

  • Ask if the home does individual assessments of everyone’s interests.

U.S. News & World Report reminds us many nursing homes are still lacking in the activities department. While birthday parties and Bingo are commonplace, you’ll need more than that when choosing a place for your future. And the best homes will ask each resident about their interests to try and accommodate as many people as possible.

Certain homes offer gardening clubs, cooking classes, and art therapy, so make sure you ask what’s available.

Next: Don’t expect too much alone time, even when you really want it. 

14. Most residents will have a lack of privacy

senior couple drinking coffee

Find out how much privacy you’ll have. | iStock/Getty Images

  • When looking at shared rooms, consider what the partition dividing your beds is made from.

While many folks in nursing homes like having company, there’s also another issue you may not have thought of: a lack of privacy. Bottom Line Inc. explains most homes offer a wide range of shared rooms, with private rooms costing serious cash. Not all shared rooms are bad, however. You’ll just want to make sure what’s dividing your bed from someone else’s is sturdier than a thin curtain.

Next: Unfortunately, neglect isn’t the only form of abuse. 

15. More serious forms of abuse take place, too

senior woman's hands

Do your research on the facility. | Zhenikeyev/iStock/Getty Images

  • Sexual assault can occur in nursing homes. 

The National Council on Aging report about one out of every 10 Americans over 60 experience abuse — and it can even occur in nursing homes, Spangenberg Shibley & Liber LLP says. Neglect aside, the publication notes sexual assault and abuse has also been cited in certain homes. And many other instances of abuse go unreported.

Do your research to see if any abuse allegations have been filed against your home of choice.

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