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Making Sense of Elder Care

by Emily DeGenova, Senior HMS

This past summer, I had the opportunity to intern under the administrator of UPMC Canterbury Place, a nursing home located in Lawrenceville, PA. During the internship I gained knowledge, experience, and passion for my anticipated career in Healthcare Administration. One take-away I would like to pass on to my fellow peers is a guide on how to choose a good nursing home.

The collective age of our population is increasing due to the baby boomer generation. Many of us young adults have loved ones facing the need for elder care now or in the near future. As you and your family begin your search for nursing home facilities, you may feel overwhelmed with the results. You may be confused about what makes one better than the other. The solution to finding a good nursing home is easier than it appears, because you can use the tools already given to you – the five senses!

  • Sight:
    • When you drive up to the facility what does the outside look like? Is it inviting, does it feel like home, and can you see your loved one here? Does the outside paint and roofing look weathered? Are the plants and shrubbery well-kept? The outside appearance of the facility indicates the consistency of their environmental services team.
    • When you walk through the front doors, are you greeted by a secretary? This greeting can indicate the friendliness, or the culture, of the facility.
    • When you are waiting for the tour to begin, take a look around the lobby. Is the facility clean (i.e. carpets swept, dust on the tables, things appear “in order”)? This indicates the care of the housekeeping department.
    • Are there any burnt out lights? This will indicate the vigilance of the maintenance department.
    • Once you begin your tour take notice of the residents. Are they smiling or talking with other residents/nurses? This shows how happy and comfortable they are in their own home. Do the residents appear rested? This suggests how well residents can sleep at night.
    • Do the resident’s clothes match and is their hair brushed? This will tell you how well the nursing aides groom their residents during morning care.
    • Additionally, take note of the nurses. Do the nurses appear frantic? Do they smile and greet you? Does it seem like they enjoy their jobs? Do they warmly care for the residents (i.e. hold their hands to say hello)? Observe how many call bell lights are on in the hallway at once. If the majority of lights are on in a single hallway at one time, this can be a sign that the facility is understaffed. Don’t be afraid to ask your tour guide what the nurse to resident ratio is in the facility, or what the reason for all the call bell lights might be (i.e. maybe it is lunch time).
    • At the end of your tour, be sure to take a restroom break. Is the trash overflowing, is the toilet bowl clean, or does the sink have mildew? If the facilities main restroom is cleaned thoroughly, then it is expected that the housekeeping department will clean your loved one’s restroom with the same diligence.


  • Touch:
    • When you are waiting for your tour to begin, take a seat and touch the fabric of the couch. Is it clean and soft? When walking the halls of the facility, run your hands along the railings. Are they sticky? Trace your finger along the top of a picture frame. Is there dust? These tricks will give you a sense of how thorough the housekeeping department is at the facility.
    • When viewing a mock resident room, touch the bedding. Does it feel soft, warm, and comfortable? This will indicate how well the laundry department takes care of linens, which may include your loved one’s clothes in the future.


  • Taste:
    • When calling to set up your tour, request to try a plate of food. This is the best way to test the dietary department’s expertise for yourself. While nursing home meals tend to be low in salt, they should not be low in flavor! Additionally, all meals should be served at an appropriate temperature. This shows the dietary’s time management skills. If you would send back a cold soup at a restaurant, then your loved one shouldn’t be served anything less here.
    • Additionally, try the coffee in the lobby; is it fresh? If the facility cares about the details in the visitor’s experience, they will care about the details in your loved ones stay.
    • During your tour, ask your guide to try a cup of the water served to the residents. Does it have a funny taste or smell?


  • Sound:
    • When you arrive at the facility take note of the music playing, if any. Is it pleasant and age sensitive? Would your loved one enjoy it? The type of music chosen will show how culturally and age sensitive the facility is.
    • During your tour, take a moment to close your eyes and really listen. What do you hear? Is it loud? Do you hear residents in distress? Are nurses yelling? The sounds of the environment should be conducive of peace, rest, and healing.


  • Smell:
    • Smell can be a triggering sense in a nursing home. With old age comes the loss of one’s bladder and bowel habits. Therefore, it is important to note the difference between a “fresh, new smell” and an “overall odor”. Meaning, the odor of a nursing home should be controlled, but the smells cannot always be controlled. Instead, they should be well masked. When you walk through the front door, are you greeted with an unpleasant odor? This can show a lack of odor control. Every place has a specific smell, just like your house. Therefore, the general surrounding aroma of the facility should be pleasant. However, if you encounter the clear smell of urine or defecation during your tour, it doesn’t necessarily mean the nursing home smells bad, because the smell should dissipate once the resident is cared for.
    • Apart from the unpleasant smells, do you notice any good ones? Do you smell an air freshener throughout the facility? Would your loved one like the smell? Do you smell lunch/dinner being cooked when you are near the kitchen? Does it smell good or like a “home-cooked meal”?


One of the many things I learned during my internship at Canterbury Place is how to quickly distinguish what kind of nursing home facility you are visiting. You can do this by using your own five senses and understanding what they can “tell” you. Once you have narrowed down your search to several homes offering the type of care your loved one requires, call their administration office to schedule a walk through tour! Bring an outline of these suggestions and jot down your thoughts as you go. Don’t hesitate to ask questions, and of course (if possible) bring your loved one with you because this is their decision and their future home.


DeGenova, E. (2019). Making Sense of Elder Care. D.U.Quark, 4 (1). Retrieved from



“Why Elderly Care Can Be So Important?” HOME CARE, Lincolnwood,IL, 2019,

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