How can I be sure my Mom’s nursing home is safe?


You are right to get all the information you can to make the best decision.

First, find out what to avoid:

  • Book a tour and consult a checklist such as
  • They advise using your senses and intuition – how does the place, look, smell, sound and generally feel.
  • Check government reports – your province’s ministry of health’s department of long-term care will give links to reviews and complaints procedures; for example, in Ontario, check and its link to inspection reports.
  • Online reviews and media reports can be found on Google, but be aware of sensationalism

Analyze your Mom’s needs:

  • You know your mom best – does she like a quiet life, or the bustle of lots of people? Dos she have issues with cognition, hearing, vision, mobility? Is she tolerant of others, or more of a loner? Assess these things honestly for the best fit.


  • Is your mom a handful to care for? A private, non-medical companion can boost her spirits, provide respite for the staff, and act as your ‘eyes and ears’ for any behaviour issues that can be resolved before they become an issue.

Look for newer homes:

  • Look for newer nursing homes have smaller units of under 20 residents, with the nursing station, activity room and dining room, on the same level, so there’s no need for slow elevator rides to a large main dining room, or long waits for attention or care, all of which increase residents’ frustrations.


  • What’s the environment? If it’s noisy with top-40 radio or TVs blaring, it’s likely to bother seniors, especially cognitive patients who do best in peace and quiet.

Staffing levels:

  • Caregiver to resident ratios are difficult to establish since care in nursing homes can be so complex and will change over time. Smaller caregiver-to-resident ratios are preferred. Ontario does not currently have a minimum standard, but the average is 15 residents per Personal Support Worker (PSW) during the day and 35-40 at night. If your mother will need more care than that, can private care be brought in? Is it affordable for you?

Signs of Trouble:

  • Violence among residents can occur when patients of different care and cognition needs are housed together. Families may feel insulted when their parent is placed in a cognitive unit and prescribed medication, but please keep an open mind.


  • Visit your mom often to spot subtle signs of fear or abuse. Does she seem fearful, confused, less confident, mistrustful of staff? Is she resisting care, especially from certain caregivers? Is she depressed and tearful? Investigate immediately.

How else can I really check the place out?

  • Talk to friends, go to seniors centres, ask at your doctor’s office – what do they hear about local nursing homes? Where do your mom’s friends live? Do your friends or colleagues have parents in nursing homes? Build up some intelligence on the subject.


  • Ask residents and their families! On a tour, talk to residents, buttonhole adult daughters in the elevator, sit in the lobby for awhile before and after your tour. Observe how visitors, families and especially residents are spoken to and treated by staff members – is it with patience and respect?


  • Ask family members about the care, whether staff and management are open to suggestions and participation by family members, and how they resolve issues. Are they consulted or does the home hide behind by policy and procedures?


  • Ask the tour guide what is being done to protect residents from harm by staff and by other residents. Ask for specifics.

Better to push for information now, not after a tragedy occurs.