Of course, meals, laundry, housekeeping and medical and nursing services are standard. But over and above the basics, quality facilities offer dietary, pharmacy, recreational and social services, plus occupational therapy, physical therapy and speech therapy. (Note that Medicare- or Medicaid-approved facilities must meet federal standards. Ask to see the nursing home’s certification and make sure it is up to date.)

There are typically many people involved in providing these services to residents. They may include:

• The administrative staff, with overall responsibility for the nursing home, includes an administrator and directors of admissions, personnel and finance.
• The medical director is a physician who makes sure residents receive adequate medical services.
• The nursing staff provides around-the-clock bedside care. The director of nursing is usually a licensed registered nurse who supervises the work of other registered nurses, licensed practical nurses and nursing assistants (nonprofessional caretakers).
• The therapists provide physical, occupational, recreational and speech therapy programs aimed at helping residents maintain their physical and emotional well-being and cope with their individual disabilities.
• The activity director is one of the most important employees. Many are trained therapists who assess residents’ needs and create and implement recreational programs that are entertaining as well as therapeutic.
• The social service staff includes social workers, psychologists and counselors who help residents cope with emotional and psychological issues.
• The food service director manages the meals program and sees to it that nutritious food, attractively prepared, is served at every meal and that individual dietary requirements are met. Good food and pleasant mealtimes give residents opportunities to socialize.
• Volunteers usually are members of the community or relatives of residents who assist the staff. They may help residents with their daily activities, assist at mealtimes, organize parties or games and help therapists with programs. They are invaluable in providing one-on-one interaction and attention.