If moving into a nursing home was a free service for everyone over the age of 80 and not based on a welfare decision, the design would look completely different. Imagine people coming to your home to see if the apartment is nice and if the staff seems good. There are municipalities that remove the requirements for a welfare decision for moving in over a certain age and where there is an excess of apartments in nursing homes. Do they choose your nursing home?

Safety requirements in a nursing home
When a new care home is being built, there are lots of requirements. It must be fireproof, have evacuation routes and extinguishing equipment. There are requirements for care hygiene standards and the size of the apartments, that it should be accessible for people with functional variations, handicapped toilet, door width and much more.

When it comes to balconies and windows, however, safety thinking seems to end. There have been several accidents where elderly people have fallen, for example, from a balcony with low railings. Likewise, architects and clients rarely think about the experience of coming to a nursing home. It happens that newly built homes have a quiet, gray and empty entrance and that there are technical solutions that are not at all adapted for the nursing assistants who will work with them.

Every summer comes a period with a heat wave. This means suffering and in some years also an excess mortality among the elderly and fragile. Air conditioning should be a natural feature in a home where elderly and fragile people are to live and be cared for.

The dream of a nursing home
In Vellinge, Förenade Care has been commissioned to develop an existing home into a dementia village. The idea is that those who live in the nursing home should be able to move freely indoors and outdoors. In their concept, there are fitness and wellness facilities, cafes and shops within the nursing home. Everything is adapted for people with dementia. Here, the municipality has adapted an existing nursing home.

Imagine what you can do if these thoughts are there from the start. You can have small clusters of houses around a carpentry workshop, a music studio or a sewing room or nice walking paths with oases in the garden where those who wish can sit and hear the murmur of running water or drink a cup of coffee in the company of friends. Surely the use of medication would decrease, as would falls and other health care injuries. Role models exist in

The Netherlands and Denmark.
A conscious architecture with color schemes and common areas can reduce the feeling of confinement and give the residents freedom of movement. At the same time, nursing homes are still being built on outdated ideas about what a nursing home should look like. Night lights in the bathroom can help to maintain the ability to independently take care of their needs. Pictures in the corridor can facilitate orientation and finding their own apartment. Maybe it is possible to create community without long corridors.  

Rooftop terraces, spa departments, gyms, common dining room and library are other things that can contribute to comfort and create a sense of belonging among those who live in the unit. With a stimulating environment, residents can more easily maintain functions and staff spend more time on social interaction, when the need for other care services decreases. Most of us never get the opportunity to build new even if we can dream. But there are certainly many things that can be done within the framework of your nursing home.

The dream would be to come to a nursing home where the feeling is "Wow, I can die happy here".

Step 1: Create a list of needs and desires

Start by making a list of what is important to you or your relative. This can be anything from care quality to comfort, activities and proximity to relatives. Here are some things to consider:
- How important is the proximity to family and friends?
- What care needs are there? Is there a need for a special focus on, for example, dementia care or rehabilitation?
- What is important for comfort and quality of life, such as access to green areas, activities or social interaction?

Having a clear list makes it easier to judge which nursing home best matches your needs.

Step 2: Gather information and read reviews

By reading reviews and reviews, you can get an idea of the nursing home's reputation and what others have for experiences. Here are some ways to gather information:
- Visit the municipality's website and read about the nursing homes in your area.
- Search the internet for reviews and reviews from other residents and relatives.
- See if there are quality certifications or other awards that indicate that the home meets high standards.

Please note that online reviews are a guide but do not always provide a comprehensive picture. A visitor may have had a single experience that does not reflect the general quality of the home.

Step 3: Visit the nursing home for a tour

A personal visit provides an invaluable feel for what it's like to live in the nursing home. Bring a list of questions and pay attention to details that may be difficult to capture in writing. During the visit, you can focus on:
- Treatment: How are you greeted as a visitor? How does the staff seem to treat the residents?
- Environment: What do the premises look like? Do they feel bright, well-kept and comfortable?
- Atmosphere: How do you perceive the atmosphere? Do the residents seem to enjoy it?

Also ask about the possibility of participating in a meal or an activity to get a deeper understanding of life at the home.

Step 4: Review the nursing home's documentation and quality work

To ensure that the nursing home actively works with quality, it is good to look at how they document and follow up their care work. Here are some important documents and questions to ask:
- Quality certifications: Does the nursing home have any certifications that show that they work systematically with quality and improvements?
- Care plan and social documentation: What does the care plan look like for the residents, and how do they follow up any changes in needs?
- Patient safety and hygiene routines: How does the nursing home work to maintain a high level of safety and good hygiene?

Asking to see or hear about the quality work can give you confidence that the home takes its responsibility seriously.

Step 5: Talk to residents and their relatives

If possible, talk to people who already live in the nursing home and their relatives. They can give you an honest picture of how care works in practice. Ask for example:
- Are you satisfied with the care and activities?
- Do you feel that your needs are taken seriously?
- How is the communication between the staff and the residents or relatives?

Their insights can be valuable in understanding how care works in practice.

Step 6: Look at the possibilities for activities and social interaction

Social activities play an important role in comfort and quality of life. Ask the home about what activities and programs they offer, and if there is the opportunity for residents to participate according to interest and ability. Here are some questions to ask:
- What does the daily activity plan look like?
- Are there opportunities for adapted activities for those with special needs?
- Are visits and contact with relatives encouraged?

Activities that stimulate both body and mind can have a great impact on the well-being of residents.

Step 7: Follow up and compare the options

After visiting and collecting information about several nursing homes, it can be good to compile a list with pros and cons for each option. Make a summary and consider how well each home matches your original needs and desires.
- Compare your impressions from the visits and the documentation.
- Review what feels best in terms of treatment, environment and activities.
- Discuss your options with relatives to get additional perspectives.

Choosing the right nursing home is a big decision that requires time and reflection. By following these steps - from identifying needs and wishes to gathering information, visiting the home and talking to others - you and your relatives can feel confident in finding a care environment that matches your expectations and needs. A well-thought-out choice increases the chances of creating comfort, security and a good quality of life for the person moving into the nursing home.

Reflection questions about choosing a nursing home
Caring staff:
• Are there things you could easily do at your home to increase comfort and activity?
• How do you want elderly care to work when you one day in the future may need care and care?

Manager, nurse, occupational therapist and physiotherapist:
• What can you do to increase comfort, activity and other things that contribute to the joy of life at the home?
• Are there measures you can take to increase the stimulation for the residents to maintain functional ability, reduce fall risk or otherwise improve the environment?

Residents and relatives:
• Is your nursing home stimulating?
• Are there activities or services you miss?
• Do you see improvements that could easily be implemented in the nursing home?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day