There may come a time when you have to consider a long term care home for a parent. There are some things to be aware of if that's the case.

First, John McDermott, the long term care ombudsman for the state says a doctor must certify the senior as needing to be in a nursing home.

"Well, I would say that first of all, they need to be sure that the senior needs institutional care. So, we have lots of options to help people stay at home," said McDermott.

It may be that the elder could do well in adult day care and stay in the family home at night. There are several reasons the family may THINK the senior should be institutionalized.

"Maybe somebody is acting out because the medications that they're taking are causing some kind of a reaction and just by changing the medications, they improve," said McDermott.

But let's assume the senior needs to be under full time care. What should we look for in a nursing home?

"The staffing - that's a very critical issue. Are there enough staff so that if a resident is ringing the call bell, how long do they have to wait? Because that call bell could be 'I have to go to the bathroom' but it could also be I'm having a heart attack," said McDermott.

Families should be sure to get a first hand look at the facility.

"I'd be concerned about - what do the residents look like, I'd ask for a tour and find out, do they look like they are in meaningful activities are they just sitting in the hallway with nothing to do, very bored," said McDermott.

In fact, families should visit several times at different times of the day - including meal time.

"What's the interaction with the staff, are the staff friendly, do they know the residents by name. With the administrator, is the administrator basically in the office or are they on the floor, they know the residents, they know the staff, they know what's going on in their building," said McDermott.

For more information on long term care click here or you can call (808) 586-0100.