There may come a time when a nursing home— which can provide 24-hour skilled medical care and supervision— is the best (or only) solution. Much has been published about inadequate nursing-home conditions, and while many of the fears these stories fuel are overblown, some are not. Just this past June, Attorney General Janet Reno announced that despite improvements, "seriously inadequate care persists at far too many of our nursing homes." That doesn't mean you can't find good care, provided you do your homework.

Start your search with Medicare's "Nursing Home Compare" database (at www.medicare.gov). This service lets you search for Medicare- and Medicaid-certified nursing homes by geographic area and provides details on each, including the results of their most recent state inspections. Your state Agency on Aging can also provide a list of local nursing homes. Next, talk to people familiar with the facilities— neighbors, your parent's physician, social workers, the hospital discharge planner, or a geriatric-care manager.

Visit the homes you're considering and ask a lot of questions. Your first visit will probably be a guided tour, but take time to observe how the staff interacts with the residents. Speak with the residents about what it's like to live there. And trust your senses: Does the place smell clean? Does it look comfortable and cheery? Is it noisy or peaceful? If your parent has special health problems, ask whether the nursing staff has experience caring for such patients. After this first visit, go back at least once more— this time in the evening or on a weekend, when many nursing homes have fewer staff on hand or provide different services. As a further check, call the Long-Term Care Ombudsman in that area ( www.aoa.dhhs.gov). The ombudsman has firsthand knowledge of local nursing homes' specific strengths and weaknesses. She can also answer questions about inspection reports and tell you if any complaints have been filed by residents or their families.

Once you've narrowed down the choices to two or three, take your parent to visit the homes you like, if possible. She's the one who has to live there, and it's important that her wishes are respected and her fears addressed.

Finally, unless you are certain your parent can pay out-of-pocket indefinitely, choose a facility that accepts Medicaid. Even patients who pay privately when they enter a home often run out of money and end up on Medicaid.