Most tours happen at two in the afternoon, when the hallways are bright, the staff are free to talk, and nobody is getting up in the dark. That is the wrong test. If she is considering a move, the question that matters is what happens when she gets up at night, alone, and walks from her bed to the bathroom. Ask for a second visit in the evening, or ask the staff to walk the route with you at the hour she usually wakes.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Walk the route in the dark
Stand where her bed would be. Walk the path to the bathroom the way she would, with her walker or cane if she uses one. Check the light on the path, whether the switch is within reach from the bed, whether the floor changes height or texture anywhere along the way, and whether the bathroom door swings in the direction that gets in her way. Look for grab bars at the toilet and the tub, and check whether a call button can be reached from the toilet itself, not just from the bed.
Ask how night help arrives
Ask how often staff check on residents overnight and whether those checks are scheduled or only happen when someone calls. Ask how long a call light usually waits before someone answers, and whether that changes between the early and late part of the night. Ask how many staff are on the floor overnight and whether they are the same people from night to night. Write the answers down in the staff's own words, and ask whether the facility will put them in writing.
Ask what happens after a fall
Ask what the facility does when a resident falls at night. Ask who gets notified, how quickly, and who makes the call on whether she goes to the hospital. Ask how the family hears about it. Questions about her specific health conditions belong with her physician, who knows her history, so bring a short list of what you want to ask.
Compare on the same questions
Visit two places if you can, and ask both the same questions in the same order. Write down the answer, who gave it, and whether the staff member seemed sure. If a place cannot show you its night route, that tells you something important. For St. Louis options and the next steps for local help, see the Local help after a fall, St. Louis page.
What to write down
Record the time of each visit, the route you walked, the light and door notes, and the answers about night checks, call lights, and the fall process. Put the place with the fewest unanswered questions at the top of your list, even if the lobby impressed you less.