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The day you visit a care home for the first time, you are making a decision that will shape your parent's life for years. Most families arrive with a list of vague intentions -- check the room, see how it smells, talk to someone in charge. Then the tour finishes, the paperwork comes out, and the moment to ask the hard questions has passed.
This is the list we wish every family had before they walked in. Fifteen questions organised by category. Some will feel uncomfortable to ask. Ask them anyway -- a home with good standards welcomes them.
Category 1: Costs and the admission process
The monthly fee listed on a website or brochure is rarely the number you actually pay. Getting the real cost upfront protects you from surprises months later.
1. What exactly is included in the monthly fee?
Ask for a written breakdown. Most Kerala care homes include accommodation, meals, housekeeping, and basic supervision in the base fee. Many charge separately for laundry, escort to hospital appointments, physiotherapy, occupational therapy, and medication management. Get the list in writing. Then ask: if my parent needs something not on this list, how is it priced?
2. What is your refund policy if my parent leaves or passes away?
Some homes charge a registration or admission deposit (Rs 25,000 to Rs 1 lakh or more). Ask whether this is refundable, under what conditions, and how long refunds take. If a parent passes away mid-month, is the remaining fee prorated? You do not want to negotiate this during grief.
3. How much notice is required before a fee increase?
Care home operating costs rise over time and fee increases are normal. What matters is whether they are predictable. Ask for the policy and, if possible, the fee history for the last two years.
4. What documentation do you require at admission?
Most homes in Kerala ask for medical records, identity documents (Aadhaar, passport for NRIs), a doctor's fitness certificate, and emergency contact details. Knowing this in advance means you are not scrambling for paperwork on admission day. For NRI families arranging care from abroad, ask if documents can be submitted digitally.
Category 2: Care quality and staffing
The physical building is the easiest thing to assess on a tour. The care quality is harder to see, but these questions get at it.
5. How many caregivers are on duty per resident, and what happens at night?
A reasonable daytime ratio is one caregiver per five to eight residents. Night shifts are where many homes cut corners -- ask the number specifically. If the home is evasive or pivots to talking about the building, that tells you something. For a nursing home or post-surgery setting, also ask how many registered nurses are on-site (not on call) overnight.
6. What training do caregivers receive?
Ask whether staff receive training in dementia care, fall prevention, and basic first aid -- and whether training is ongoing or a one-time orientation. Staff turnover is also worth asking about. A high-turnover home is harder on residents because they are constantly adjusting to new faces.
7. How do you handle a resident who is having a difficult day?
Ask about agitation, refusal to eat, or a fall. You are listening for a specific protocol, not a reassuring platitude. A well-run home has a written procedure and staff who can describe it without hesitation. This question also tells you about the home's culture: whether residents are seen as individuals or managed in bulk.
Category 3: Medical care and emergencies
8. Which hospital does the home use, and how far away is it?
Know the answer before you need it. Ask the typical ambulance response time and whether there is a nurse on-site 24 hours or only on call. For parents with a known medical condition -- cardiac issues, diabetes, post-surgery recovery -- ask whether staff are equipped to manage that specific condition. If you are looking at our Kochi listings, proximity to a multi-speciality hospital is a meaningful variable.
9. Is there a visiting doctor, and how often do they come?
Most residential care homes in India have a visiting physician rather than a full-time GP. The frequency matters. Once a week is reasonable for a stable resident; once a month is not enough if your parent has active health issues. Ask whether the home coordinates with specialists and how medical records are shared with the family.
10. What is your protocol for informing the family about a health change?
Who calls you, and when? Is there a threshold -- they contact you for anything above a certain level -- or does the home decide what families need to know? NRI families especially need to know they will be contacted immediately for anything significant, and that a video call can be arranged quickly. For more on evaluating care from abroad, see our verified care homes in Kerala.
Category 4: Daily life and family access
11. Can I visit at any time, or only during set hours?
A confident, well-run home has nothing to hide and welcomes unannounced visits. Strict visiting hours are not automatically a red flag -- some homes use them to protect residents' routines -- but the reasoning matters. Ask why the policy exists and whether exceptions are made for family members who live far away.
12. What does a typical day look like for a resident?
Ask about meal times, activities, time spent outdoors, and how social the environment is. For parents who were used to an active life, isolation is a genuine risk in a care setting. A good home has structured activities -- not just television -- and staff who encourage participation rather than just managing the schedule.
13. What happens if my parent and another resident have a conflict?
Small communities produce friction. The question is whether the home has a process for addressing it -- or whether it gets managed by whoever raised their voice last. This also opens up a conversation about how the home handles complaints from families.
Category 5: The paperwork
14. What does the admission agreement say about grounds for discharge?
Some agreements include broad clauses allowing the home to ask a resident to leave with relatively little notice -- if their care needs exceed what the home can provide, or for behavioural reasons. Read the agreement before you sign it, not after. If something is unclear, ask in writing and get a written response.
15. Are you registered with any government body or inspection agency?
In Kerala, residential elder care homes may be registered under the Maintenance and Welfare of Parents and Senior Citizens Act or with the State Social Welfare Board. Ask whether the home has been inspected and when. At GetCareIndia, a home earns our Verified badge only after one of our team visits in person -- we use a 15-point inspection that covers many of these criteria. Read about how our verification works.
Frequently asked questions
What documents are typically required for old age home admission in Kerala?
Most Kerala care homes require: a government-issued photo ID (Aadhaar card, passport), recent medical records and a doctor's fitness certificate, emergency contact details, and proof of address. Some homes also ask for two passport photographs and a completed admission form. NRI families can usually submit scanned copies digitally and complete originals on the first visit.
How long does the old age home admission process take?
For most residential homes in Kerala, the admission process takes one to three days from the initial inquiry -- assuming documentation is ready and a room is available. Some facilities have a waiting list for specific room types. It is worth beginning the process before it becomes urgent.
Can I negotiate the monthly fee at a care home?
In practice, most established homes have fixed pricing tiers. Where there is room for discussion is on add-on services (physiotherapy sessions bundled vs. charged separately, for example) and on deposit terms. That conversation is easier before you sign than after.
What happens if the care home cannot meet my parent's changing needs?
Ask this directly before admission. A good home will be honest about the upper boundary of care it can provide and should be able to refer you to a more specialised facility -- such as a skilled nursing facility -- if the need arises. Some larger campuses offer multiple levels of care, which avoids the need to move.
Is a care home admission agreement legally binding in India?
Yes. Care home admission agreements are contracts. Read the termination clauses, fee-escalation provisions, and liability limitations carefully before signing. If you have doubts, have a solicitor look at it -- the cost is trivial compared to the commitment.