How To Choose a Long-Term Care Facility
Make an appointment for your first
visit.
If you think you might choose that facility, plan on dropping
in unannounced at least twice thereafter. The best times are
around mealtimes so that you can observe how meal service
is provided.
Try to speak with some of the residents
without staff present.
Ask them how they like being there. Try to get a feeling about
whether your relative would fit in and be comfortable with
the type of residents living in that facility . Are they experiencing
similar problems and care needs?
Do NOT be Distracted by a Perfect Looking Home.
Although a residential care home or nursing home should be
neat, clean, orderly and not have any offensive odors, ultimately
you are looking for GOOD CARE , not perfect decor. At California
Registry, we often visit homes that are exceedingly well decorated
but have managers and owners that have little or no experience
in caring for elderly people.
Observe how the residents and staff
interact with each other.
Do the residents seem withdrawn and silent? Do they seem depressed
and off in a world of their own? Do the staff treat residents
as adults or more like children? If so, this may indicate
that a facility is understaffed or that they don't understand
the psycho-social needs of their residents. To a large extent
the way the staff treat the residents will more than anything
else determine the quality of life that a resident experiences
in a facility.
Competent, caring staff that respect the personal dignity
of each resident is essential.
Read over the rental contract or
patient agreement form carefully.
Take it home with you if necessary. What extra charges are
there? What items are not covered in the care contract? If
these are not listed ask the facility to list what is not
covered and what it will cost for those extra services. Never
choose a facility that will not specify basic rates and extras
in writing for you. Another important thing to check is how
much notice you contractually must give a facility if you
must move your relative out of a facility either due to medical
reasons or if you are not satisfied with the facility.
Observe and sample meals.
Food is often one of the few pleasures that elderly people
can enjoy on a daily basis. If the food is bland and tasteless
or lacking in variety the quality of life of an elderly person
is seriously impacted in our opinion. We think that food is
very important in the choice of any facility, be it retirement
community or nursing home.
Usually it is not possible to sample the food prepared in
small homes, but in the larger facilities such as retirement
residences, assisted living facilities and nursing homes you
may be invited to eat with the residents. If you are not,
ask if you may eat a meal with the residents. Observe how
the meals are served to the residents. Are the servers courteous
and friendly. Is the food served hot ? Is the food easily
managed by an elderly person (e.g. can they easily cut it
up and chew it?) Is there a variety of drinks available? How
many choices do the residents have at each meal? Are there
adequate amounts of each item? Are there a variety of fruits
and fresh vegetables available? Are their desserts tasty and
attractive?
Ask to see the latest state licensing
inspection survey.
Every facility is visited at least annually whether it is
a residential care
home, assisted living facility or nursing home. In the case
of nursing homes, the annual survey is supposed to be placed
in a public area of the lobby or entrance to the nursing home.
If you don't see it , merely ask someone at the front desk
for a copy of it or where it is located. Every nursing home
will have some violations - but what you don't want to see
in the survey are documented observations of poor or negligent
patient care. Many of the deficiencies can be for things that
seem simple or even trivial, but the sheer number of deficiencies
may indicate a facility with real problems. A nursing home
survey that is ten pages or less and has no significant deficiencies
in direct patient care may be a good facility. One that 20-40
pages of deficiencies and lots of patient care deficiencies
is a facility that you may want to avoid.
Ask to speak to the Director of
Nurses Every nursing home will have a D.O.N. (Director of
Nurses).
In speaking to the D.O.N. try to ascertain
his or her philosophy of care and how long that person has
been in that position. The D.O.N. sets the standards for care
in a facility. If that person is good at their job and is
supported by management (i.e. the Administrator) then care
generally is good. Where there is turnover you are likely
to see a facility that has real problems in caring for its
patients.
