Caring for an aging parent often involves a rather shocking role reversal. It’s now the grown child ensuring the safety and well-being of the aging parent through a number of important decisions, and one of those decisions is when, where, and how to choose a care facility. Placement in a care facility can be an emotional and trying time for both parent and child. Plus, most people haven’t the slightest idea of how to go about the selection process. Here, you’ll find some tips to help you know what to look for in a care facility, which will make the selection process easier and hopefully make the transition as smooth as possible when it’s time.
Care should be taken to ensure that the care facility you are selecting is in line with the specific needs of the parents. There are some common ailments, which our parents start facing when they are old. If your parents are suffering from dementia, it would be best if you go to a facility that specializes in dementia respite care. Likewise, if your parents need more than one person as an attendant, you should make sure that the facility has enough staff members, which can be assigned to your parents.
Eight Things To Look For In A Care Facility:
1. What Level Of Care Does The Facility Offer?
Care facilities are not one-size-fits-all. So, the first step is to understand that there are different types of care facilities, such as:
- Independent Living – a retirement-like community where the residents continue to function on their own with limited assistance from the community’s management staff.
- Assisted Living – provides a community of support services, such as light cooking, cleaning, and medication management, to help a senior continue to function independently.
- Dementia/Alzheimer Care – provides skilled nursing support designed for the challenges of memory care.
- Long-Term Care – a nursing home environment with skilled 24/7 care for residents facing any number of non-specific health issues.
When looking at facilities, you’ll need to consider what level of care is offered in relation to needed/required. Also, look at whether the transition to higher care is an internal option should the need arise. It’s not uncommon for a facility to have an independent and assisted living community alongside the dementia and Alzheimer’s care unit, which makes the transition easier when memory care becomes a need.
If you’re unsure what level of care is best for your parent, you have several advocacy groups that may be able to help. For example, the National Association of Area Agencies on Aging can help you find local aging resources, locate elder care services, and give you a list of preferred providers in the category best suited for your parent’s health needs.
2. Is The Atmosphere Congruent With Your Parent’s Tastes?
Just as the skill and care level fluctuates from facility to facility, so does the atmosphere. Some facilities have a vibrant, highly engaging atmosphere that centers around community involvement and participation efforts by both staff and residents. Others may have a pool or game hall that’s more come as you please. Here are some questions to ask to help you gauge if a facility’s environment is a match for your parent:
- Are activities and functions person-centered, such as can my parent wake up and go to bed as they please, eat his/her meals when they please, and attend events and activities as they please?
- Is there a safe outdoor space available? Research has shown that green space has significant health benefits, such as improving mental health, lowering blood pressure, and decreasing cancer risks.
- Can I view the current activities calendar to see if my parent would enjoy the types and scheduling of activities?
- How large is the facility, what’s the size of individual units, and what’s the staffing ratio for each shift?
- Look around. Do grounds and facilities feel safe, secure, clean, and well-maintenance? What do you hear and smell? Do the staff seem happy? Do other patients/residents seem cared for and happy? Is the lighting sufficient? Are the grounds and facility set up to minimize fall risks? Are exists marked? Do you see sprinklers and fire alarms?
- Do special considerations exist for the parent? Will they need a pet-friendly facility? Do they use tobacco? Will they be bringing their own furniture such as high end hospital beds? Will they be bringing their own vehicle to the facility? Do they have a vision or hearing impairment special needs?
3. How Will My Parent’s Nutrition Needs Be Met?
Whether it’s assisted living or a nursing home, most care facilities offer a meal schedule of some sort. Generally, these facilities are managed by assisted living software. This software is designed to manage all the facilities. Still, as mentioned above, you’ll want to find out the schedule of the meals. However, you’ll want to dig deeper to ensure your parent’s nutritional needs will be met, particularly if they have a memory care problem that leaves them inclined to nutritional deficiencies. Read more about the common nutritional problems in memory care and nutrition tips to counteract the problems. Here are some questions you can ask to help determine if the facility has a good nutrition offering:
- Will my parent be hand-fed by qualified staff if necessary?
- Can a meal be delivered to my parent in their room?
- Is there an alternative main dish option available at each meal?
- Is there a program to monitor my parent for appetite changes, weight loss, and dehydration?
- Is there a nutritionist, chef, dietician, or other food and nutrition expert on staff to plan and monitor meal options?
- Are nutritious snacks offered?
- Can I sample the food? If so, does it look, taste, and smell appetizing? Is it the appropriate temperature and adequate serving size?
- Is alcohol allowed?
4. Are Staff And Facility Standards Up To Par?
As you tour a facility, you can tell a lot about it by just observing the demeanor and behavior of the staff. If staff aren’t happy to be at a facility, then chances are your parent won’t be happy to be there either. You’ll likely be in direct contact with the administrator, social worker, wellness director, and marketing director as you vet a care facility. You’ll want to ask them plenty of questions about the support staff and staffing policies and procedures. Here are some examples:
- Do all staff have background checks before being hired?
- Does the facility have any staff-related legal complaints, citations, or lawsuits?
- Does the facility have a high staffing turnover rate or frequently use agency staffing? Will my parent’s primary care attendees be somewhat stable so they can become familiar with each other?
- Does the facility offer staffing in-services in areas such as safety, abuse, and continuing education for skills?
- Our nursing and rehabilitation services are offered in-house by licensed and certified staff should they be needed?
- Does the facility have a resident or family council?
- What’s the emergency protocol for evacuations and disasters?
5. Can The Care Facility Handle Alzheimer’s And Dementia Needs?
If your parent has memory care needs, you’ll want to specifically address those in vetting a facility. You’ll want to know the answers to questions like:
- Is memory care a separate unit from any other independent, assisted, and long-term care facilities on-site?
- Are staff trained to work specifically in memory care and handle the challenges of a parent not wanting to eat, bathe, etc?
- If a parent speaks a foreign language or has an otherwise communication barrier, can staff accommodate this for effective communication?
- How will the care plan be maintained for my parent?
- What’s the process for hospice, therapies, hospital stays, checkouts by family, visitation, and so forth?
- Do staff arrange and transport for outside appointments, such as for a dentist, gynecologist, or optometrist, or is that the family’s responsibility?
- What’s the security protocol for wandering?
- What are the facility’s adjustment and orientation practices?
- How does the facility manage common dementia issues like sundowning or pica?
6.Family Involvement Versus Staff Care Expectations:
Ambiance, activities, meals, and safety are important for your parent, but knowing that you, the family, have a place in the care being offered is also an important consideration. In fact, when it comes to dementia, studies have found that one of the most important placement considerations is family involvement. Yet, there’s often a disconnect between family and facility, which leads to family expectations not being congruent with what staff are required to do and what high-functioning parents want and need to be done for them. Here are some tips to help ensure you’re on the same page as the facility:
- What’s the objective of care or mission statement for the facility?
- How are care plans handled?
- Can you easily and effectively communicate with staff?
- Are patient fund accounts available, and can fund inpatient accounts be managed by the administration?
- Can family request adjustments, and are such recommendations taken seriously?
- Does the facility recommend limited family visits, and, if so, for how long?
- Does the facility facilitates long-distance communication should you not live nearby?
- Is there a family engagement portal available?
7. Ask About Administrative Matters:
Payment is according to the type of facility and level of care offered. Private facilities, for example, typically do not take payments from government-funded insurances. Some long-term care facilities only take Medicaid and others may take both Medicaid and Medicare. Private long-term insurance may apply for only certain types and degrees of care. As you can see, it can be quite complicated beyond private pay scenarios. So, you’ll first want to make sure the care facility you choose accepts and qualifies for the type of payment you’ll be using. Beyond that caveat, you’ll want to consider some other important administrative matters:
- Why and how could my parent be evicted or discharged from the facility?
- What costs are covered by the basic payment?
- What common services and goods fall under additional expenses?
- How are medications obtained? How are they administered? Who refills them?
- Are our in-house doctor’s services included in the price or separate?
- Do checkouts and hospital stay affect residency?
- Is the facility licensed?
- Does the facility get inspected routinely, by whom, and how often?
8. Trust Your Instincts:
A care facility can look ideal on paper and check all the boxes for safety, affordability, and services. It may still simply not be the right tempo or atmosphere for your parent to thrive and be happy. The best judge of this will always be your instincts. Get your instincts primed with these tips:
- Tour the facility multiple times at different times of the day before deciding.
- Explore inside and outside.
- Talk to a variety of staff members.
- Ask the administrator for references.
- Don’t just look at the sample room… look at the dining area, common areas, and staff stations.
- Use all your senses as you examine the facility.
- Bring your parent with you if possible, and consider their opinion if possible.
- Try to remove society standards and your own tastes from the assessment so that you can determine if the environment fits your parent’s unique ideal.
- If possible, place more emphasis on the fit over the cost.
In conclusion, you can use these practical considerations and tips to help make the best call on picking a care facility for your parent. Having a “to do” and “to ask” list helps take the pressure, emotional upheaval, and unknowns out of the equation so that you can simply focus on what serves your parent’s continued well-being and happiness.