Choosing a Care Facility


I live in a continuing care community and am a volunteer for the state’s long-term care ombudsman program, visiting an assigned nursing home to talk with residents and observe their care. I would like to share some of my observations and those of the daughter of my friend who is in a long-term care facility in the hope that it might help you if you are searching for the right place for a loved one.

Of course, you will tour potential choices. Take your list of questions and a trusted, knowledgeable friend who knows you and your loved one and who is fearless about telling you what he/she thinks, both positive and negative. As you visit, is the facility very clean? This is basic. In the halls are only the things in immediate use so that there is plenty of room for walkers and wheelchairs to navigate easily and safely? Do you notice unpleasant odor? Are call lights answered promptly?Does the staff look at least content, hopefully happy? Do they make eye-contact, acknowledge your presence?

Ask about certification, look at the state Board of Health report, the ratio of nurses to patients, their qualifications and in-house training. What is their turnover rate? How is management chosen? Are promotions almost automatic or are efforts made to recruit highly qualified individuals? If you can talk to individual staff, ask how long they have been there, what they like about their work. Remember that individuals, patients and staff, may not be typical, so talking with several may be helpful. Caring for this population is hard and wages are low. I think it is a “calling” for those who do it well. Those who care are not just task oriented, checking off the boxes, but see the resident as an individual and relate to them as individuals, trying to be thoughtful about how they care for them. Many agencies have a regular meeting where residents have an opportunity to bring their concerns. Ask if you may attend, if it is possible for you.

Stop in the dining room at mealtime. How is seating arranged? Are people talking to each other? Does the food look appetizing? If individuals need clothing protectors, are they wearing them? Who puts them on? Are they attractive, clean, and well received? Is there variety or are they all the same (no individuality).

How flexible is the agency? Is room service provided? If needed or desired, can you bring in someone to provide extra care or therapy? What is the visitor policy?

So much research describes the importance of exercise and being with others in a social environment. My experience validates this. If your loved one is able to participate, are planned activities things he/she might enjoy and offered frequently?

Is the location convenient? I can’t tell you how important are visits from family and friends. Make it as easy as possible if you can.

Of course, money is important. How can your loved one’s assets be spent most wisely? Care is very expensive and planning is important. What options are available and what do you both need?

Keeping some of these ideas in mind, along with the desires of your loved one, will help you make the right choice at this difficult time.

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