Tips on Choosing a Long Term Care Facility

Life happens. As we grow older we may be forced, for one reason or another, to contemplate long-term care facilities as an option for ourselves or someone we love. This person may need more attention than we are physically able to provide. Their health concerns may prevent them from living a more independent lifestyle. Do not be mistaken, these facilities are not all created equal. There are many things we can do, as the primary decision maker, to ensure our loved one is getting the best care, and can reside in such a place while maintaining their security, dignity, and lifestyle.

The following tips will help you to make a more informed decision, and give you peace of mind that you are giving your loved one the best care available.

The first consideration should be to decide what level of care is needed for the person in question. Relatively healthy, mobile people may do well in an independent living facility. If there is some question as to the person's ability to care for themselves, assisted living provides trained aides to help with daily tasks and prescription monitoring. People with more serious health ailments may require a nursing home where constant supervision is necessary.

Researching long-term care facilities will be primarily accomplished over the phone. Check the local Council on Aging, Senior Services, or Better Business Bureau for listings and contacts. Call several places and discuss the level of services offered, pricing structure, housing arrangements, etc. and get a basic feel for the places you would be interested in visiting. Schedule an appointment to visit each of your selections and take notes comparing the overall atmosphere of each.

Your first visit should be arranged with the facility director. Later, you may wish to make an unannounced visit, especially if you have any reservations about the first meeting. This will provide a more honest, day-to-day view of the operation.

Arrive a few minutes early and inspect the buildings and grounds. The facility should feel more like a home than an institution. Grassy areas, plants, and outside seating provide residents a way to enjoy nice days. Take note of any security procedures for gaining entry into the building. Are residents permitted to come and go at will?

Once inside the building, your first impression should be the absence of any conspicuous odors. It should be free of offensive smells. If it does, there may be a lapse in the housekeeping area or an understaffed department. Keep an eye open for any sanitary or safety issues. Are gloves worn by the employees dealing with or cleaning up after the residents? These signs will demonstrate the overall commitment of the management and staff.

One of the best barometers of a facility's ability to provide care is the residents themselves. Are they clean, dressed, and groomed appropriately? Do they seem happy? Are sick residents allowed to mingle with the healthy residents? Are there any sick staff members in patient contact? Look for wheelchair-bound residents that may have been "left" alone or out of the way. Much can be learned by watching the residents and staff performing daily routines.

The director should introduce you to the staff and give you a tour of the entire facility. Watch the manor in which the staff interacts with the residents. Take note of patient's rooms. Room layout and personal decorations are important to a healthy environment. Are the beds made and bathrooms clean? Have the director explain the division of responsibilities between the resident and housekeeping department. Ask yourself this question, "would I want my mother living here?"

Inquire about the variety and scheduling of activities. Does the facility provide transportation to doctor appointments, shopping, and other activities? Look for bulletin boards announcing upcoming activities or pictorials of previous ones. It has been my experience that they may over exaggerate the many activities only to find out that many were canceled.

During your tour of the dining room, you should see a posting of the planned menus for the week. Notice the variety, balance, and portion size of meals. Check for a nutritionist on staff. Ask about any special diet requirements your loved one may require. Sometimes the director will invite you to join them for a meal. This is an excellent opportunity to watch the other residents. Are they being treated with dignity and respect? Are they getting enough to eat. Are their requests being met or ignored. Are residents requiring assistance being cared for with patience and understanding? This will tell you a lot about the quality of care being provided.

Have the director explain the billing procedure. What is included in the base price and what is extra? Are statements itemized and mailed or handled in some other way. Who does the accounting? Be sure to understand the policies and procedures used.

Finally, ask the director about doctor's appointments and prescription control. Who has access to and dispenses both prescription and non-prescription medicines? Are medicines kept in a locked room and labeled appropriately?

If the facility transports residents to doctor's appointments, is the family notified of the results and any changes in treatment? Do you need a Power of Attorney to make inquiries and/or decisions about these or any policies of the facility? Make sure you know your rights and the rights of the resident. Having a clear understanding from the start will eliminate a lot of potential problems down the road.

Having done all of these things, you can then make an informed decision and choose the best possible place for your loved one. It may not be the ideal solution, but knowing that they are in a safe, healthy, supervised environment makes this difficult transition easier for both the prospective resident and their families.