How to Choose a Senior Care Facility

As a geriatric care manager, I frequently visit long-term care facilities. Because each facility offers a distinct setting and array of services, it is difficult to know which one is the best choice for your family member. Most families recognize that choosing a facility based on cost alone is not the wisest decision. Choosing a facility based on its proximity to the primary caregiver is often not the best choice either, even though it should be close enough for family and friends to visit often. Keep in mind that your loved one will be in the facility 24-7; the best choice is one that will provide your loved one with options for continuing her own life in her own way, not the one that's easiest for everyone to visit. Here are some of the major factors I consider when evaluating long-term care facilities for a client. Every family will place a different value on each of these categories.

Factors to Consider

• Cost
• Location
• Activities
• Environment
• Staffing
• Medical Issues
• Ancillary Services
• Owner Information
• Discharge Criteria

Don't Underestimate Activities

Activities are critically important. People are social, and we look to each other for cues on how to behave; social stimulation prevents isolation and depression, and may contribute to delaying the progression of dementia symptoms. The best facility for your loved one should have activities that require participation as well as some that involve only observing or listening. Also look for a facility that has current residents with interests, backgrounds or physical disabilities that are similar to your loved one ’s. People have an innate need to belong.

One of the most important things to consider is the activity calendar. Ideally there will be something scheduled after dinner and on both weekend days. Ask about staffing hours. In some facilities, the main staff works Monday through Friday from nine to five, but in the better facilities, the staff rotates, taking different days off mid-week so that someone familiar is always present on weekends. A crisis is just as likely to occur in the evening or on the weekend as it is during the weekday, and the residents deserve an experienced professional to be present to manage their care. Ask if key employees, such as the administrator, have cell phone numbers that you can call when they are away from the facility.

Ask the Tough Questions

Find out whether the marketing people are on commission. Generally, those on commission will try to fill all the rooms, whether or not a resident is appropriate for the facility, so they can collect their commission. If they are commissioned, you must make a diligent effort to speak with residents’ families and the residents themselves. No one is more familiar with life in that facility than the residents!

Be sure to ask how medical emergencies are handled. Every company has a procedure that must be followed. Is the staff required to call an ambulance if your grandmother stubs her toe? Are they allowed to notify a family member and wait to make a decision? Is hospice care allowed in the facility, or will your loved one have to move into a different type of facility if he or she develops a terminal condition? Is there a physician who makes house calls in the building? Is there a staff or visiting nurse who sees patients who are hurt or ill? Some residents only leave their building for medical appointments. Life is more fun when the outings can be fun ones, not simply a medical necessity, so find out whether a podiatrist, dentist and eye doctor make regular visits to the facility; and whether a portable X-ray machine can be brought in to prevent a trip to the ER.

Do Your Homework

One of the most important pieces of information you need is the name and location of the owner. If the owner is in a different city in another time zone, and owns multiple facilities, the likelihood of you discussing an issue with that person is low. If the owner lives in the same town as the facility and has only a few properties, then it is more likely that you might speak with him or her directly in the event that a discrepancy occurs between the care you anticipated for your loved one and the care he or she receives. If you choose a facility that is part of a large corporation or a chain and it isn't possible to speak to the owner, take your concerns to the highest level that you can. In your preliminary research, get a name, title and the contact information for this person.

Check out GilbertGuide.com for consumer reviews of the facilities you are considering. Also look at the state inspections. Most states have licensing requirements and annual inspections to ensure that the facility is in compliance. The results are posted online. For skilled nursing facilities, go to Medicare.gov. Because licensing requirements for assisted living facilities vary from state to state, you'll need to check with your state's Department of Health, Department of Social Services or Department of Human Services for this information.

Consider the Future

Most importantly, remember that this facility may not be a permanent move for your loved one. It can be a trial. If this one does not work out well, there are others, and the next time you have to choose a senior care facility, you will be better informed. Look for the facility where your loved one has the best opportunity to continue living with the highest possible quality of life and personal satisfaction. When you find the right fit, you will not feel the need to visit every day, and your loved one will not be dependent on you for something to do.

Posted in Care Facility Evaluation Checklists, Choosing the Right Nursing Home, Geriatric Care Solutions, How to Choose the Right Community, How to Choose the Right Community, How to Choose the Right Community, How to Choose the Right Community