- Ask about the credentials and training of staff at an assisted living community or nursing home. Have all staff members received specialized training in the care of those with Alzheimer's disease and dementia? Keep in mind that there usually are state regulations mandating that all staff members have a minimum number of hours of dementia care training. Ask how the staff handles disruptive resident behavior such as "sundowner's syndrome" (the increase in acting out and confusion that people with dementia often experience during the evening hours), night wandering or emotional outbursts. Ideally, these behaviors should be managed without the use of physical or chemical restraints. Also, ask what kind of on-going education and support is available to the staff. All employees who come into contact with residents should have both training and support to help to minimize the likelihood of staff burnout, including the facility's housekeeping and cafeteria personnel.
- Ask what makes the Alzheimer's care at the facility special. Read the "Mission Statement" to learn about the facility's philosophy of Alzheimer's care. Does it sound like it fits the needs of your family member as well as the rest of your family?
- Find out about the facility's licensure and certification. Does it have appropriate state licensure? Medicare certification? Medicaid certification? (Keep in mind that, even if a facility has all of the appropriate licensing and certifications, those documents do not guarantee quality care.)
- Ask to see a copy of the most recent care audit report. All facilities are surveyed once a year by the state's licensing and/or regulatory agencies. Read these reports carefully! In addition to profiling the facility's problems, the audit also lets you know which problems have been corrected as well as those areas that have improved from year to year.
- Find out what support services and educational programs are available to family members. For example, is there an ongoing support group for family members? Is there a Family Council? Ask when meetings are held. Ask how the families are kept informed and involved with the resident's care. Are phone calls encouraged if family members have questions or concerns about their relative? Learn when care plan meetings are held and plan to attend. The input of family members can help staff to better understand the personal history of the person with dementia who may no longer be able to provide this information. Knowledge of a resident's life prior to the dementia can help the staff to better understand the person's behavior since it may relate to an earlier life experience. It also helps staff to view the resident as more than just a person with dementia. In addition, family members can find out how they can contribute toward their loved one's overall care.
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John J. Connolly is President and CEO of Castle Connolly Medical Ltd.