Everyone has their own personal checklist for finding good housing for their elderly parent. We want them safe, well cared for and happy. Happy depends a great deal on the individual, but safe and well cared for should be part of the bargain. So, what do you look for when you tour a center?
- First, don't just take a tour with an administrator and say, "all done." Yes, you will want a tour with an official guide and you will want to talk about options and contracts.
- Then, go back at a different time. If you can manage it, go back several times - once early in the morning while they are getting people up, especially if you are looking at nursing home. Assisted living centers will not be hustling people out of bed, but it's still a good time to get a feel for how mornings generally go.
- Expect to have some unpleasant smells, especially in a nursing home. This is unavoidable, but the home should be equipped to hand these issues quickly and efficiently.
- Watch how members of the staff treat each other, and the elders. Are they a cheerful bunch, working together and treating each other and the residents with respect? Do the hands-on caregivers in a nursing facility - generally Certified Nursing Assistants - seem to know "their" elders? Do the elders, in general, seem happy to see the CNAs? Please understand that some elders won't be happy - ever.
- Visit again mid-day. Residents should have meaningful activities. One reason to move from the old home into assisted living or a nursing home is for socialization. Many studies have proven that being socially active is good for the health - mental and physical.
- If you can, visit again in the evening. Security is more of an issue -- and that is a good thing. But it makes unannounced visits more difficult. Arrange to get past for evening visits.
- In any setting, are people treated as individuals with their personal likes and needs addressed? Or are they just like a little chain of beads, pushed along to conform to the efficiency standard of the home? This is an important aspect of care that is now called "person centered care." and you want to see respectful person centered care in action.
- Look for cleanliness. Look for attention to healthy detail.
- Make sure the facility is licensed and has no history of abuse. Read contracts carefully to see what is covered and what is extra.
You can go to the Medicare Nursing Home Compare Guide at http://www.medicare.gov/, and find a ranking for most homes. This can be useful, but the number of "stars" is only a guide. Most of these categories are self-reported, so many nursing homes may fudge. Also, this is a snapshot based on locality. In some states nursing homes are held to fairly high standards and others are pretty lax, therefore a two star home in one state may be far better than a five star home in another. Certainly, the Medicare ranking is useful, but only as one tool.
Bottom line, go with your gut. Check with families who have loved ones in the home. Don't go by just one recommendation (or condemnation). People have different expectations and even grudges. But do check with families you see who are visiting their loved ones. Several opinions should give you a fair idea of what families think. And what families think is far more important than the fluffy pillows on the couch and the smiling guide. Trust your instincts and word of mouth before you trust glitzy marketing strategies.
To recap: If Mom is declining, start thinking about whether she is safe in her home. If so, then she may be a candidate for in-home care. I'll throw in adult day care, here, too, as an option for her to get out, but that's another article.
If Mom needs more watching than is practical with just in-home care for a few hours, but doesn't need a lot of nursing care, she may be a good candidate for assisted living. If Mom needs quite a bit of nursing care, and an in-home agency that provides nursing care isn't enough, then a nursing home may be the next step.
Your guide to choosing the best of any one of these care options is the same: check references, observe how they interact with elders and use your gut. A quick check with the Better Business Bureau may not be a bad idea either.
Elder care author, columnist and speaker Carol Bradley Bursack is an AgingCare.com contributing editor and moderator of the
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Read her full biography