There is a lot of information available to help you choose the right skilled nursing facility for you or your loved one. With such a big decision, it is natural and important to ask as many questions as possible. You need to know that your health care professional can help in a way that just wouldn't be possible at home.
How can you be certain you are choosing the right care center? Let’s dig into some of the factors that go into making that decision, such as specific precautions taken to protect patients with dementia and how often family can visit. What is the process for determining if a patient has improved enough to be discharged? And finally, what kind of therapeutic techniques does this care center use? Here are a few questions to ask when selecting a facility for you or your loved one.
What precautions do you take to ensure the safety of the residents?
Patient safety is a paramount aspect of treatment, and high-quality care facilities recognize that it is their responsibility to provide the safe and caring atmosphere that patients with Alzheimer’s or other forms of dementia need to thrive. It is crucial that facility branches such as social services and the activities department work together to maintain a well-rounded understanding of each individual patient.
Another way facilities ensure patient safety is through close supervision. Jessica Lynne White, Director of Rehab at Fireside Convalescent Hospital, explains: “The number one thing is paying attention to their basic needs. Know when they are hungry, when they have to go to the bathroom, and respond in a timely manner and in a dignified way. If you’re not constantly aware and alert, they might try to get up and meet their own needs—and that’s when injury can occur.”
Introducing patients to walkers and wheelchairs early on can also improve patient safety. If the walker or wheelchair is introduced after a patient has lost some cognitive functions, then he or she may have a harder time using it. Medical professionals must act quickly to analyze each situation appropriately.
How much should family members be involved during rehab therapy sessions?
Concerned family members want to know how involved they can or should be during rehab, and understanding their role can show them how to best support the recovery of their loved one. According to Mary Anne Mullane, director of rehab at five-star-rated Linda Mar Rehabilitation, high-quality skilled nursing facilities will weigh each case on an individual basis.
“There is no straightforward answer to this, because patients are so different and come into our care in different scenarios,” says Mary Anne. “Sometimes the patients need support in the beginning so they can get comfortable. But other times a patient can get overstimulated or distracted by visitors.”
Although Linda Mar is careful to consider each case separately, Mary Anne states that family presence generally helps patients and improves their rehab outcomes. “Sometimes patients only respond to someone they know,” she adds.
When do you typically discharge patients?
High-quality skilled nursing facilities conduct initial assessments on patients to evaluate their skilled needs and create a care plan. Carina Arceo-Vergara, Director of Nursing from Lake Balboa Care Center, explains: “We try to have the care plan meeting immediately to discuss the anticipated progress and put together a time frame. After therapy, we have another care plan meeting—this one with doctors, social services, and anyone else involved—to make sure the patient is safe for discharge.” Careful preparation of a care plan can ensure patient safety upon discharge.
Highly rated skilled nursing facilities will discharge patients as soon as they are no longer in need of skilled care. If the family or caretaker is not yet ready to receive them, then the social services discharge planner will help the family to make accommodations. “Sometimes all the family needs is a bit of training, which we can provide,” concluded Carina. “And if the patient needs to be transferred to a long-term facility, then we work together with social services to help them in that process.”
Be wary of any skilled nursing facility that offers to keep patients longer than needed for skilled care.
How do you define “progress”?
Patients typically enter skilled nursing when they are not able to go home from the hospital directly after a surgery or procedure. Gauging progress is different for every patient, but the main goal is to try and get them back to their previous level of ability. Signs of improvement include improved health as determined by the medical director and the ability to accomplish activities of daily living (ADL’s) independently.
“If a patient comes to us with very little prior function, then the goals are radically different,” said Alyssa Higgins, Director of Rehab from Scottsdale Nursing and Rehabilitation. “Also, a lot of patients live alone or with only one other person. Progress is also defined by how easily they can integrate back into that specific home setting. We’ve found that patients with a lot of family support typically do better.”
A high-quality facility will chart a patient’s progress daily and communicate effectively with family members about the expected recovery time. Similarly, a high-quality facility will communicate well about any decline that they observe in the patient’s health or abilities.
What types of therapy do you provide?
A high-quality skilled nursing facility will assess each patient and create an individualized care plan, which usually includes physical therapy, occupational therapy, and speech therapy. Physical therapy treats disease or injury through methods such as massage, exercise, and heat treatment. Occupational therapy helps patients gain back the ability to engage in activities of daily living, such as pushing a shopping cart or making cookies. Speech therapy generally helps individuals with swallowing and speaking clarity.
Kit Quan, director of rehab from Pacifica Nursing and Rehab Center, takes care to fully assess every patient’s progress in order to individualize treatment. Rehab schedules can then be prepared and followed, assuming the patient progresses as expected. But, Quan reaffirms, “We can’t tell you exactly how long anything will take because we don’t have a crystal ball.”
Choosing a skilled nursing facility can be a daunting task for patients and loved ones. But by asking the right questions, you will be able to assess which facilities have the highest quality programs and know which options are the best for you.