So, you and your loved one have taken the plunge. You’ve put in the time and effort to research senior housing options, take tours and compare your thoughts. The big move is finally behind you both. You might think the hard work is over, but not so fast. Caregiving doesn’t end once a senior has transitioned to a long-term care facility. Now it’s up to you to be their advocate, visit regularly and follow up to determine if this particular senior living facility lives up to your expectations.

You had an idea of what to look for in senior housing when you started this process, and most of those things still apply. However, now that your loved one resides there, your exposure to the community and staff isn’t as limited as it was when you had to go on carefully guided tours as prospective clients. It’s important to continue monitoring a loved one’s care after the move to ensure they’re comfortable, content and well cared for.

A Caregiver’s Tip for Gauging Care Quality in Senior Living

Over the course of two decades, I visited loved ones in senior housing nearly every day. While my visits were focused on spending time with my elders and attending to their needs, it was natural for me to assess how well the nursing home was functioning and whether the staff was meeting my elders’ immediate needs.

We all use slightly different criteria when we evaluate an elder care provider’s appearance and performance. For senior housing, my personal top priority happens to be assessing what I would call the atmosphere. The atmosphere I'm referring to has little to do with decor, although clean, pleasant surroundings are desirable in a senior living setting. I’m more interested in getting a feel for the overall vibe of the facility.

Have you ever entered someone's home and felt good things about it, even if it's cluttered or decorated in a way that doesn’t jive with your personal tastes? In some cases, a home can have an aura of happiness or lightness about it and we feel comfortable there. Conversely, other homes might come across as too rigid or formal, creating a feeling that the air inside is heavy and unwelcoming. Our reactions to our surroundings are often a product of the appearance of the environment itself combined with the demeanor of the people in the space.

The same can be said for senior housing. By definition, long-term care facilities like independent living communities, assisted living facilities, memory care units and skilled nursing facilities handle illnesses, disabilities and even deaths on a fairly regular basis. However, the atmosphere in these communities should be genuinely pleasant and light. Much of this atmosphere depends upon the way staff members interact with their residents, with visiting family members and with each other. Overall employee satisfaction has a palpable influence on these settings as well.

I'm not suggesting that every moment of every day at a senior living setting will be filled with chipper residents and employees, peace, and joy. However, if you visit often at different times of the day, you'll get realistic glimpses of staff members’ attitudes and how they handle routine tasks, extra busy times, and emergency situations. You'll be able to see the staff at their best and their worst and make an accurate assessment of the facility your aging loved one is living in. If you feel positive about the atmosphere and the staff, it’s likely that your loved one lives in a facility where they are receiving quality hands-on care and personal interaction.

Quality Markers to Look for When Visiting a Senior in Long-Term Care

  • Do you and other family members and friends feel welcome whenever you visit?
  • Do you notice lots of eye contact between staff members and the residents? Fear and avoidance are red flags. If you see that employees take the time to make a connection with each elder they interact with, then you've likely hit the jackpot.
  • Do you see signs of physical reassurance between staff and residents, such as gentle touches and hugs?
  • Are staff members appropriately dressed, personable and outgoing? Are they friendly to you during visits?
  • Is the staff quick to inform you either in person or by phone of changes in your loved one’s health status?
  • Has your loved one experienced any issues with their medications since moving in, such as timing, regimen changes or reactions?
  • How is your loved one’s personal hygiene? Do they look presentable? Are they bathed frequently and wearing clean clothes? Is their hair washed and are their nails trimmed?
  • If your loved one is incontinent, how often do you arrive for a visit and find that they need to be changed? How long does it take for an aide to handle this task? Is your loved one experiencing any skin integrity issues or UTIs associated with their incontinence care?
  • What condition is their room in? Is it well-maintained or is it cluttered? Is it clean and fresh? Are there any foul smells?
  • If the facility serves meals, does it offer a varied menu? What does your loved one think of the menu options? If you can, attend a meal with them every so often. What do you think of the food there? Refusal to eat and weight loss can be red flags that the food quality and selection are lacking.
  • Is there a dietician on staff overseeing menu selections and residents’ dietary restrictions? Are the meals nutritious without being bland or boring?
  • Are residents able to choose how often they eat, when they dine and where they take meals?
  • Are there rooms residents and their families can reserve for private gatherings?
  • Is there an activities calendar that includes a variety of hobbies and social opportunities that are appropriate for residents of all ages and abilities? A senior living facility should offer a plethora of options for residents to keep them active and engaged and help them get to know their new home and neighbors.
  • Are birthdays, holidays and other important events celebrated in ways that include residents and their visitors?
  • Are the residents encouraged to help themselves as much as they are able?

Keep in mind that I'm not overlooking basic quality indicators like health department ratings, licensing inspections, staffing ratios and complaints. Far from it. In my mind, those considerations are a given, and most people have already done this kind of research prior to moving their loved ones into senior housing. While this information can be very useful, in-person visits are what give you a complete picture of what life is like in a particular long-term care facility.

Seemingly small things can add up, and typically these minor issues are only observed firsthand. They can shed light on the overall quality of care in an assisted living community or nursing home if you visit often and are attentive to your loved one’s health and interactions with the staff.

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For example, several of my elders resided in the same nursing home throughout my caregiving years. When I heard the staff there joking with each other, I'd always smile. Laughter was everywhere, except when a resident had passed away. Then there were genuine tears from the employees because they lost someone they had grown to love. There's nothing like being there firsthand and seeing how the staff reacts to the death of one of their own to tell you what kind of a facility it is. That feeling and many others can't be quantified and ranked on a website. It's all in the atmosphere or the “vibe” of the place.

Handling an Elder Who Is Unhappy in Senior Living

In many cases, seniors vehemently oppose the move to long-term care. Keep in mind that some come to love their new homes after the initial transition period, but others simply will never allow themselves to settle into this unfamiliar environment. Although we want to see our aging loved ones thrive in this setting that is supposed to support and stimulate them, sometimes this is simply too much to ask for.

Your loved one may gripe daily about where they live, the staff and their neighbors. It’s important to listen to their complaints but be sure to take them with a grain of salt. If you’ve done your due diligence, visited often and found that they are receiving quality care from pleasant, well-trained employees, then there isn’t much else you can do to improve their situation. You can’t force them to socialize, try new activities or develop a more open mind. You’ve done your best to provide for your loved one. For that, you deserve a pat on the back and some peace of mind.