The Next Step: Choosing Long-Term Care for Your Loved One
When it comes to making long-term decisions for elderly loved ones, their quality of life and well-being is of the upmost importance.
If you have a family member who may need extended care in the next few years, go ahead and begin educating yourself on the process and researching optional facilities. Being familiar with the options and having a portion of the research complete ahead of time will help reduce the chance of making a poor decision when the need becomes immediate. Your research should include a combination of referrals, state inspection reports, online reviews, scheduled and unscheduled facility tours and personal interviews with individuals utilizing extended care services for their family member. Below are several things to consider during an onsite visit.
Location
Frequent visits from family members help maintain a level of security, as well as the mental and emotional well-being for an elderly resident. Choose a location that is convenient for family members so that your loved one will be able to enjoy visits from family throughout the week or be transported by relatives to family events. This will help your loved one feel connected to their children, grand-children and great grand-children. If needed, this also allows family members to address any care issues while on site and ensure a happy and healthy resident.
Cleanliness
If the smell of urine greets you at the door, this is cause for concern. This could mean one or more things. An overpowering smell of urine could indicate the facility is simply not cleaned consistently or thoroughly by the staff. Caregivers and janitorial staff members are motivated by the managing directors to perform and meet standards. If cleanliness is not a priority to the managing directors, then it will not be a priority of the caregivers or janitorial staff. The smell of urine also presents itself when the janitorial staff reduces, or is directed to reduce, the strength of their cleaning and disinfecting agents to save on costs. If cutting costs in sanitation management is necessary, it is likely that the facility is not handling their expenses and Medicare/Medicaid reimbursements well. Sadly, another reason for a noticeable smell could be that the hygiene of residents lacks proper attention. When simple sanitation, resident hygiene or budgetary issues are a challenge to the staff and directors, then it should be safe to assume that managing the care of your loved one might also be a challenge.
Observations
Take time to observe interactions between staff members and residents. Are the staff members actively communicating and engaged with the residents? Skilled-nursing facilities are in the business of service – serving the needs of elderly or physically impaired residents who cannot attend to themselves. If a majority of the staff members are stationary for extended periods of time, not interacting with residents nor completing resident-oriented tasks, then the philosophy of the management and staff may be a very reactive-based philosophy. The best extended care facilities have proactive and service-oriented philosophies that are driven from the top (from the directors), down (to the staff). Anticipating residents’ needs builds trust between the staff members and residents, increases the consistency of attention residents receive and decreases the chance of neglect or injury. Once the decision is made and your loved one is settled into their new, extended care facility, your detailed observations should continue. Drastic social, physical or behavioral changes in a resident could indicate abuse or neglect.
Nutrition
Mealtime is a large component of the lifestyle experience in an extended care facility and a pivotal time of day for the delivery of care. Mealtimes represent family, tradition and identity. Observe and consider the meal schedule, the rigidity of the meal schedule, nutritional value of menu items, the look and feel of the dining room, as well as the assistance provided by the staff during mealtimes. Is the dining experience based on a medical model, which is bland, institutional and focused solely on meeting nutrition requirements? Or, is the dining experience based on a social model that holistically focuses on both nutrition and quality of life components? A more interactive, flexible, comfortable, home-like dining experience creates a feeling of independence. This culture also nurtures healthy eating habits, which reduces the risk of malnutrition – a common and widespread problem in nursing homes.
Other important information to gather and consider are cost, the various types of extended care facilities, the optional medical and therapy staff available, and transportation provided.