We spend a lot of time researching where to spend our vacations, where to send our children to college, where to spend or invest our money and even how to create meal plans, whether for a big family occasion or nightly dinners. However, one thing that thousands of proactive planners do not do until it’s too late is investigate where to place an aging parent.
Most older people want to live at home until they pass away. Unfortunately, this isn’t feasible in many situations. When and how we will pass away is not something most people can plan on beforehand, and the reality is that we do not age gracefully — we do so with ailments ranging from inconvenient to debilitating in various degrees.
It is common for seniors living at home to experience a fall or a medical condition that renders them unable to continue living in their own home. In this situation, the choices are few and often less than ideal: Either a family member takes them in or places them in an assisted living or nursing home facility. Additionally, this decision often must be made in haste — before mom or dad’s release from the hospital.
If you find yourself in this situation, the following is a list of considerations to guide you in selecting a facility to care for an elderly parent.
Seek out “culture change” facilities
The trend in senior care is a departure from the drab, institutional nursing home of yore. These days, many facilities are upgrading their environment, staff training and general approach to embrace residents as members of their broader family. These efforts to improve the quality of life for residents include fewer regimens, with the ability to eat, sleep and bathe according to their own schedule — not the facilities’. Ask what food alternatives the facility offers if a resident doesn’t like the main entree offered, or if a separate meal can be prepared to accommodate wishes.4
Tour after hours
It’s easy for a facility to put on a good show when it’s fully staffed during regular business hours. But you should also schedule times to “drop by” at night or on weekends to get a true sense of how the residents fare and if they are engaged and/or attended. Ask how many attendants are available at night, and if they engage with residents who are awake.
You can ask about staffing ratios, but that may not give you the whole picture. As you tour the residence, observe if there are elderly people waiting — to be fed, to be helped to their rooms after dinner, etc. If so, the facility may not be properly staffed at all times.
“Consistent assignment” is a term used to describe how care attendants are assigned. Ideally, each elderly person receives help from just a few different people throughout the week. This allows them to develop a relationship with them, and the caregivers to learn about individual needs, preferences and even quirks. Change can be disruptive, so having as many as 20 or 25 different people caring for one person in a month can be highly detrimental. Ask if residents have a say in who cares for them.5
RNs are the only staff licensed to assess a resident’s medical condition, so it’s important to ask if the facility has an onsite registered nurse 24/7. Federal mandates required that nursing homes have an RN on site only eight hours per day, but the better facilities will have one available around the clock.6
Ask about staff turnover of staff direct care workers (CNAs or nurse assistants). While the national average is 70 percent, look for a facility with less than 40 percent. Also ask about the turnover rate of licensed nurses. The national average is 50 percent; seek out a facility with less than 30 percent.7
4 Eleanor Laise. Kiplinger. December 2014. “Find the Right Nursing Home.” http://www.kiplinger.com/article/retirement/T027-C000-S004-find-the-right-nursing-home.html#zhMI3EJO5Muom4yo.99. Accessed March 25, 2015. 5 Ibid. 6 Ibid. 7 Pioneer Network. March 25, 2014. “Facts for Features: Older Americans Month: May 2014.” https://www.pioneernetwork.net/Consumers/Guide. Accessed March 25, 2015.