Sherrie Bennett
Choosing a long-term care facility for yourself or a loved one is confusing and stressful. Learning about the various options and considerations ahead of time can take some of the doubt out of a frustrating experience.
Factors To Consider
There are many types of long-term care. What's appropriate for you or your loved one will depend on the answers to these questions:
- Is long-term care insurance available?
- Can the person needing care walk unassisted, and feed him or herself?
- Is constant medical supervision necessary?
- Is special assistance, such as physical therapy or Alzheimer's help, needed?
- What resources - such as Medicaid, Medicare and private insurance and other funds - are available to pay for the care?
Types of Facilities
There's a big range of care available to residents of long-term care facilities. From least restrictive to most restrictive, they include:
- Independent living residences, with separate living quarters and no special living or medical assistance
- Assisted living facilities, with small private living quarters, some help with daily tasks such as eating and dressing, and monitoring of health needs when needed
- Nursing home or rest home facilities, which offer 24/7 assistance with daily living tasks and fulltime health monitoring, but no extensive medical care
- Intermediate care facilities or skilled nursing care facilities, with intensive medical care for the chronically and seriously ill
- Extended care facilities, which are usually hospital-affiliated and offer short-term care for seriously ill patients
Resources For Long-Term Care Facility Referrals
There are many people who can give you ideas on which long-term care facilities to consider, including:
- Your family physician
- Hospital discharge planners, social workers and home healthcare nurses
- Friends and neighbors who have been through similar experiences
- Your church pastor
- Geriatric screening programs through a local hospital or community center
- Government agencies such as the federal Area Agencies on Aging, or local social services or family services groups
Touring the Facility
When you have your choices narrowed down, it's best to tour the facilities during business hours without an appointment. You can meet with the staff, see everything, and take a meal if there are dining facilities. It's best to go back for a second look in the evening or on a weekend, to see if there are differences in staffing at "off" hours.
Things to think about when touring a facility include:
- How long did you have to wait to see a staff member?
- Does the facility look and smell clean?
- How does the staff interact with the residents?
- Are residents interacting socially with each other?
Necessary Information
Some questions to ask while at a facility include:
- Who responds to emergency calls for help and how soon?
- What is the ratio of staff care providers to residents?
- How are immobile residents cared for?
- What is the cost of care? Are there additional charges for "extra" services?
- Is the care covered by Medicare or Medicaid? (Aside from practical financial considerations, eligibility for these programs means the facility has met minimum government standards for safety and cleanliness)
- Does the facility maintain liability and malpractice insurance?
- Are health licenses and state inspections up to date?
- Is there a physician on staff or on call? Is a licensed nurse on duty at all times?
- Are all staff members trained in first aid and CPR, with emergency equipment easily accessible?
- Are medications and other potentially dangerous items locked up, so that someone who is disoriented can't access them?
- Is there an emergency exit plan in place, with easy exit access?
- Can family members visit? Can you visit any time or just at specific times and places?
You can also investigate on your own by:
- Checking with the local courts to see if there are any pending lawsuits for malpractice or unpaid debts
- Checking with state and local agencies and boards to find out what certifications the facility has and how well it rated in recent surveys of state facilities
- Checking with local fire marshals to see if safety standards are met
If you or your loved one has an Alzheimer's diagnosis, you'll want to ask about staff members' familiarity with the disorder, and ask specific questions about:
- Special physical precautions, such as extra locked cabinets and supply areas
- Alarms on exits
- Staff familiarity with recent Alzheimer's developments and treatments
- Increased staffing ratios for Alzheimer's patients
Related Web links:
Nursing Home Checklist