Considering Assisted Living Facilities: Finding A Village That Cares

When it comes to aging loved ones (spouses, parents, aunts, uncles, grandparents, etc.) it can be difficult for a family to understand their feelings, the best way to help them or predict how they may react to new or different situations. This is especially true if they have common underlying medical conditions associated with aging or in the early stages of Alzheimer’s Disease or Dementia. This article will be an insider’s guide on how to look for and interview senior care facilities and will cover all of the areas that are important to address to potentially avoid hurt feelings for anyone involved in the process of finding the perfect home for their loved one. Also, discovering ways to collaborate and communicate with the Administration team and the rest of the staff will help lay some anxiety to rest when it gets closer to choosing a facility and touring it.

Many times, all the care for an elder falls on the shoulders of one caregiver with little to no break. It is nearly impossible for that person to feel comfortable enough to get away for simple self-care tasks like a hair appointment or a trip to the grocery store. When tasks like these continually become too daunting for one person, they often turn to senior care living for their loved one. If it is not pure exhaustion pushing caregivers to think about the idea of senior care living, looking into facilities may also be prompted by their loved one needing to go to the ER because of a fall, more frequent hospital stays, or it could even be a suggestion brought on by the family’s physician.  When the subject of senior care living is breached, it does not come without many questions along the way. It is important to remember that when the journey in the search for quality senior care living options begins, no matter how hard the questions you have, you should ask them. I say this because many people are hesitant to ask questions because they may feel the facility may judge them or that the facility staff may feel they are being judged by the questions asked. The care and wellbeing of each resident is the bottom line, and the family deserves to have the answers to all the questions they have prior to any care they or their loved one receive.

It may be an assumption that senior care living scoops up a resident admission from somewhere, not learning much about the person and then the staff within the facility just try to do the best with what they got. Fortunately, for the new resident, the caregivers, and staff members of the facility, which could not be further from the truth.  One of the top priorities for a new resident (and resident’s family) is to collaborate and communicate with them about the needs of their loved one to ensure the highest quality of care. There are some great tech products available to help monitor your loved one’s environment to make sure they’re comfortable or feel less lonely by making it easy to check in via a video call and sharing pictures and videos with them.

It should be of utmost importance to develop a family relationship from day one that is ensured to last the entirety of the resident’s stay. One might ask, “How do I create a relationship that is open and transparent with my loved one’s care team?”  As a Director of a long term care facility, I will tell you!

• Choose a facility that you and your loved one is comfortable with. Some factors that one may want to consider when looking for a care facility when they begin their search is: location, level of care, and size. Go online and look at pictures, head over to the community health department and gather pamphlets. When you visit about these facilities and the possibilities, what does your gut say about each one? That just might be enough to tell you which one to tour.
• Location: How far are you willing to have your loved one away from you? Will you be visiting every day? Are you in a climate where winter travel would be difficult for visits if you must drive 30 minutes or more? If there is an emergency, how quickly can you get there?
• Level of Care: Does your loved one need a skilled nursing facility (a.k.a nursing home) or is an Assisted Living adequate? How do you know the difference? Depending on location, facilities may be capable of various levels of care.
• Size: senior living facilities can range from 20 bed facilities to 300+ bed facilities. This may not matter to some people.
• Go on a tour of the facility—pamphlets are much different than the inside of the building and the inside of a building is much different than a pamphlet. In many instances, you do not always want to ‘judge a book by its cover’ because the book is darn good, but the cover is tattered and torn. Look for the following when on the tour:
• Are the staff members smiling? Are they greeting you?
• Do the staff members seem rushed and tired?
• Do the hallways feel tense? Can you hear the communication between staff members? Is it appropriate?
• Can you see the call lights going off? Or hear them? Do they seem to be answered in a timely manner?
• Of the other residents you do see/meet, do they seem well groomed, nourished? Happy? Overall healthy?
• Is the facility decorated for the various holidays? Or appropriately in general? Are there pictures on the walls? Does it seem and feel like a homelike environment?
• When on the tour make sure your meet the Administrator, Director of Nursing, Social Services, and the rest of the administration team that is pertinent to that facility. The administration team will look different for each facility depending on their population.
• Administrator: this person that oversees all operations of the entire building. They oversee the “whole works.” The Administrator for most buildings is usually taking care of the operating systems throughout the day.
• Director of Nursing: this individual oversees the entire nursing department, this includes the licensed nurses (RN, LPN) and CNA’s. If there is an issue with resident care or anything nursing related in any way, shape, or form it is brough to the Director of Nursing.
• Social Services: this person oversees the residents, and their families. Communication from the facility to the family usually begins with Social Services. If there is a complaint from a family standpoint or grievance of any kind, this is the person it would be brought to.
• Ensure the facility matches the needs of your loved one- more often, if a resident has behaviors of any kind, has certain medical conditions, even has certain insurance, they may not be able to go to that facility. It is important to provide all the information to the facility that they ask for. Providing all of the correct information will allow the facility to make an educated decision on the ability of them able to accept your loved one. Often times the information they will need right away just to evaluate the possible admission is demographics, insurance information, medical diagnoses, most updated progress notes from most previous physician visit, and updated medication list.
• Find out what the admission process is – this looks different for each senior care facility.
• Depending on the situation, you will want to set up a meeting with the Director of Nursing and Social Services prior to admission or the day of admission to go over intimate details about your loved one to ensure that the care they receive is the best it can be. Having a meeting such as this will hopefully avoid confrontation in the future. To ensure a next to seamless admission be prepared with sharing the following information which was gathered from a Dementia specific facility perspective:
• What are your loved one’s favorite foods? Often in new environments Alzheimer’s and Dementia residents tend to lose their appetite so we ensure that we have items that are familiar to them.
• Familiar items include photo albums (the flipping of pages prompts story telling), favorite blankets, favorite sweaters, figurines, or memorabilia that was displayed within the home. This is just a brief list of items that would provide comfort.
• Did you have a problem with them taking their medications at home? If yes, what did you all try? Crushing their medications? Hiding it in food? Re-attempting? Dissolving it in a drink (if possible)? Are you concerned they won’t take their medications for us? Explain why.
• Was your loved one ever left alone or were you with them all the time? This helps us understand the risk of loneliness that the new resident may experience especially the first couple of nights without their loved one there and honestly, for the caregiver as well. This is something that the families often never prepare for.
• What did your loved one do for a living? We ask more so for the past than the present or future because that is often not apparent to them. Their past is their present so to provide structured activities for them we often try to find similar tasks that were related to their previous job. It is wonderful watching a 97-year-old retired hairdresser putting curlers in our lady’s hair every day! She genuinely believes she was brought to the facility everyday just to do that.
• Does your loved one have any behaviors that make it difficult to help them? This can range from refusing care to medications to food, to undressing in the hallway. It includes cursing uncontrollably or hitting, kicking, or punching. If they do have behaviors, is there anything that we can do to stop them right away? Is there an action or a response you use often to help calm them? If you have been searching for help yourself on how to get help in these situations, that is okay too. If nothing has been found to help, it is best to be honest about that as well.
• Do you know the trigger for the behavior? This is a hard one for many people. There may not be a trigger developed until sometime down the road. At one point I determined one of my Certified Nursing Aides looked like one of my resident’s daughters that had passed away and seeing her caused him to have behaviors. She was his trigger.
• Are there any family members that should not be talking to your loved one or coming to see your loved one? What would you like us to do if that happens?

The list could go on, but this touches on many of the highlights, for a complete list download our free facility visit communication tip sheet & check list.

Without a doubt, placing a loved one in a senior care facility can be one of the hardest decisions that one will have to endure, and we can all hope that everyone will have a large village to help make those decisions.  Hopefully, if or when that milestone does approach, these resources can be used to help the family breathe a little easier.

If you are curious about helpful technology, try Livindi. It's really simple to set up, it's free to try, and can make a world of difference for your family in giving you peace of mind.