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ask questions when choosing long-term care facilities

Father Gene Neff, director of the diocesan office of Ministry to the Sick and Aged visits nursing homes, celebrates liturgies with residents and works with volunteers who bring Communion to senior residents at nursing homes.
Over the years, Father Neff has compiled a list of questions that can offer insight into whether a particular place would be compatible with a loved one’s needs.

When you decide to visit a facility, you may get a better feeling for regular daily life at the home if you “drop in” unannounced to visit.

Following are questions you might want to ask:
• Does the facility follow the medical model of care of person-centered holistic care? (A question to ask yourself: Will the facility adjust to the resident, or is the resident expected to adjust to the routine of the facility?)

• Does the facility provide skilled care, assisted living, supportive living, or independent living. Or does the facility allow the resident to “age in place,” (provides continuous care from independent to skilled care)?

• How will you meet the expenses? What are the base costs? What are add-on costs (e.g. laundry, bandages, beauty salon, etc)?

• Is the facility Medicare and/or Medicaid certified?

• Is the facility clean and odor free?

• Are the residents happy, alert, groomed, clean, well nourished, and healthy? Or, are they restrained to wheelchairs or lethargic?

• Are the levels of care available appropriate to your needs?

• Is the staff respectful of the residents?
• What is the noise level?

• Is the home located conveniently nearby for frequent visiting?

• How involved will you (or can you) and family members become in monitoring your loved one’s care?

• How often can you visit? What are your loved-one’s expectations regarding your visits?

• Is there an adequate staff-to-resident ratio?

• Is privacy respected?

• Is there a qualified social worker on staff?

• Are call bells accessible to residents?

• Are safety procedures adequate? Are stairways and exits clearly marked?

• How many residents share a bathroom? Do bathrooms have hand grips or rails near all toilets and bathing areas? Is there a call button?

• How often are meals offered? Are alternatives available, as required by law? Are there any ethnic-specific diets? Is there flexibility in the time meals are scheduled?

• Are meals served at appropriate temperatures and in a timely fashion?

• Who plans the meals? Is there a staff dietitian? How are special dietary needs met?

• Can residents bring their own furniture and personal effects to decorate the room? Is there a safe for valuables and money?

• Are there a variety of activities for the residents to participate in? Is there an activities coordinator?

• What arrangements are made for residents to honor their religious preferences?

• Is there a council for residents? When does it meet and who coordinates it? Is there a family council?

• Which hospital is used in emergencies? What is the emergency procedure? The evacuation procedure?

• What is the billing procedure? Will you be informed in writing of any changes?

• Is the telephone number of the ombudsman program listed?

• How is personal laundry handled? Will you need to do personal laundry for your loved-one?

• Is there a system to protect wanderers?

• Do you provide specialized care for persons with dementia? Physical and occupational therapy?

• Does the facility have a handicapped accessible vehicle for resident use outside the facility?

• Ask to see the report of the latest state inspection of the facility.

Today, long-term care facilities are safer and better managed than they have ever been. Some have moved away from a strictly medical model of care to the more holistic person-centered (pioneer) model of care, due in part to increased regulation and inspections, and the political activity of organizations that lobby for older Americans. But despite the improving picture of long-term care facilities, there are still facilities that may not measure up to the legal standards set by a state, or that may not measure up to the standards of care and environment that many people consider minimal for an acceptable lifestyle. So choose carefully and monitor the facility continually. And most importantly, remember that your loved-one needs you to be their constant advocate for care. Don’t abandon them!