When to Start Looking at Facilities

Now that you know a little bit about the types of facilities there are out there, when is it appropriate to actually look at one? Even getting started in the search can be laden with emotion. Does looking at facilities make you a bad person? Does it mean you no longer love you parent or spouse in need? Of course not, but it is common to feel these feelings. The truth is it means you know you must face the future. That is something you must do—with as much confidence and clear-headedness as you can muster. So begin, and begin early.

In fact, the sooner you start physically going to various facilities to see what they offer and to compare the differences, the more informed you will become. You may surprise yourself with the amount of knowledge you will learn. This will no doubt help you become more comfortable and confident with the performing the many tasks before you and weighing the many options that you will have.

Starting your search early on has other benefits as well. Chief among them is that you will have ample to time to get your loved one’s name placed on the waiting list. This will become very helpful later, for when your family member is finally ready to make the move into a facility, you will be in a better position to choose the one you want rather than the one that simply has room.

How Much Care does Your Family Member Need?

The first thing to do when evaluating a facility is understand your needs. What can your family member do for him or herself? Can he tend to his own hygiene? Can he feed himself? Is she reliable at taking the medications she needs when she needs them? How well can he or she get around the house? These and other activities make up what is known as activities of daily living (ADLs). These are all those things which we do day-in and day-out… taking a shower, tying our shoes, cooking dinner, and so on. Often we take these sorts of things for granted. However, to a person in physical and/or mental decline, the inability to perform these tasks can be not only heartbreaking, but moreover life-threatening. Knowing how much and in particular what kind of care your loved one needs will help you evaluate and compare different facilities with clarity.

What do you look for when choosing a long-term care facility?

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Once you understand your loved one’s needs, you’ll have a better grasp on the services that each facility offers, and you’ll be better able to match up those which more closely meet your family member’s clinical needs. Among these are the following considerations (Check off all those offered):

1. Therapy Options
   speech physical occupational
2. Special Services
   Alzheimer’s Unit Hospice Care Mental Health Care Nutritional Rehabilitation Dementia Unit Chronic Care
3. Religious Services
   In-House Transportation Available to Outside Services
4. Social Activities
   Movies Game Nights Knitting Other Types of Recreation
5. How are Residents Kept Physically Active?
   ___________________________________
   ___________________________________
   ___________________________________
   
6. What Community Programs are offered?
   ___________________________________
   ___________________________________
   ___________________________________
   
7. Is there Transportation out of Community into Town?
   Yes No
8. Is there a resident advisory council?
   Yes No
9. How does Your Loved One get His/Her Medication?
   In house pharmacy
   Other (Name) ___________________________________

There is no question that the clinical capabilities of each facility you consider should rise to the top of your decision-making criteria. That said, there are also quality-of-life considerations. These are significant, because in many ways it will be quality-of-life issues that will determine how well adjusted your loved one is in this setting. And how well adjusted she is will strongly influence her health and functionality. Here are several important factors to consider in this area:

First, while you should certainly be willing to travel within reason for the best care, remember that geography matters. If the facility is an hour away, it will be much more difficult for you to visit than if it were 15 minutes away. Look for the best care that’s closest to home or work.

Second, how comfortable do you think your family member will be here? To answer this, review the following checklist. In fact, answer each of these questions immediately after you visit a facility. That way when you go to compare notes later you’ll have a lot more than memory to rely on:

10. Is there an odor?
    Yes No
11. How is the noise?
    Much too loud Noticeable Quiet
12. How clean is it?
    Very Clean Somewhat Uncleanly
13. Is the lighting adequate?
    Yes No
14. How are the visiting hours?
    Very Accommodating Average Too Limited
15. How is the temperature?
    Normal Too Warm Too Cold
16. How is the food?
    1. Does it comply with religious and cultural demands?
       Yes No
    2. Is it available at proper times during the day?
       Yes No
    3. Is it nutritional?
       Very Nutritious Average Not Nutritious
17. Is it safe?
1. Are handrails located throughout the halls?
   Yes No
2. Does it meet fire safety requirements?
   Yes No
3. Are locks and security systems up to date? (ie; are there guards at the doors?)
   Yes No
4. Are there security guards?
   Yes No
5. Are the mentally imbalanced properly separated from the general population?
   Yes No
6. Do the plumbing and electronics work? (Call buttons, elevators, outlets, TV, etc)
   Yes No
18. Is it wheelchair accessible?
    Yes No
19. How many beds are occupied?
    _____________ out of _____________
    
20. What is the roommate situation—are there private rooms available?
    Yes No
21. How is the atmosphere?
    Cheery/Pleasant Courteous, but not Friendly Cold, Clinical
22. How many nurses to patient/resident?
    ___________________________________
    
23. How is the training of the nurses, aides, administration?
    Excellent and Ongoing Adequate Insufficient
24. How is the housekeeping?
    Frequent & Thorough Acceptable Incomplete & Inadequate
25. How does the staff interact with the patients?
    1. Are they attentive to patient needs and emotional well-being?
       Yes No
    2. How is the health of the patients? (bed sores, infections, weight, etc.)
       Good Fair Poor
    3. Are the patients properly dressed?
       Yes No
    4. Does the staff appear happy to be there?
       Yes No
26. Is the administration willing to sort out any problems easily?
    Yes No
27. In good standing with state requirements?
    Yes No
28. Fees
    1. Are they clearly marked/laid out?
       Yes No
    2. Are they competitive?
       Yes No
    3. Is the Social Worker helpful understanding/utilizing Medicare?
       Yes No
    4. Have they dramatically increased in recent years?
       Yes No
    5. What, if any, insurance is accepted?
       ___________________________________
       ___________________________________
       ___________________________________
       
29. What happens when there becomes a financial difficulty?
    ___________________________________
    ___________________________________
    ___________________________________
    
30. Would you want to live there?
    Yes No

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