Making the decision to move your loved one into a long-term
care facility can be difficult.
What is Aging?
Aging refers to the inevitable process of growing older. Much
of the process remains a mystery to researchers. Why do some
people retain youthful vitality and good health well into
advanced old age (defined by the World Health Organization as
over the age of 90), while others suffer from age-related
degenerative conditions? Do genetics hold the key to aging
successfully, or can we prolong and improve life through diet,
exercise and positive thinking?
While scientists grapple with these fascinating questions, our
life expectancy has risen from, for Americans, age 47 less than
100 years ago, to age 73 for men and age 79 for women today In
the US alone, there are an estimated 61,000 centenarians -
citizens aged 100 or more. The majority of older persons are
healthy, self-reliant and active. As scientists unlock the keys
to debilitating and life-threatening conditions such as cancer,
multiple sclerosis, Parkinson's and Alzheimer's diseases,
more of us can look forward to a vigorous and active old age.
We owe this increased life expectancy to advances in medical
knowledge that have eradicated or controlled many of the diseases
and infections that once caused premature death. We can also
attribute our long-term good health to an increased awareness of
the role of diet, exercise and mental health in our well
being.
According to the World Health Organization, aging can be
classified as:
Elderly - ages 65 to 75
Old - between age 76 and 90
Very old - past the age of 90
How to choose a long-term care facility
Making the decision to move your care recipient into a
long-term care facility is not easy. Along with the emotional
implications of "abandoning mom" there is also the
stress of finding the "right" home. Taking the time to
investigate several different homes will allow you to make an
informed choice about your decision; being confident about your
decision will go a long way to making you feel better about the
move your care recipient is making.
Try to keep in mind that, for many people, life in long-term
care home can, in many ways, be better than living at home. Care
facilities that can provide regular meals, medical attention and,
a good home, will facilitate social interaction and offer
stimulating activities. Often, people moving to care facilities
will feel better about themselves since they will be less
dependent on family members for support.
Before you start looking at homes you may want to talk to
other people you know with family members in a home. You might
also want to consult with doctors, nurses or other community
members that are familiar with care home environments to get
their impressions of what makes a good home.
Make arrangements to be given an initial tour of the facility.
Try to visit a few times after this tour at different times of
the day and/or week. You will get a better sense of the routines
of the facility. Choosing a facility close to your home will make
visiting easier, but it may be more important to have a
higher-quality facility than a closer one.
The following points may help you make a more informed
decision about the appropriate care facility for your care
recipient.
First Impressions
Is the facility odor-free? Odors of urine and feces can
indicate that the facility does not have sufficient staff to
ensure regular cleaning of the restrooms and/or regular
incontinence care for the residents.
Is the environment of the facility comfortable and
homey?
Are there residents seem happy and active or are they
wandering aimlessly or sitting and doing nothing?
Are the residents properly dressed and clean?
Is the environment friendly and relaxed? Are any of the
residents restrained? (Restrained/confined residents can also
indicate lack of sufficient staff.)
Are the individual rooms bright and cheery?
Staff
What experience do they have, what are their
qualifications?
Are they respectful to the residents?
Are they friendly/patient/have a sense of humor?
Is there a high turn over of staff in the facility?
Do they respond to requests for assistance within a
reasonable amount of time?
Meals
What time are the meals served?
Are snacks available between meals?
What is the central dining area like?
Is it easy for residents to get from their rooms to the
dining area?
Is there an area for residents to make a snack or drink
(coffee or tea)?
Do residents have a menu of items to choose from during
meals?
Can residents eat in their rooms?
Is there staff available to assist with feeding during
meals?
Can the facility cater to any special dietary needs? What are
the costs associated with this?
Activities
Is there an activity director for the facility?
Will the resident's participation in activities have an
extra cost?
What types of activities are planned - e.g., day trips, craft
making, games?
Are there activities planned for the weekends and
evenings?
How are the residents informed of the activities available to
them?
Is there space in the facility for different activities -
watching TV, crafts or games, socializing?
Is there an outside area like a garden or patio?
Can the residents do their own activities/hobbies?
Access
Can the family visit any time?
Is there an area in the facility for visiting?
Is the resident allowed to go in and out as they please?
Can the resident have a phone in their room and, if not, what
are the rules for phone access?
Is access available to banks, shopping, restaurants,
libraries etc.?
Privacy
Is there a lock on the door to private rooms?
If not, do the staff knock before entering the rooms?
Can the resident have a bath or shower whenever they
want?
Personal
Are pets allowed? If not, does the facility allow visitors to
bring pets?
Can the resident bring in personal belongings e.g., a TV,
furniture, photographs?
Can the resident keep food or alcohol in their rooms?
How about magazine subscriptions or newspapers?
How much storage/closet space do the rooms have?
How is personal laundry (not linens or towels) taken care
of?
What is the facility's policy on lost or missing
valuables?
Medications/Medical Care
How are prescription medications monitored and
administered?
What is the policy on residents keeping non-prescription
medications?
Can the resident stay with their current doctor (vs. the care
facility's)?
What kind of medical assistance/support is available
regularly (e.g., physiotherapy) and for emergency
situations?
Services
Are there hair/barber services available and is there an
extra charge for them?
What kind of dental care is available both on a day-to-day
(e.g., assistance with dentures or brushing/flossing) and
"check-up" basis?
Are there extra costs associated with this form of care?
Administration
Who can you contact with questions or concerns?
Who will contact you in case of an emergency?
Will there be a regular review of the care provided? If so,
how involved will you be in this process?
Is there an active resident and/or family board for the
facility?
Has the facility been approved by the appropriate
agencies?
If you decide to take your resident out of the facility, what
are the policies on giving notice or refunds?
Is there an service agreement listing the services available
and changes for extra services for your reference?
Is the facility safe - fire alarms, sprinklers - and prepared
for such emergencies? Are there regular emergency drills?
Remember, if you are going to be responsible for choosing a
care facility, you are your care recipient's best advocate.
Don't be afraid to ask difficult questions or to turn away
from a care facility if it is not appropriate. While this process
can be long and time-consuming, the benefits that come from
knowing your care recipient is happy and well looked after will
be well worth the effort.
Sources:
AARP - "Choosing a good nursing home."
British Columbia Ministry of Health and Ministry Responsible
for Seniors. "Choosing a Care Facility: A Guide to Selecting
a Licensed Long Term Care Facility." 1999.
