Select Senior Housing with Care
Before helping an older adult find housing, have them write down what they want out of a residence setting. Each residence has its own personality and finding a match for the potential resident is imperative to their future happiness.
Make sure they have a list of their financial assets because that information will be needed during admission. Also bring along a copy of the Healthcare Power of Attorney and Advance Directive. Provide the address and numbers of anyone that should be contacted during an emergency hospitalization. Who will be the advocate for that person? The person who does advocate for the individual resident will be able to attend monthly Care Plan meetings with staff. This will give an opportunity to address special needs and desires of the resident. Most residences offer a free lunch to try out the place. How does it feel? Are residents friendly? Is staff cordial or busy and in a hurry? Do they converse with residents? Ask some residents what they like about the place and would they recommend it to others? Check to see if there is a residents’ group that speaks on behalf of residents when they want to change a policy or add a program. The Long Term Care Ombudsman Program (LTCOP) is supported by the Area Agencies on Aging. Their purpose is to advocate for residents when there is a problem that cannot be resolved by themselves. Check with your local Area Agency on Aging to locate the LTCOP near you. What kind of activities do they have planned? What kind of exercise do they offer for mind and body? Do they offer transportation to doctors visits, grocery and drug stores? Is there an extra charge? When are they available to residents and what arrangements do they have to make? Do they offer medication assistance? Will they aid in bathing, dressing and other activities of daily living?
Elders with dementia have specific needs
If the potential resident has dementia, do they have a special wing for dementia residents? Dementia residents require more attention and stimulation through social and mental activities. Facilities that have no special wing generally do not provide the type of care a person with that condition would need. A residence may be expensive and look beautiful but that has no bearing on what kind of service the resident will receive. Ask for the average response time from the time an alarm is sounded to the time a resident is seen. What is the ratio of aides to residents during the day? What is it at night? Is there a nurse on duty or on call 24/7? Is there a physician who comes into the facility on a regular basis? Can you use your own physician? Can you hire outside services, i.e. in-home care aides, hospice, etc.? What services create extra charges? What happens when a resident has a health event? Will their room be kept available for them? What if they need additional care? What will happen then? What costs will they incur while they are away from their room? Looking at the room or apartment, is there enough closet space? Is the room handicap accessible? Are there emergency pull cords if there is a problem? Are hallways well lit? Are chairs or loveseats situated along the route if an elder is having ambulation issues? Is cable offered or is it an extra expense? Are there enough windows for sunlight? Many dementia residents need extra light to offset the effects of sundowning, a condition that often happens when light levels are low. Many residences are now incorporating more skylights in hallways and other main areas so that natural light levels are higher.
Continuum of Care is important in the selection of housing
Some residences offer “continuum of care” facilities. This means that if a resident goes into a facility and then incurs a health event and must go to a higher level of care, they can stay in the same system. In other words, independent, assisted living and skilled nursing are all in the same location even though they might be in different buildings. Moving when a resident becomes ill is the worst circumstance. They are not up to the move and may be confused as a result of medications and anesthesia. There are companies that specialize in moving seniors. They offer the more “hands-on” care that seniors require. There are also companies that offer estate sale services to help older adults in disposing of items they may not be able to take with them to the new facility. Some realtors offer special ‘fix-up’ services to help make a residence ready for sale. Check with www.medicare.gov/NHCompare/ to learn how different facilities are rated and whether they have had consistent or unresolved issues. Your state will also have a rating service for nursing homes in your state. It is often on the Attorney Generals’ site. As you can see, searching for housing is a complex task, one which is better undertaken over time when the potential resident is in good health and not undergoing a health crisis. It then gives them time to accept the situation and to have a choice in what suits them best. You may want a Geriatric Care Manager to help in the selection of housing. Once as assessment is conducted, the appropriate facility can be identified. With the many options available today for senior housing, it may well be a very good step toward providing the supports to have a higher quality of life during their final years.