Elder Care: Many Choices Based On Your NeedsPosted on October 20, 2014 by ElderCare Resources in Assisted Living, Blog, Caregiver Education, Caregiving, Long Term Care Information, Nursing Homes, Retirement Communities
New Stages, New Needs: Choosing the Right Elder Care Arrangement
As adults age, their housing and care arrangements might need to change as well. There are a wide range of options for today’s mature adults, ranging from active living retirement communities to comprehensive assisted living facilities. While making this transition can be challenging, it can also be a time of opportunity, freeing the individual from some of the challenges of housing maintenance and care.
For those who require personal care assistance, moving to a facility designed to meet their needs can also be a great relief. The first step is to choose the right type of living arrangement.
Determining the quality of care
Choosing out-of-home care starts with evaluating your or your loved ones’ current and future needs. Is the person very active, but isolated and in need of more social connection? Or are there age-related property maintenance or self-care issues, requiring a greater level of care?
Options may range from retirement communities, where couples or individuals live in a central location with similarly situated people to assisted living facilities or nursing homes, which offer comprehensive care. For an explanation of different types of facilities, see “New stages, new needs: Evaluating housing and care options for mature adults.” When you’re considering a care facility, there are a number of questions you should ask in key areas.
- Medical: What are the frequency of physicals, and types of onsite specialist visits, such as dentists, ophthalmologists, or physical therapists? The facility manager should be able to tell you how many licensed nurses there are on duty during each shift. Familiarize yourself with the emergency services available onsite and procedures for accessing any necessary offsite care.
- Staffing: What is the ratio of staff to residents? Among staffers, what is the average level of education, training and experience? It’s also a good idea to ask about staff retention. A high turnover ratio could be a red flag, so ask about the average length of employment at the facility. What steps does the facility take to keep its staff up-to-date with required ongoing education and training? In addition, be sure you understand the responsibilities of various staffers. For example, a room attendant might provide personal assistance, such as bathing, using the restroom, or getting in and out of bed. How many residents does a room attendant oversee? A higher number might indicate less attentive care. Some states regulate staffing ratios
- Safety: The facility should have security and fire safety systems, as well as backup generators or alternate power sources. Residents’ rooms should open into unobstructed hallways and should not be locked from the outside. Stairways and hallways should be well lit and exits should be clearly marked. Handrails and wheelchair accessible bathrooms are other appropriate features.
- Complaints: Administrators should be forthcoming when asked about the types of complaints the facility has received and how they were resolved. Inquiries to the state or local nursing home ombudsman or area agency on aging can be revealing. But don’t be too put off when the list of complaints becomes available. A specific complaint may or may not be well-founded. Overall trends may be more telling
Making a site visit
An effective site visit requires paying attention to a number of key factors. When you visit the care facility you’re considering, pay careful attention to the following things:
Facility appearance and cleanliness. Look for well-maintained grounds, and updated, comfortable rooms and common areas. Note whether residents are allowed to decorate their rooms, how well lit the rooms are, and whether they have sufficient windows. Consider the level of cleanliness and ambient smell. Bad smells may be indicative of the staff being unable to keep up with residents’ bathroom and hygiene needs.
Activities and meals. Ask about exercise opportunities as well as social and personal activity options. There should be ample opportunities for residents to interact and participate in social and leisure activities base on their abilities. The dining area should be clean and attractive. Try the food yourself or at least visit at meal times to check quality.
Staff. Take time to observe the staff in action. Ideally, employees will be happy and upbeat and seem to care for their residents. Hurried, unpleasant or abrupt attitudes may be a sign of understaffing or an uncaring staff. Note how much of an interest they take in the opportunities for resident socializing.
Independence and quality of life. Ask whether residents are allowed to make their own choices about daily routines such as what time to go to bed, when to get up, when to bathe, and when to eat. Privacy should be respected and staff should knock on doors before entering and protect privacy when residents are getting dressed or being bathed. Determine whether the facility is easy to get to for visits from friends and family, and review the visiting hours and policies.
Choosing the right option
Finding, evaluating and selecting the right care facility is an important process, filled with varying emotions. By remaining focused on the needs and the objective evaluation of care facilities, including appearance, cleanliness, staff and quality of life indicators, the process can become less daunting. Work with your loved ones and your TIAA-CREF financial advisor to make smart decisions about the best options for your situation, as well as how to prepare financially for the transition.
Published: Teachers Insurance & Annuity Association of America