Each family must weigh the pros and cons of in-home care, elder day care and placement in a skilled nursing facility. In-home care may be enhanced by time spent in elder day care, where activity and mental stimulation for the parent suffering from senile dementia or Alzheimer’s disease are provided. But sometimes the only realistic choice is to place the aging parent in an elder care facility. The services provided in the elder care assisted living facilities range from nursing and long term care facilities to assisted health care facilities.
At first, these may sound similar but there is a major difference in what these services offer. For instance, nursing homes and/or long term care facilities are designed for people with extreme medical needs. Twenty four-hour medical supervision is the normal level of coverage needed by individuals who live in these types of places. On the opposite end of the spectrum is a health care specialist who comes to the person’s home. This option can work for many people with disabilities that don’t necessarily relate to age. The most common decision for most situations is the middle option, known as an assisted living facility.
Finding the Best Facility
Once past the guilt and anguish of deciding to place an elderly parent with Alzheimer’s disease or senile dementia in a nursing home, the next challenge is finding the right facility for that parent. Elder care living facilities can range from private care in a licensed caregiver’s home to fully staffed nursing homes. A family member can help an aging loved one choose from a variety of senior communities, retirement communities, apartments for the elderly, and many levels of assisted living care.
Some things to consider when looking for an elder care facility:
- Location: If the parent with senile dementia or Alzheimer’s disease recognizes places and/or people, they may be more comfortable in an area they are familiar with, such as their hometown. An elder care facility here might also allow for visits from old friends.
- History of the Elder Care Facility: How long has the facility been in existence? Have there been any incidents of neglect or abuse in the nursing home? Have there been commendations or recognition of outstanding care?
- Staff History: How long do staff members tend to stay? High turnover rates indicate problems which may affect the quality of care given.
Things to note when visiting an elder care facility:
- Is the reception staff friendly and courteous? The front desk often reflects the attitude of the facility.
- Look around the lobby for evidence of real caring: Photos of patient activities, both on and off -site indicate more than minimal care. Recognition of staff for outstanding care, especially from the families of patients is another good sign.
- General impression of cleanliness and professionalism: A clean facility with knowledgeable staff is a good indicator of the care likely to be given. Patients should be clean and well groomed.
- Staff interaction with patients: Alzheimer’s and senile dementia patients can be a real challenge to deal with. Staff that is relaxed and caring deals calmly with difficult patients. Do the staff members chat with the patients? Do they seem to be enjoying their work? Do they seem to really know their patients?
- Interactions between staff members: Tension amongst staff members can spill over into patient interactions, setting the stage for patient abuse or neglect. These underlying tensions may reflect management issues that can result in high staff turnover. Alzheimer’s and senile dementia patients do best with consistency in their world.
Involving Senior Person in Decision Making
Adult children who have never faced elder care decisions are often faced with the overwhelming task of trying to figure out the best living arrangements for an elderly parent or other aging relative. Allowing the senior to help with the decision eases the transition from independent living to assisted living.
Decide What Type of Home Placement the Elderly Person Needs
Discuss home placement options with the elderly person, using a positive attitude. Remember the parent or relative should have input and some control over what he or she wants in living arrangements. Working together takes away some of the emotional sting – and perhaps reduces some of the resistance – when family members must place an elderly loved one in assisted care.
Make a list of medical issues, hygiene assistance, and daily living tasks that require complete help or even minimal assistance. This provides some idea as to what level of assisted living the elderly person needs. Seek the advice of the person’s doctor or other medical practitioner if there is any uncertainty about what kind of living arrangements would best suit the elderly parent’s needs. Once all the needs have been identified, it’s time to find and tour the suitable facility.
Tour the Facility
Tour the facility to get first-hand information. Medical care is a top priority and so is lifestyle; however, there are other questions a caregiver – and the elderly loved one – should ask before deciding on an assisted living facility. The sample questions shown here are directed to facilities offering a moderate level of client care.
- Observe the other residents. Do they seem relaxed? Is their general appearance acceptable/appropriate?
- Is there any kind of stimulation other than sitting and watching TV? Are there planned activities and recreation?
- How do staff members respond to the residents? Do staff members seem bored? Do they look clean? Do the staff persons behave and act professionally? Are they friendly, compassionate, and helpful?
- Is the building well-maintained inside and out? Does it look cheerful or drab? How does it smell?
- If the facility is an apartment, check safety features such as grab rails in the bathroom. Check floors for worn spots, raised tiles, and slip-resistant material. Check for sharp countertop edges. What kinds of door and window locks are used? Is the room thermostat easy to read and adjust? Is housekeeping provided; and if so, to what extent?
- Does the facility have a nurse on call? What is the protocol for medical emergencies?
- What kind of security does the building or apartment have? Can anyone leave and enter (including strangers) as they please? What rules do clients have as far as having visitors, leaving the premises, and entertaining guests?
- Is the dining area clean? Are residents allowed to choose meals? Can residents take their time eating and is there help available if one cannot manage alone?
- Are there outings planned, such as trips to the mall? Who provides transportation?
By asking the right questions, the adult child or family caregiver can help an aging loved one find the best solution for assisted living. An appropriate facility does not have to be a luxury resort, but should meet specific requirements – safety, medical, social, recreational, and more – to promote the highest quality of living and ensure peace of mind for the family and elderly loved one.