More and more elderly are finding their way to live in assisted living facilities. How do you know what you are getting and if the care you expect will be delivered? The Assisted Living Industry is a growth business with many of the large hospitality chains, such as Marriott, and many of the largest senior health care companies like Manor Care, entering and in some cases dominating the field. Many are privately owned. Some are faith-based, related in some way or another, at least initially to a religious organization. Smaller, regional companies own more, ome with good records and financial health, but others with spotty results and not-so-deep pockets. No matter what the ownership situation, remember that health care delivery is a business, first. You must evaluate it as such.

Not all Assisted Living Facilities are created equally. As Monday’s article about Ruxton Health in Williamsburg, VA, pointed up, people are at k if good policies and procedures are not implemented and followed. Here are some steps to take to evaluate a potential home for Mom or Dad.

1. Use Your Eyes.

• Is the property in good repair? Look for worn carpet, holes in the parking lot and missing or bent air conditioner grills and screens. You should not see much chipped paint around the doorframes or scuffs on the doors themselves. Evaluate the age and repair of the furniture in places OTHER than the front lobby. Good maintenance and upkeep of the small things means the big stuff is taken care of.
• Do the residents seem happy? Are they out of their own rooms and socializing or do they seem withdrawn and isolated? A healthy social and vibrant environment is a key to enjoyment of this type of facility. Isolated, unhappy seniors may mean a lack of social events or worse; fear of other residents with behavior problems or staff bullying.
• Are residents dressed appropriately for the time of day? This indicates staff are providing timely assistance in dressing and bathing and encouraging people.
• Observe a meal if possible. Would you want to eat in this dining room? Do you find the food to be personally appealing and palatable? If you would not eat it, why should you expect your parent or loved one to?
  

2. Use Your Ears.

• Listen for staff/resident interactions. Does the staff greet people by name? Are they cheerful and encouraging? Scolding, ridicule or talking as if the resident is not present are all warning signs of a disconnect between staff and seniors.
• Observe resident/resident interactions. Are they pleasant? Do people seem to get along?
• Ask residents about the care, the food and the staff. Listen for what is not said. Remember the phrase, “Damning with faint praise.”
• Interview other family members. Stop obvious visitors in the hall. Identify yourself as someone considering the facility for your parent. Ask them if they would recommend it. Do not just take the names of family members offered by the admissions counselor (sales person).

2. Use Your Head.

• Gather a list of key contacts, including phone numbers. The facility should willingly provide these. If not, be wary. At a minimum, get the names of:
  • the facility Medical Director
  • the Hospital most frequently used by the home
  • the name of the owner or corporation which manages the property
  • the name of the administrator or director
  • the nurse in charge of the program and the name of the State Long Term Care Ombudsman assigned to the facility
• Call the hospital ask to speak to a discharge planner. Tell them you are considering placing someone in the facility. Ask them if they would feel comfortable placing their mother there. I use the “my mother” test on every facility I run or evaluate. Sadly, many do not pass.
• Place a call to the Ombudsman and ask if there have been any significant problems at the home.
• Ask what the policies are about notification of next of kin or the responsible party (you) in case of emergency or a serious health condition.
• Evaluate what kinds of medical care the home is well equipped to handle. Ask what conditions may cause your loved one to no longer be appropriate for this level of care. Think up as many “what if” questions as you can.
• Know when the home’s policies require treatment or evaluation at the local hospital. What happens if you are out of town on a trip down the Colorado River in the Grand Canyon and cannot be reached?
• Ask who you voice complaints to and what their procedure is to handle them.
  
• Do a Google Search on the facility using its name and city. Look for negative AND positive articles. Do the same on the names of the administrator or director and the medical director.
• Run a D&B check or similar if you have access.

Most assisted living facilities do a credible job caring for the elderly as long as they stay within their area of practice. As the name implies, they are there to provide assistance with activities of daily living; bathing, dressing, eating, moving about and self administration of medications. If your loved one needs more than minimal assistance, you should consider a skilled nursing facility or hire someone to “sit” with your loved one to more closely supervise care.

Tomorrow’s concluding article will be about how to complain and get someone to listen and act. You may be surprised at my thoughts.

This entry was posted on Thursday, April 17th, 2008 at 9:27 am and is filed under Assisted Living, Commentary, Potpourri. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.