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Assessing
a Long-term Care Facility
Contact
your local Alzheimer Society for
information about the long-term care application process in your area. Some communities will have a number of facilities to choose from. Once you have compiled a list of long-term care facilities in your area, call and ask some general questions such as: Is there a waiting list? What is the cost for living at the facility, including the cost of extra care as the disease progresses? Will the person with Alzheimer's disease be able to live there throughout the course of the disease? You should be able to narrow your list based on the answers you receive. When you have shortened the list, you will want to visit the facilities yourself. If appropriate, you may wish to consider having the person you care for visit the facility, too. You will have your own set of priorities to consider, and some of your expectations may be more important than others. Keep these in mind as you begin your search.
The following are general questions that may be helpful in assessing the quality of each of the facilities you visit. Don't forget to pay attention to your "gut" feelings as you begin to tour; they can be very helpful in determining if a facility is appropriate for the needs of the person you are caring for. You may find it useful to bring along a friend or family member for input and support as you visit each facility. Talking to the residents and their family members can also be helpful.
Questions
to consider when visiting long-term care facilities
| Area of Concern |
Questions to Ask |
| Location |
Is
the facility conveniently located? Will you be able
to visit easily? Does public transportation run nearby? |
| Appearance |
Are
the kitchen, day rooms and bedrooms clean and tidy,
and free from unpleasant odors? |
| Menus |
Is the menu varied, nutritious and tasty? Can the facility accommodate special dietary needs? Is food available throughout the day? Is snacking possible? Are mealtimes flexible? |
| Bathrooms |
Are
they private? Are they clean? Are they easy to find?
Are there grab bars and other safety devices present? |
| Alzheimer-friendly |
Are staff specially trained to care for someone with Alzheimer's disease? Is there ongoing staff training about Alzheimer's disease? Is the facility "home-like"? Is there a separate unit for Alzheimer residents? Can the residents walk safely indoors and outside? |
| Resident-to-staff
ratio |
What
is the resident-to-staff ratio? What proportion of
residents have Alzheimer's disease? |
| Interaction |
Do
all staff interact with residents on a regular basis,
and in a friendly and personable manner? |
| Activities |
Is
there a variety of meaningful activities for groups
and individuals? Are there therapeutic activities,
such as music, pet, horticulture? Are there opportunities
to socialize? Is there flexibility in the routine? |
| Visiting |
When
can you visit? Can you have privacy with the resident?
Can you take the resident for outings? |
| Understanding behaviour
|
Do staff try to understand what residents are communicating through their actions? (such as a person pacing because they are looking for a family member). Restraints should not be used without first exploring all alternative ways of responding to a person's behaviour. (Restraints may include physical restraints, like a geri-chair; chemical restraints, like sedatives; or restraints to the environment, like a locked door.) |
| Safety |
Are
there smoke detectors? Are there slip-proof mats
in the baths, grab rails, etc.? |
| Quality |
Is the facility accredited by an independent body? What were the results of the most recent provincial inspections? |
| Medical
care and continuum of care |
Can you continue to use your own doctor or is there a resident doctor? Is there a doctor on call? How often does the doctor visit? Can you meet the doctor? How are medical emergencies handled? Are there situations where the facility will no longer be able to provide care to the person? |
| Care
philosophy |
Does
the facility focus on individual resident needs?
Can it accommodate flexibility in routines? ("My
mother has never been a morning person.") Are
there regular care planning meetings that include
family members? |
| Individualized
care |
Is
consideration given to individual cultural, religious
or spiritual needs? Are other languages spoken? |
Even after an extensive search, be aware that you may not find everything you want in a single facility. Try to remain flexible. Ask yourself how you feel about working together with staff to meet the needs of the person with Alzheimer's disease. Moving to a long-term care facility does not mean that your role as a caregiver is any less important than before. You may find that you have a different focus such as staying connected to the person and advocating for quality dementia care.
You
can promote quality care for the person with the disease
by sharing the Alzheimer Society's Guidelines
for Care booklet with staff. A copy is available
from your local Alzheimer
Society. Your local Society can also provide staff
training and education.
If
you make the decision to arrange for care in a long-term
care facility, see the other pages in this section for
advice on preparing for the
move and helping staff get
to know the person with Alzheimer's disease.
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