Driving by residential care facilities only gives us a glimpse
of its environment. Before stepping inside potential custodial care
homes, think about the needs of your loved one, and prepare a list
of questions and concerns. Since there are no federal standards for
these small care homes, it's vital to thoroughly research each
potential residence. States with licensing regulations provide
surveys on each
residential care home, so start by contacting your state's
department of aging for information, or ask each residential care
home for its survey.
Often, people are apt to judge residential care facilities by
their outside facades and interior glamour. While ambience is nice,
the most important aspect is the caregivers experience and
background, says Jerry Graham, a Senior Living Advisor for A Place
for Mom. "You're looking for care with dignity. If the caregivers
are smiling and happy, the residents will be happy. Chandeliers and
caviar do not mean quality care." Keep the following in mind:
- The experience of the owners and each staff member. Ask for
references and check them.
- Ease of communication: Will you be able to effectively
communicate with the staff?
- The staff-to-resident ratio.
- Are the caregivers live-in or do they work in shifts?
- Is there an RN on-site at all times? If not, is there an RN
advisor or an RN on-site at specific times?
The "right" answers to these questions depend on the care your
loved one needs. For example, some residents will need an overnight
on-duty staff member to take care of them.
Of course, potential residential care facilities should be clean
and tidy. This also translates to the appearance of its current
patients. "I also speak to the other residents, take note of their
appearance, and also how the staff interacts with the residents,"
says Graham. It's not a good sign if a staff member barges in on a
napping resident to show off a room, or if everyone is still in
their pajamas at 2 pm, he says.
When touring, ask yourself, "Would my loved one fit in here?"
says Charlotte Stackpole, MPA. Try to watch residents in action
during an activity time, and look at the home's
activity calendar. Stackpole and Graham recommend asking about
the following issues:
- Pets: Are they allowed?
- Smoking: Some states don't allow smoking
in-doors. Some allow it outside, but some do not.
- Transportation: Is there transportation to
medical appointments or even outside activities such as church
- Health: How are health issues managed,
including the activities of daily living, such as bathing and
toileting? Does the staff make doctor's appointments?
- Money: Can spending money be managed by the
- Medications: Are the residents just reminded
to take meds, or does the staff administer them? Will prescriptions
be filled and picked up by staff?
- Security: If the residential care home accepts
dementia patients, make sure the perimeter is secure, and that
doors are alarmed. How does a caregiver know if a resident attempts
to exit the home?
- Meals: Will the home provide different meal
options that appeal to your loved ones tastes?
- Finances: How much is the monthly rate,
including all the fees? Does the home accept Medicaid? Do you need
to pay out-of-pocket for a period of time before they accept
Medicaid? How does billing work, whether residents pay themselves,
with long-term care insurance, or by Medicaid?
It's also essential to visit more than one home before you make
your final decision. Graham recommends visiting 5 or 6 residential care
facilities. Always schedule an appointment for your first
visit, asking the owner or house manager all your questions. "After
you've toured several properties and narrowed your choices down,
then do un-announced visits," says Graham. "I do think it is
important to show up un-announced at different times of the day,
but please be respectful of the other people living in the home,
not showing up early in the morning or very late at night."
Before choosing a residential care home, make sure all of your
questions are answered. "Don't be embarrassed to ask anything.
These people are now going to be your employees," says Graham.