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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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Observe the interactions of staff with residents a key to the culture of dignity and respect throughout the facility. Ask about therapeutic recreation programs. How do the activity care plans support the efforts of the ordered therapies like PT and OT? Ask about restraint policies, initiatives for resident safety such as fall prevention and infection control, what is the "continuous quality program" and customer service philosophy. Ask for testimonials or references.
It is SO important as the other writers have said to research, research, research.
Also, what is the per diem on your mother's long-term care insurance. Different plans pay different amounts. Every facility has a per diem, and as you know any difference would come out of her or your pocket. It's very important you know the per diem allowance you will have as you're looking at facilities. I'm assuming Medicaid is not involved.
The first thing you want to notice as you walk into a facility, is does it smell. If it does, I would walk out. Bad smelling facilities are poorly run. It means that the patients are not being changed and cleaned routinely. It also means the staff and director are willing to tolerate that -- which raises concerns about what other poor care they are willing to tolerate.
I would ask to meet with the Director of Nursing, not just the Admissions Officer who is basically the sales person. If the DON is not willing to make an appointment to meet with you, I would also go elsewhere. It is unusual for the request to be made, most people don't know to ask. But he or she is the person who runs the facility, if it is skilled nursing, so it is very important to learn from them.
Ask the DON what the staff turnover rate is, what is their proportion of CNAs, LVNs (who give medicine) and RNs per patient. How many charge nurses are on duty (those who sit at the desk) during each shift. This should also be posted somewhere on a wall in the entry way by law in most states.
Many facilities have trouble finding quality nurses to work in their facilities. Often you will see that they don't even have every shift covered by one nurse. That is also a bad sign.
You should also look at the most recent state health board report on the facility. Look at how many negative notices there are made against it. Often times, they will be cited for not giving medications at the proper time (very important) or skipping them altogether. Ask also what is the turnover rate of staff.
Stop in some time during the week when they are not typically expecting family visitors and ask to take a tour -- look through the entire facility. Is there water and a pitcher by each person's bed. Is there a television, telephone? Ask to look into the shower areas and see how clean they are.
And, of course, as recommended above, ask other family members of other patients. But make sure you make a surprise visit during the week to really see what happens when the facility is not typically expecting visitors.
You need to fully understand what your long-term care insurance plan covers. I would start with that and not take them at their word that every facility is okay. Will there be extra charges for diapers, gloves, wipes, laundry, medicine -- if you have to purchase these, they can be brought in from the outside; don't pay the rates the facility charges, that's usually where they make extra money. Go to Costco or WalMart.
There are also outside mail-order pharmacies for any medications not covered by Medicare or secondary insurance. A good facility will help you arrange for that. If not, you can also do it on your own.
Finally, find out about doctors. Does the facility have a Medical Director who visits or is on call. Typically, only the highest-end facilities do. So, you need to make sure that your parent's physician will come to the facility or that it's easy for you to arrange for transportation to the doctor.
Finally, meals. Some facilities do not want to serve individuals in bed because they want them up and out, they say, it's more social for them, but it's also more work for the staff. You should find a facility that will allow meals to be served in the room, at the patient's discretion. There may be days or come a time when your parent will want/need to be served in bed.
Hope this helps. Best wishes on this journey. You have lots of support out here!
Observation is key. ARe the employees treating each other with respect no matter what their job is? (such as nurses with CNAs)
People who are happy in their work are going to be better caregivers. Also, there is less turnover in staff which is very beneficial to the residents.
So they treat the residents as individuals? Nearly all are understaffed, but can you see they care about each person?
The tips from everyone above are good. Lots of defined questions are necessary, but your gut is not to be ignored. Be realistic (this isn't one-on-one care), but check the pulse of the place. The staff is more important than fancy surroundings. Carol
My husband added, "If it smells bad, it probably is bad." His Dad was in a lovely ALF, but felt isolated. His next "home" was a for-profit Nursing Home, and lived there for almost two years. We visited often, and had no complaints. But after my Dad was moved to a fabulous place, we became dissatisfied because we had something better to compare it with, so moved his Dad there. Our present, and favorite choice, is a County-funded facility. They are probably one of the country's finest available, and it's close, so we are extremely blessed to have that choice. We made several visits, and specifically asked for a tour on two occasions.
Of coarse, they will "sell" you on their positive attributes. It's sometimes hard to find out the negatives, until you become more familiar with a place, and learn as you go along. No place is perfect. For us, how the facility handled residents with Dementia and Alzheimer's Disease was a primary consideration. After the 8 months Dad has been there, I am still highly satisfied with the care he receives. Do I agree with everything they do? No, but the major things are well-cared for. Things continually change in the medical field, and governing regulations. We can't control everything, but often can have direct impact as an advocate for our loved one's care. Hopefully, your journey will be fruitful and rewarding.
We have had our loved ones in several different types of facilities. A couple we just did not like, for a variety of reasons. Dad was hospitalized, and when they said they were placing him in a Nursing Care facility, we drove down 200 miles to search for a suitable one. We visited everyone within a 80 mile radius, and got a good idea of what's available. I was not impressed with a single one of them, but the pressure was on, so we chose from among them, what we thought would be at least, "tolerable." Some were actually hideous! I swore to oppose his placement into such a place as that. So I suggest you "shop" a few, and that will begin to give you a comparison. Ask questions about their philosophy on medications, behavioral management, staff to patient ratio, and state ratings. All are ultimately governed by the state's control, but different types of facilities have different standards to adhere to. Some facilities are definitely better than others. Do you have many options to choose from in the area you are looking for placement? Find out how they care for someone with your Dad's specific condition. Visit on Saturday or Sunday, when family visits are heaviest, and talk to family members are their experiences and level of satisfaction with a facility you are considering. And if you are uncomfortable with one, trust your instincts. There's many more questions to ask, but hope that gave you a little to think about.
Long term care, still waiting to be medically qualified but they want me to start interveiwing Nursing Homes. They said they are not seeing any problems so far.
Victoria, I was wondering if you are looking for short- or long-term care for your Mom? Has she already been medically qualifies for a Nursing Home, or are you just seeking information for future use? What are yours and her needs? This will make a difference what questions to ask the Nursing Home. Thanks for asking this question.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Ask about therapeutic recreation programs. How do the activity care plans support the efforts of the ordered therapies like PT and OT?
Ask about restraint policies, initiatives for resident safety such as fall prevention and infection control, what is the "continuous quality program" and customer service philosophy.
Ask for testimonials or references.
Blessings to you, Jane
Also, what is the per diem on your mother's long-term care insurance. Different plans pay different amounts. Every facility has a per diem, and as you know any difference would come out of her or your pocket. It's very important you know the per diem allowance you will have as you're looking at facilities. I'm assuming Medicaid is not involved.
The first thing you want to notice as you walk into a facility, is does it smell. If it does, I would walk out. Bad smelling facilities are poorly run. It means that the patients are not being changed and cleaned routinely. It also means the staff and director are willing to tolerate that -- which raises concerns about what other poor care they are willing to tolerate.
I would ask to meet with the Director of Nursing, not just the Admissions Officer who is basically the sales person. If the DON is not willing to make an appointment to meet with you, I would also go elsewhere. It is unusual for the request to be made, most people don't know to ask. But he or she is the person who runs the facility, if it is skilled nursing, so it is very important to learn from them.
Ask the DON what the staff turnover rate is, what is their proportion of CNAs, LVNs (who give medicine) and RNs per patient. How many charge nurses are on duty (those who sit at the desk) during each shift. This should also be posted somewhere on a wall in the entry way by law in most states.
Many facilities have trouble finding quality nurses to work in their facilities. Often you will see that they don't even have every shift covered by one nurse. That is also a bad sign.
You should also look at the most recent state health board report on the facility. Look at how many negative notices there are made against it. Often times, they will be cited for not giving medications at the proper time (very important) or skipping them altogether. Ask also what is the turnover rate of staff.
Stop in some time during the week when they are not typically expecting family visitors and ask to take a tour -- look through the entire facility. Is there water and a pitcher by each person's bed. Is there a television, telephone? Ask to look into the shower areas and see how clean they are.
And, of course, as recommended above, ask other family members of other patients. But make sure you make a surprise visit during the week to really see what happens when the facility is not typically expecting visitors.
You need to fully understand what your long-term care insurance plan covers. I would start with that and not take them at their word that every facility is okay. Will there be extra charges for diapers, gloves, wipes, laundry, medicine -- if you have to purchase these, they can be brought in from the outside; don't pay the rates the facility charges, that's usually where they make extra money. Go to Costco or WalMart.
There are also outside mail-order pharmacies for any medications not covered by Medicare or secondary insurance. A good facility will help you arrange for that. If not, you can also do it on your own.
Finally, find out about doctors. Does the facility have a Medical Director who visits or is on call. Typically, only the highest-end facilities do. So, you need to make sure that your parent's physician will come to the facility or that it's easy for you to arrange for transportation to the doctor.
Finally, meals. Some facilities do not want to serve individuals in bed because they want them up and out, they say, it's more social for them, but it's also more work for the staff. You should find a facility that will allow meals to be served in the room, at the patient's discretion. There may be days or come a time when your parent will want/need to be served in bed.
Hope this helps. Best wishes on this journey. You have lots of support out here!
Jane
People who are happy in their work are going to be better caregivers. Also, there is less turnover in staff which is very beneficial to the residents.
So they treat the residents as individuals?
Nearly all are understaffed, but can you see they care about each person?
The tips from everyone above are good. Lots of defined questions are necessary, but your gut is not to be ignored. Be realistic (this isn't one-on-one care), but check the pulse of the place. The staff is more important than fancy surroundings.
Carol
Of coarse, they will "sell" you on their positive attributes. It's sometimes hard to find out the negatives, until you become more familiar with a place, and learn as you go along. No place is perfect. For us, how the facility handled residents with Dementia and Alzheimer's Disease was a primary consideration. After the 8 months Dad has been there, I am still highly satisfied with the care he receives. Do I agree with everything they do? No, but the major things are well-cared for. Things continually change in the medical field, and governing regulations. We can't control everything, but often can have direct impact as an advocate for our loved one's care. Hopefully, your journey will be fruitful and rewarding.