How do you choose an assisted living facility?

[elise1mds]

My grandmother is 87 years old. She currently lives independently, but she is aware of the fact that she is 87 and is planning to sell her home and move into an assisted living facility in the next year or two (assuming nothing catastrophic happens before then). There is a small assisted living facility in the town where she lives, and that is where she currently plans to move. She has lived in that general vicinity her entire life and does know the local population inside and out... and most of their genealogical and social history as well. The problem is that this tiny, tiny town is 2 hours from where I live and 3.5 hours from my sister and my mother. My mom, sister and I (and my two kids) are the only direct living descendents my grandmother has. She has two younger sisters who are living and who live near her, but one of them is in very poor health and the other has family who still live locally.

 

Anyway, my grandmother's next youngest sister has always been like an 'other mother' to my mom, and the last time my mom went up to visit, they talked about my grandmother's future living arrangements. My great-aunt made some very good arguments against allowing my grandmother to move into the local facility (none safety-related). My mom now wants to look at facilities closer to where she lives, but she's not sure how to get started. I have offered to help her look and research, but I'm not really sure what I'm doing, either. Financial considerations aren't really an issue, but my mom, sister and I want to make sure that my grandmother is going to get into a place that's a good fit and is going to take good care of her. Any tips on how to make this happen? What are the questions to ask? How can you tell a good place from a bad one?

 

TIA :)

[Aggie]

You'll know more once you start going into the facilities. My aunt is in one that is wonderful. (I told my kids that's where I want to go when I grow up ;))

 

Shop around now, find out admittance policies, talk with some of the residents. Talk with the social director and find out what the residents can do. Are there trips, games, etc?

 

We found out (the hard way) that some good ones are so full that you can't just waltz in and get a room. My aunt was on a waiting list for a while.

 

My aunt was reluctant to going into an assisted living home and fought it for the first 3 months she was there. The only thing that changed her mind was visiting her bil in another home. The difference was incredible and it made her appreciate her home more.

 

Wish I could answer more questions, but truly, go visit a few and you'll get a feel for what you're looking for.

 

ETA: The home my aunt is in has an assisted living center and a nursing home. Residents can move to the nursing home part when/if they need to. It was very convenient when that happened and she didn't have to move again.

[OrganicAnn]

I would look for one that is close to the most relatives. It is important to visit often. Both to help your GM be happy there, but also so you can keep close tabs on what is going on.

 

I would also look for the best one that she/your family can afford.

 

Having one associated with a nursing home can be helpful. You don't have to do a 2nd search later.

[*Lulu*]

I would look for one that is close to the most relatives. It is important to visit often. Both to help your GM be happy there, but also so you can keep close tabs on what is going on.

 

I would also look for the best one that she/your family can afford.

 

Having one associated with a nursing home can be helpful. You don't have to do a 2nd search later.

 

:iagree:

 

We put one of my grandmothers into an assisted living with a long term care wing that was specially equipped to deal with dementia patients. When her mind got to the point that she was at risk, they simply moved her within the facility.

 

Also, most places around here keep a guest room and will allow those considering their facility to come and spend the night and experience their facility's "personality". It really can help when you are trying to decided between the places that make your short list.

Edited June 8, 2011 by BLA5

[G5052]

I won't relate the whole situation, but we're in a family mess now where the person in charge is in another state and there isn't the detailed oversight as there should be. They are currently in assisted living, but probably will be moved to the nursing home soon for hospice care. It was extremely hard to get them to move into assisted living, so we never broached the move-out-of-state issue, but I wish that somehow we had gotten that done.

 

Ask the standard questions and read every document. You want to know about staff turnover, what is included/not included, under what situations would they no longer be allowed to stay in assisted living, what activities do they have, what staffing do they have after hours, what is the food like, how do they handle doctor visits, etc. etc. I got a lot of insight from a hospital social worker and a neighbor who had worked at several different facilities in the area.

Edited June 8, 2011 by GVA

[Tarreymere]

. My great-aunt made some very good arguments against allowing my grandmother to move into the local facility

TIA :)

 

Well, first of all, if your grandmother is of sound mind and does not have a court-appointed guardian due to mental incompetence, there is no question of 'allowing' or 'not allowing'. It would be your grandmother's decision and you would have to respect that.

 

As for your actual question, as a former RN I would ask around to find former or current employees of the facilities you are interested in. Most nurse's aides or nurses who have worked in a facility would be able to tell you if they would put their own family member in that facility or not and why. The nurse's aides and nurses work hands-on with the residents and know all the pros and cons of what really goes on in a facility. I did some time working in nursing homes as a staff nurse in between travel assignments and some of the prettiest and best advertised places had horrid care and some of the older and less nice-looking places had great care. Often times the residents of a particular facility don't know enough to judge how good or how bad a facility is. I have heard many residents praise really awful places because they don't know how much better the care is at other places.

[Granny_Weatherwax]

Ask to see the results of the last Dept of Public Health Survey. They are required to have a copy available to residents, family and potential residents. Many facilities have it sitting by the reception desk or in the foyer. Giving you a difficult time about the survey should raise a red flag.

 

You also might want to contact the local Ombudsman and have a short chat about the facility. The Omb. will not be able to give you specific details but she will be able to disclose general info about the facility.

 

Tour the facility at least twice, once during meal time and once in the evening. This will give you a chance to see if the residents are interacting or remaining in their rooms. Most facilities allow you to purchase meal tickets and eat in the dining room while you are visiting. Take advantage of this.

 

Visiting later in the day will allow you to see how staffing is for second shift.

 

Use your nose. If the facility smells like urine there is something amiss. ALFs should not smell; most ALFs are not equipped to handle severe incontinence and the urine smell would be an indicator that the ALFis either accepting residents that should not be there or are understaffed.

[Impish]

Unless your grandmother has any issues with dementia, the decision will be hers.

 

To move her hrs away would be very, very hard on her.

[littlebug42]

Unless your grandmother has any issues with dementia, the decision will be hers.

 

To move her hrs away would be very, very hard on her.

 

:iagree:

 

I understand the importance of being closer to family but removing your Grandmother from her friends, day to day social dynamic could be very hard on her. My Grandmother lived in a similar situation and her friends were what sustained her day to day, not her family that popped in and out. Of course, we all loved her and wanted what was best for her but to have removed her from that would not have been what was best for her.

[elise1mds]

Yes, I know that ultimately the decision is hers. She's very sharp mentally and will make a good choice. However, my grandmother has certain expectations of what my mother, sister and I are supposed to do for her once she "puts herself in a home" (her terminology, not ours). These expectations are not realistic if she lives in her current town, which is why my mother is looking at alternatives. The local facility is not particularly well-equipped for visitors, especially children, and is not linked to a skilled nursing facility (of which my grandmother has been very vocal about her dislike, particularly about the ones local to her). We would definitely work within the parameters given if that's where she goes, but our goal is to give her other options to consider before she makes a final decision, especially if she wants her expectations met. We definitely don't want to make her move to another town. The bitterness that would come from forcing her to do that wouldn't be worth it at all!

 

I appreciate all the tips so far. I'll be passing them along to my mother. Thanks :)