Choosing a long-term health care or assisted living facility that is right for you and your family is a big decision and a big commitment; comparable to buying a house. Though the conclusion to move to or help your loved one transition to a Lifecare community is often decided far in advance, making the actual choice is often a bigger decision than anyone bargains for.

The ultimate goal is to be comfortable, safe, happy, and secure, and because it is difficult to determine which long-term health care facilities have the residents’ best interests at heart, it is often difficult to distinguish a really great home from one that is just “good.”

To aid in the decision-making, here are some questions to help identify facilities truly dedicated to health care support and service excellence and to creating a warm, inviting community for you or your loved one:

Facility and Staff Credentials

o Find out about the licensing requirements in your state for various types of facilities and then make sure the facilities on your list are licensed and that their licenses are visible.

o Ask about the credentials of the staff. Does the nursing facility offer training? Are there staff dedicated to the different types of dementia? How many licensed RNs are on staff at all times?


Care and Service

o Read the Resident's Bill of Rights. Copies should be made available for you. If you choose a facility, keep a copy of the Bill of Rights on hand.

o Some life care centers have developed a "neighborhood" concept so residents can live and socialize with people who have similar needs and experiences. Are residents with dementia grouped together in one wing or are they spread out?

o Is there a Social Services Worker on staff in the facility? These workers help to make the transition easier for your loved one, as well as help to make their stay comfortable.

o What do the meals consist of? Can a special diet be implemented? What steps are taken to ensure the proper foods are given to the right residents?

o Look at the activity noise level and cleanliness of the facility. Is it clean? Is there a healthy amount of background noise?


Safety and Accessibility

o Are safety and accessibility top priorities for the facility?

o What precautionary steps are in place for emergencies?

o Are there smoke detectors, how many, are they all working?

o How often do they have the fire extinguishers checked and if they know where they are located?

o Are safety procedures adequate? Are stairways and exits clearly marked?

o Is it easy to move from one place to another?

o Are halls and toilets wide enough for wheelchairs?

o Are there any floor hazards like being too slippery or having a thick carpet?

o Are the doors operated electronically?

o Is there an emphasis on allowing residents to be as independent as they can be?

o Are there bathing devices available? Are handle rails provided in the bathing area?

o Are there multiple dining rooms and amenities to keep walking distances short?


Amenities and Comfort

o Does the facility have a “community” feel?

o Are the residents happy, alert, groomed, clean, well-fed, and healthy? Are the interactions between co-workers and between workers and residents caring, friendly, and supportive? Does the staff know the residents by name?

o What services does the facility provide?

o A facility dedicated to resident comfort and service should provide laundry facilities on each floor, flat linen service, monthly housekeeping, maintenance and scheduled transportation.

o Other amenities may include a hair salon, bank, and gift shop.

o Each room should have individually controlled heat and air conditioning with an emergency response system.


Recreation

o What types of activities are provided?

o How are they supervised? How often are they held?

o Are there social, recreational, spiritual, fitness and wellness programs available?

o What kinds of exercise regimes are included?

o Do they provide exercise equipment that is appropriate and easy-to-use?

o Is there a fitness instructor on staff?

o What is offered for social and solo activities?

o Is there a computer room, meditation room, library, craft room, game room or wood shop?

o Are there Chaplain Services including visitation, Bible study and worship?

o Are there nature areas, gardens and footpaths?


Health Care Services

o Are different levels of care, from assisted living to health care to short term rehabilitation programs, available? Is there a focus on needs assessment to determine the appropriate level of care for each resident?

o Is there sufficient nursing and personal care, including medication management?

o Are in-home health services available?

o Are nurses always close at hand?

o If the facility offers short term rehabilitation programs, is there a private wing with private room and dining area.

o Does the facility offer care for residents with dementia? What kinds of programs are available for these residents?

o Are personal care plans developed by an inter-disciplinary team?
Financial

o Is there a guaranteed refundable entrance fee?

o Do the assisted living and health care services come at no additional monthly fee?

o To what degree does the life care center manage the residents’ finances?

o Are Medicare and Medicaid plans accepted?


Dedication to Improvements

o Are there programs in place to study processes, re-evaluate services and ask residents and families what might be done better?

o How often are the findings from these programs implemented into changes for the staff, residents, and administration?

o Is the center dedicated to the continuous training of its staff? How is training implemented? And how often?

o Does the dedication to improvements carry over into every facet of the facility? For instance, at Keswick Pines, a life care center in Ocean County, New Jersey, each of the following has been implemented:

o The nursing staff is exploring best practices in the field that might be good to introduce to the community

o Health Care Aides are creating a personal care manual called “Gentle Touch” that includes tips on dealing with difficult or frail residents.

o The housekeeping department created a satisfaction survey tool.

o The Food Service Department has already undergone two independent audits for safety/sanitation and overall food quality and has earned exceptional marks.

o And the CEO is creating a task force of hourly workers to discuss what more can be done to fulfill the 7 AAHSA objectives.

Finding the right Lifecare community can be a fulfilling and truly rewarding experience. And going in asking the right questions can mean the difference between good and excellent care for you and your loved ones.