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WHAT TO LOOK FOR WHEN PLACING A LOVED ONE FOR LONG TERM CARE?
- When the time comes to place your loved one in a long-term care facility, the decision can be difficult and often overwhelming. Here are some questions you should ask at each facility you inspect in order to ensure quality care:
- Is the staff happy and involved with the residents?
- Are there licensed nursing services onsite 24 hours a day, directed by a full-time R.N.?
- What is the resident-to-direct care/caregiver staffing ratio?
- Do you see residents restrained in wheelchairs, unattended and looking over-medicated?
- Are residents involved in activities designed to eliminate feelings of boredom, loneliness and helplessness?
- Is there a physician Medical Director with expertise in gerontology coordinating medical care?
- Is there a full-time Social Worker on staff to help families?
- Does the facility have outdoor areas that encourage exercise?
- Is the outdoor area locked?
- Is the outdoor area accessible from the inside during the day?
- Does the facility have walking paths to encourage physical movement and help relieve frustration?
- Does the facility have pets?
- Do they allow residents to bring their pets to live with them?
- What are the facility’s visiting policy and hours?
- Are there any restrictions for children or pets?
- What is the pricing structure?
- Is it a fixed rate or “tiered structure” with added unpredictable costs for increasing levels of care?
- What happens if my loved one’s physical condition/behavior deteriorates?
- What would be the circumstances or medical conditions under which I would be required to move him/her?
- How often are residents discharged to hospitals and skilled nursing facilities for medical problems?
- If a resident needs to go to the emergency room or hospital, does a staff member accompany them at no extra charge?
- Does the facility provide care for residents at all stages of dementia – from early stages through hospice?
- Does the facility collect data on clinical outcomes?
- What are the clinical outcome results for residents?
- How is the Living Environment?
- Is it homelike?
- Is it carpeted?
- Are there any unpleasant odors?
- Are the planned activities appropriate for the age/skill levels of the residents?
- Are there activities of interest to both men and women? Are there community outings or are residents isolated from the outside world?
- What is the dining area like?
- Is food service available to residents 24 hours a day?
- Are families invited to meals at no extra charge?
- Are there routine care planning meetings and are the family and resident included?
- Are the residents dressed and out of bed by 9 a.m.?
What to Look for When Choosing Home Care
- When selecting a home care agency, there are some very important questions that you should ask of your prospective services provider:
- Is the Care Provider a:1. Home Care Agency, 2. Employment Agency, 3. Registry/Broker, 4. Independent Contractor?
- Home care agencies accept responsibility for screening, training, insuring, and supervising their staff. The other models do not.
- How long has the agency been providing private duty home care?
- Is the agency a member of the National Private Duty Association?
- How does the agency screen and select caregivers prior to an assignment? Do they hire independent contractors?
- Are references checked and criminal background and drug screens conducted on all employees?
- Is there a licensed health care professional, who along with the client and family develops an individualized plan of care? How are emergencies handled after normal business hours?
- How often are caregiver services monitored, and does the agency employ a full time registered nurse or other qualified professional to make regular visits to the client's home?
- Does the agency adhere to state and federal guidelines in their employment practices, such as: withholding appropriate taxes, providing workers' compensation and other benefits?
- Does the agency manage all payroll and employee related matters?
- Whenever possible, ask to meet with the prospective caregiver(s) before they are assigned to provide care. This will provide a good opportunity to interact with the caregiver prior to an assignment. If you are not satisfied with the caregiver, this is a good time to let the agency know.
- Are Care Companions trained with actual clients prior to assignments?
- Are Care Companions specially trained to understand and work with memory-impaired clients?
What to Look for in Hospice Care
- Choosing a hospice is a personal decision. Whether you are looking for hospice care for yourself or a loved one, it is important to find out about what services each hospice in your area offers. You may want to request services from a particular hospice and can communicate that wish to your physician.
- How do I decide if hospice is the appropriate care choice for me?
- How do I choose among different hospice programs?
- Are all hospices the same?
- These are common questions for patients and loved ones facing life-threatening illnesses. Determining if a hospice is right for you may best be learned from interviewing different hospices and talking to those you trust who are familiar with hospice programs in your area. Resources for information about hospice care in your community include:
- Physicians, nurse, and other healthcare professionals;
- Social workers, clergy, and other counselors;
- Friends or neighbors who have had direct experience with hospice care;
- Are Care Companions specially trained to understand and work with memory-impaired clients?
- Local or state Office on Aging or senior centers;
- Various medical and health-related Internet sites;
- Your local yellow pages or directory information; and,
- National Hospice and Palliative Care Organization’s HelpLine (800( 568-8898 can help you find a hospice in your communityor visit the website www.caringinfo.org.
Questions to Ask When Choosing a Hospice Program
- Hospice care is a philosophy of care that accepts dying as a natural part of life. When death is inevitable, hospice seeks neither to hasten nor postpone it. Below is a list of questions you should consider when looking for a hospice program.
- What services are provided?
- What kind of support is available to the family/caregiver?
- What roles do the attending physician and hospice play?
- What does the hospice volunteer do?
- How does hospice work to keep the patient comfortable?
- How are services provided after hours?
- How and where does hospice provide short-term inpatient care?
- Can hospice be brought into a nursing home or long-term care facility?
How do I ensure that quality hospice care is provided?
- Many hospices use tools to evaluate how well they are doing in relation to quality hospice standards. In addition, most programs conduct family satisfaction surveys to get feedback on the performance of their programs. To assist hospice programs in these efforts, the National Hospice and Palliative Care Organization has developed recommended standards entitled 'Standards of Practice for Hospice Programs as one means of self- and field-evaluation. www.caringinfo.org.
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