CHOOSING
A NURSING HOME:
Choosing
the right nursing home is a very difficult and important decision. This
choice is made for someone who is unable to make the decision and, usually,
is unable to report the care that they receive. Take a friend or relative
with you for their opinion and observations. Observe interactions between
staff and residents and overall atmosphere. Are the residents treated
with respect? Visit on more than one occasion at varying times of the
day. Visit at a meal-time, which can be hectic, how does the staff respond?
Do not always announce your visit. The following are some topics and
points to consider. Also, in this packet is a "Nursing Home Checklist"
which is provided by Medicare. Their complete booklet can be obtained
from www.medicare.gov oral 1-800-MEDICARE (1-800- 633-4227).
Also, our website listing may provide additional assistance. This is
only a guide. TRUST YOUR INSTINCTS.
"IMPORTANT:
Louisiana Ombudsman Program. Respond to problems and needs of residents
in long-term care facilities. Caddo Council on Aging Ombudsman Program
(318)632-2090. Outside of Caddo, check with local Chapter of Council
on Aging.
LICENSE:
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Is
license prominently displayed? |
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Is
consumer information available to residents and families? (Information
on LTC Ombudsman Program) |
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Is
most recent licensing survey displayed? It will tell what areas
were found to need improvement and seriousness of the deficiency. |
PHYSICAL:
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When
touring a specialized dementia unit. remember, though it
may seem sparse in appearance, they should be providing a modified
environment that is geared toward the safety of its residents. Many
units do not allow telephones, TVs, dorm refrigerators, or glass
items. |
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When touring, are you allowed to see every part of the facility
and outdoor area? |
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Are rooms and common areas clean, odorless, well-lighted, well-heated
and cooled? |
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Do rooms and bathing areas allow for privacy? |
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Are
residents allowed to bring own furniture and accessories? * Do not
bring any valuable items or heirlooms. Dementia residents often
wander In and out of rooms and items are often carried around or
hidden. Yet, bring items that may offer comfort or memories, i.e.
old photos, blanket, small furniture item. |
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Are
dining room, living room and other common areas spacious and pleasant?
Does the area allow for mobility? |
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If a courtyard exists, does it promote independence in a safe and
secure manner? |
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How
will your loved one respond to the number of residents, size of
the facility and noise level? |
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Is the home pleasant to visit? |
QUALITY
OF CARE:
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Is staff trained to work with AD residents? |
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How
does the staff deal with behaviors, such as agitation and wandering?
Do they speak to the residents in a calm voice? Individuals with
AD react/perceive other's emotions; loud/aggressive voice may only
increase agitation/behavior. |
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Are
residents being unduly medicated or physically restrained to handle
behavioral issues? |
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Is staff respectful? Are residents treated like adults? Called by
preferred name? |
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Is
staff friendly and genuine with residents, visitors and co-workers? |
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Is staff neatly groomed, appear rested and not overworked? |
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What
is the staff-to-resident ratio? |
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How
many direct-core staff work during various shifts? Day? Evening?
Overnight? Weekend? |
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Does
Dr. make monthly visits? If resident must see a doctor off-site,
will they arrange for the appointment? Obtain prescription drugs,
etc. |
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Does
staff keep a regular updated "plan of care?" Are monthly
inter- disciplinary meetings held? Is resident/family invited to
attend? |
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Are there hours that families are not allowed to visit? |
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Is there a family counsel or support group? |
MEALS
AND ACTIVITIES:
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Is food healthy, ample, appealing and adjusted to the individual
tastes and medical needs? Request to see a copy of the menu. |
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How
are adequate nutrition and hydration assured? This is extremely
important for individuals who cannot express or remember their needs. |
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Are
snacks offered/available anytime? At times when a dementia resident
becomes agitated or requires redirection, a snack or beverage is
offered. |
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Are
activities tailored to the needs and limitations of AD residents?
Do they promote independence/ feelings of accomplishments? Activities
are very important to AD residents. These activities should be offered
in a variety of ways to include everyone regardless of their functioning
abilities. They are a therapeutic method that can aid in handling
some behavioral issues, as well as providing an opportunity to express
their thoughts and feelings, and stimulate pleasant memories. Types
of activities include: creative, physical, social, grooming. |
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How
often are organized activities offered? Daffy? On week-ends? Request
to see a schedule. |
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Are
off-campus activities offered? Participation in this type would
depend on level of functioning. What safety measures are taken?
Staff/resident ratio? |
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Are
off-unit activities available? Do they integrate AD residents with
other residents or are they able to participate/attend activities
offered to non-AD residents? |
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Are
religious services/spiritual activities available at the facility?
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FEES:
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What
is included in the basic monthly fee? |
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Is
there a flat-rate for all services? Are fees added for additional
services, such as medications, incontinence supplies, activities? |
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Under what circumstances might the fee change and how much notice
is given if there is a fee increase? |
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Is
a deposit required before moving in? If applying for Medicaid upon
admit.
fee should not be required? |
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Are
there conditions in which a resident might be required to move?
Change in behavior, health status, financial status? |
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If you are unhappy with the facility, how much notice needs to be
given? Are refunds available/ prorated? |
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Is
minimum required to open resident account? |
THE
TRANSITION:
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move from home to long-term care can be a difficult experience.
This can vary depending on a person's ability to understand the
situation and handle the stress. |
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Personalize the room prior to admission. Familiar items provide
comfort and reassurance. |
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If
possible, choose the right time of the day for the move. Mid-morning
hours are usually best since more staff members are present and
people with dementia tend to be more alert and less agitated. |
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Try
not to show fear or sadness. Be aware that individuals with AD can
be very perceptive and responsive to the emotions of others. |
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