We understand that when considering long-term care for a loved one, there are many factors to consider. It’s hard to know where to turn for accurate information. And we know you want assurances of the best possible personal and medically advanced care available. We want to help you as best we can. So we’ve provided some answers for many questions we are asked regularly. If you need additional information beyond what we have provided, we certainly want to help. Please feel free to contact us with your questions and concerns. At Touchstone Communities®, we’re here to help you with your long-term care needs, whenever you need us.
When a person needs help with dressing, shopping, meal preparation and personal chores — and when the family can’t meet these needs alone or with community services — a long-term care facility may be advisable. Also, when a person needs medical attention the family can’t afford to provide at home, or when keeping the person at home is too disruptive, long-term care could again be the best choice.
It’s wise to consult family members, as well as your physician when making this decision. If you are faced with having to move someone from a hospital to a long-term facility, the hospital’s social worker may have valuable suggestions.
We also recommend focusing on the individual’s needs and preferences. This is very important in achieving a more than satisfactory and hopefully fulfilling solution.
Some homes specialize in one type of care, while others may offer a continuum of care. A long-term care facility may be certified in one or more categories, from independent living to skilled nursing care. It’s best to schedule a personal visit and talk to the administrator to clarify levels of care for each facility.
Typically, an intermediate care facility, also know as “assisted living,” is for people who need health services and some nursing supervision in addition to help with eating, dressing, walking or other personal needs.
A skilled nursing facility is staffed to make round-the-clock nursing services available to residents who need them. Check with the administrator to see what Medicare and/or Medicaid benefits are available for each types of care, if any.
Some persons may be able to obtain the care they need in a room-and-board home. However, these facilities are not licensed and are not required to provide supervision.
It’s simple. We recommend making a list of facilities in your area that seem to fit the needs and preferences of the person needing care. The more choices you have, the better your chances of making the optimum choice. Try to get references from other families who have placed family members in long-term care communities. Then check out the yellow pages. Other sources could include the local health department, senior citizen groups, your physician, clergyman, relatives and friends.
It’s not necessary. You can eliminate some by making phone calls to determine what kind of care the homes provide, based on what needs your family member has. Also, particular Medicare or Medicaid benefits can be determined. And not all facilities have vacancies.
It’s best to visit a facility more than once and at different times of the day. One visit could be to observe the noon meal being served. You may try to schedule a visit to observe activities being offered, and then again to see the evening meal. Plan to spend at least an hour on each visit. It’s usually best to schedule an appointment to meet with the administrator the first time to explain the purpose of your visit. Following a guided tour, it’s smart to chat with residents and observe conditions all by yourself. If the administrator refuses to let you tour without a staff member present, you can assume he or she has something to hide.
Definitely. Most homes display their licenses and certificates. Never accept someone’s word that certificates exist without seeing them. Take time to examine them and be sure they’re current. The more important documents include the long-term care facility license and nursing home administrator license. If neither license is secured or available, do not use the facility. You could also ask to see the latest state survey inspection report of how the facility meets state standards.
Consider whether an urban or rural setting is best. Being close to a hospital and the person’s physician can be advantageous. And it’s important the location allows for family and friends to visit regularly.
Make sure the facility is focused on eliminating hazards and has sufficient accident prevention. Check for handrails in hallways and grab bars in bathrooms.
Be sure the facility complies with state fire safety codes. Ask to see the report of a home’s last fire safety inspection showing that it meets state codes. Choose a home that has routine inspections. Regular fire drills are also good and a written emergency evacuation plan is valuable.
Each bedroom must open to a corridor and have a window. Each resident should have privacy, closet space and drawers for personal belongings. Check for adequate room for wheelchair access. Ask how the home selects roommates, if applicable.
Check for cleanliness and the preferred level of tidiness versus that lived-in look.
A lobby should contain comfortable chairs and couches, plants and flowers, and a bulletin board with notices of activities and menus. License, certificates, a copy of any current order pertaining to the facility issued by a state department or by a court, and a notice regarding complaint procedures should be on display.
They should be large enough to allow for two wheelchairs to pass with ease and should have handgrip railings on either side.
Dining rooms should be attractive and inviting, with comfortable chairs and tables that can be moved to accommodate residents in wheelchairs. Sample the food and see if it matches the menu.
Food preparation, garbage and dishwashing areas must be separated from one another. Food needing refrigeration should never be left on counter tops.
All facilities must have sufficient space for activities. Residents who are up to it should be engaged in activities of some kind.
Bathrooms should accommodate residents who use wheelchairs, have a sink with hot and cold running water and grab bars on or near the toilet and bathing facilities.
Every home must have physicians available in an emergency, as well as an advisory physician or committee. Good homes allow residents to be treated by their private physicians. They also require that residents be seen as often as necessary. If a resident will be depending on the home’s physician, find out how often the physician visits and how closely they supervise resident care.
The facility you choose should have arrangements with other health care professionals such as dentists, podiatrists and optometrists in the community to see that residents get the ancillary medical treatment they need.
A good long-term care facility usually has an arrangement with a nearby hospital in case residents become acutely ill. Ask the administrator what arrangements the home has and, in their absence, what is done in case of an emergency.
The competence and attitude of the nursing staff is vital. Registered nurses (RNs) should direct nursing services in skilled nursing homes. An RN may not be on duty during all shifts, but must be responsible for the nursing staff. Licensed vocational nurses (LVNs) with at least one year of specialized training, should be on duty day and night. Certified nurse aides (CNAs) help with bathing, eating, dressing and other personal needs. Ask the administrator to explain the facility's CNA training program to you.
Full- or part-time specialists should be available to help residents regain lost abilities, such as walking, talking and dressing.
Activities can help residents feel right at home. Activities should include trips to community locales and visits to friends and family. Community institutions, such as libraries, should bring their services to the home. People from the community should be encouraged to volunteer to work or visit with the residents. Residents should be encouraged, but not forced, to participate.
Be sure the home provides on site services or arrangements for transportation to preferred services.
Good homes have social workers on staff or as consultants to aid residents and their families in dealing with various problems.
A dietitian should plan balanced, varied and tasty meals that meet all of a resident’s nutritional needs. Personal likes and dislikes should be considered. Ask to see menus. Good homes serve meals at normal times, allow plenty of time for leisurely eating and provide nutritious between-meal and bedtime snacks.
Good homes arrange for barbers and beauticians as needed.
The atmosphere of a home is a vital consideration for you and your loved one. Look for a long-term care facility that treats residents like vibrant individuals and works to satisfy their emotional and physical needs. Be sure the home allows the resident to participate in planning their treatment.
Residents should have the freedom and privacy to attend to their personal needs. All residents should have the freedom and opportunity to make friends and to socialize.
Residents should be allowed to decorate their bedrooms with personal belongings and to wear their own clothing. Visiting hours should be generous and set for the convenience of residents and visitors.
Remember, real care and true compassion go hand in hand.
As you might expect, the more services a resident requires, the more he or she will probably pay. Talk to the administrator about the basic monthly charge and exactly what the resident receives for it. Some homes charge extra for services like laundry that other homes include in their basic rates.
Find out whether the resident is entitled to Medicaid or Medicare benefits. If not, check into private health insurance, such as Blue Cross/Blue Shield, or another major medical plan to see if it covers nursing home costs.
It’s smart to compare the costs of several homes providing the same or very similar services. Also, visit with a home’s administrator to explain all costs. Before a contract is signed, be sure it is completely understood by all persons concerned.
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