Tuesday, January 11, 2011

Always with the Checklists! Ways to Narrow the Search for the Perfect Home

Determining the type of facility your loved one is best suited for is just the first step in finding a Home. Several factors should be considered before choosing a Home but, thankfully, much of the research can be done before ever leaving your own home.

A few steps to get you started:

1. Create a checklist. You think I’m kidding? I find them so handy I have a checklist for my checklists! Create a list of facilities in the category needed by your loved one (RCFEs, SNFs, etc.) using resources such as internet searches, Dept. of Health & Human Services, organizations such as the California Advocates for Nursing Home Reform or the California Assisted Living Association. Each state differs with the type of resources available but I have found that once you start the search, you can quickly expand the information available by just asking a few questions when calling facilities (there’s help with that below) or by searching for key phrases related to assisted living.

If your loved one is being discharged from a hospital or SNF, the discharge coordinator can also be very helpful and provide you with possible options. However, these coordinators (for whatever reason) can also be completely unresponsive and out of touch with the needs of your loved one so keep your advocate hat on and be cautious about their recommendations.

Also, don't underestimate the power of personal referrals.  Many people have had to place someone in a facility at one time or another and these personal experiences and recommendations can be invaluable.  Ask around for recommendations.  It can't hurt. 

Update information on your nifty checklist (yes, I said nifty – a highly underutilized word in my opinion). Include the Home name, phone number, administrator or other contact person, address and website (if available).

2. Narrow the checklist based on the importance of geographic location. For instance, it was important to me to be close enough to Robert's place to quickly get there from either work or home in case of an emergency. His Home is located mid-way between both so I can be there within 15 minutes no matter where I am.

3. Jot down any important information about your loved one so you can start the phone calls by conveying information about them. Be sure to note any special needs or behavior such as if they wander or have seizures; include their age and medical condition. Sometimes this immediately narrows the search if the facility doesn’t take a resident who wanders or, as in my brother’s case, a potential resident that is younger than the rest of the population. In California, RCFEs house residents aged 65 or older; however, there is wiggle room which allows for at least one resident younger than that.

4. Create a list of questions to ask, based on your loved one’s particular needs and wants. What is the population of the residents? (for example, how many residents are there? What is the male/female ratio? What is the typical age?). What are staff/patient ratios? Do they have a current opening? If so, what types of rooms are available? Are there private rooms available or will your loved one have a roommate? Is there a private bathroom or is that shared? If it is shared, by how many people? How are meals set up (do residents eat together at certain times or come out and eat whenever they like?).What activities are available to residents? Are there church services?

5. Now it’s time to make some calls! Describe the needs of your loved one and start asking the questions you've assembled. Try to call during mid-morning or early afternoon (basically any time that isn't a meal time or possible shift change). If they are not accepting new residents, ask for a recommendation of another facility – it may not be on your list!

Be sure to ask about payment. I only found out about the Medi-Cal Assisted Living Waiver program because someone told me after I asked if they accepted Medi-Cal. With the current economic climate and looming budget cuts, be particularly vigilant about this area if your loved one receives any health related public assistance.

Your list has now been reduced by quite a few based on these calls (and, hopefully, a few were added as well). It’s almost time to tour but before doing that do a bit more research to find out if a facility has any citations or infractions. The California Advocates for Nursing Home Reform website (www.canhr.org) allows you to search each home and will list complaints, citations and fines. Cross off any facilities that appear to have continuous problems. Consider giving a pass to those with citations/infractions but who have recently changed administrators. That usually indicates a willingness to address and resolve problems.

Now it’s time to tour the homes! Before we get to that checklist (yes, another one), take a break and eat some chocolate. You deserve it!

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