Selecting Residential Care for Older Adults

Choosing the Right Facility

The following questions will help you select nursing home care for older adults. Remember, there is no such thing as a “stupid question.” All questions are important and you have a right to information about service providers.

  • Determine that the facility provides the level of care needed by you or your loved one now and in the near future. Be realistic about care needs.
  • Make a scheduled visit first and unannounced follow up visits.
  • Ask to see a copy of the most recent survey by the Department of Health Services.  Have there been complaints filed/deficiencies noted against the institution? If so, what were they?
  • Does the facility have a contract to provide care to residents in the Arizona Long Term Care System (ALTCS)?
  • What is the monthly base fee and what services does it cover? What additional services are there and do they cost extra? Is there an itemized list of services? Is there a move-in fee?
  • Under what conditions might fees increase? What are the conditions for terminating a contract? How much notice will be given? What is the refund policy?
  • What if the older adult must be hospitalized or needs another level of care? What is the procedure if care needs increase above that which the facility can provide? How much notice will be provided?
  • Do research on the ownership of the facility. Interview the executive director/owner/manager. How long has he or she been at that facility? What is his or her philosophy of care?
  • Can they accommodate couples and are the fees specific to the individual care needs?
  • Do physicians or registered nurses regularly visit the facility?
  • Review the documentation of medication administration. What techniques are used if someone with dementia refuses his or her meds?
  • What is the ratio of staff to residents, including on weekends and at night? Is there awake staff available 24 hours per day? How often are residents checked at night?
  • How are caregivers screened? What background checks are done? What initial and continuing education is required? How are their skills evaluated and their credentials checked? How long has staff been at the facility?
  • Have caregivers received specific training in dementia care? How do staff handle difficult behaviors?
  • Are caregivers available with the physical strength and training necessary to perform safe transfers or whatever task is required?
  • Are caregivers available with the cultural sensitivity and language skills you or your loved one need?
  • Is this facility able to meet your or your loved one’s specific requirements (e.g., non-smoking, fragrance free, etc.)?
  • Does the agency have nondiscrimination policies and provide staff training on cultural competency issues including lesbian, gay, bisexual, and transgender (LGBT) concerns?
  • How are complaints made and how are they handled?
  • Is the environment attractive, both indoors and outdoors?
  • Are sanitary conditions maintained throughout the facility?
  • Are residents addressed by appropriate names?
  • Are residents appropriately dressed and groomed for time of day?
  • Do caregivers knock before entering a resident’s room?
  • Are residents cheerful and able to talk freely with you?
  • Ask for a copy of the monthly activity calendar to see if the activities would interest you or your loved one.
  • Is there meaningful stimulating activity available at the needed frequency and level?
  • How far do residents have to walk to activities and to their dining room?
  • Will the distance be a barrier to participation in activities or meals for you or your loved one?
  • Can residents decorate their own rooms? How are roommates selected?
  • Ask to see a menu. Can the facility accommodate special dietary needs?
  • Do residents participate in menu planning if desired? Are snacks available
  • between meals?
  • Is there an emergency call system? Is it conveniently located? Who responds to
  • the call?
  • Is there private phone service in each room?
  • Are visitors welcome at any time? Could pets live in or make visits?
  • Are visitors monitored or screened in any way?

The following websites may be useful: www.medicare.gov  for nursing home information, and www.azdhs.gov/als for information on assisted living homes and centers. For information about survey results or complaints you may contact the Tucson branch of the Department of Health Services Healthcare Licensure at (520) 628-6965.

 

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