Personal question looking at LTC for parent
0Jul 4, '12 by KJRN79OK, let me say that 80% of my nursing career has been spent in Maternal Child or Pediatrics and that I went to nursing school in the 70s right after that whole big nursing home scandals.
I know that most LTCs give good care. I also know that my 84 dad is no longer safe at home, due to his dementia/ poorer vision and overall health problems in a home with stairs as the only entrance/exit. (unramp-able due to steep hill in front and driveway). He walks with a walker and is starting to bump into things. Mom also has issues: diabetes, arthritis, chronic pain and myasthenia gravis. Her mobility is getting worse due to pain in her feet/ neuropathy. So, I have looked at several places around here and they all look okay. The state reports are all okay. There is always a complaint here or there.
Can anyone give me any insider info? Anything else I should pay attention to? AND tell me how NOT to act like "one of those family members"!
1Jul 4, '12 by VivaLasViejas, ASN, RN GuideYour folks sound more appropriate for assisted living than a nursing home, unless there are wandering and/or severe behavioral issues going on. It's amazing what ALFs will handle nowadays, from sliding-scale diabetics to total-care hospice respite patients. They are also cheaper and much more homelike than the average LTC. =)
1Jul 4, '12 by VivaLasViejas, ASN, RN GuideNow that I'm off the iPhone and onto my desktop: What to look for?
When you tour a community, take a sniff. Do you smell a nice neutral scent, or do you catch a hint of urine or feces? Is the facility clean? Are the staff friendly and helpful? Do they take an active interest in the residents, or do they look like they're just going through the motions? How do the residents look---are they groomed properly, are they bathed and fresh, are their clothes clean? Do they look happy to be there?
Ask to have a meal at the facility (I've never known a place that didn't include lunch or dinner during a tour, but I suppose there are some exceptions.) and ask the dietary staff how they prepare the food. Does it look, smell, and taste good? Is it the appropriate temperature? Does the community offer special diets/textures? (These are usually pretty limited to NAS, cardiac, CCHO, mechanical soft.......we don't thicken liquids because we don't handle residents who need them due to liability issues.)
Inspect at least 2-3 apartments if possible. Do they have private walk-in/roll-in showers? Are they clean and fresh-smelling? Do they have their own heat/AC? A kitchenette? Does the facility furnish towels, shower curtains, TP etc.? Can you bring your own draperies, or paint the unit as your folks would like? Does the unit have pull cords in the living room, bathroom, and bedroom, or does the resident wear a special call pendant (much like Lifeline)?
Activities: Are there enough, and are they appropriate for residents of differing age groups and cognitive status? Does the community have a bus to take residents to appointments and outside activities?
Levels of care and of course, prices: What services does the community provide, and what are the criteria for move-out should one or both parents need a higher LOC? Is there a nurse on duty at least 24 hours per week, and what is her/his function---direct care, or mostly administrative? Who covers on weekends/holidays/vacation?
OK, that should help get you started. Wishing you luck in finding the right place for your Mom and Dad. PM me if you want to.
0Jul 4, '12 by JustBeachyNurseDoes CMS/Medicare website still have the checklists of what to look for in ALF and LTC facilities along with the facility inspection ratings? That was a huge help when we had to urgently place some family members as the social worker case managers were a bit inept and geographically challenged (you don't want to know)
2Jul 4, '12 by DragonmomCare is better at the "not for profit" rather than the private or "for profit". This is true for obvious reasons, not for profit are there for the residents while for profit are there to make sure those in upper management and the corporation make the biggest amount of money possible.
I have worked both and I've seen this. State reports are OK but seeing has the facility knows the state people are coming they will add staff, supplies, whatever they have to, in an attempt to cover their you know what. Once state has left it's back to the same old same old.
Activities are also better at the not for profit, better variety, these are important to consider as well since there are many places that only offer bingo, and not everyone wants to play bingo everyday, and the activities easily become a large part of the residents lives.