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The Quest for a Quality Nursing Home
Choosing a long-term health care or assisted living facility that is right for you and your family is a big decision and a big commitment; comparable to buying a house. Though the conclusion to move to or help your loved one transition to a Lifecare community is often decided far in advance, making the actual choice is often a bigger decision than anyone bargains for.
The ultimate goal is to be comfortable, safe, happy, and secure, and because it is difficult to determine which long-term health care facilities have the residents’ best interests at heart, it is often difficult to distinguish a really great home from one that is just “good.”
To aid in the decision-making, here are some questions to help identify facilities truly dedicated to health care support and service excellence and to creating a warm, inviting community for you or your loved one:
Facility and Staff Credentials
oFind out about the licensing requirements in your state for various types of facilities and then make sure the facilities on your list are licensed and that their licenses are visible.
oAsk about the credentials of the staff. Does the nursing facility offer training? Are there staff dedicated to the different types of dementia? How many licensed RNs are on staff at all times?
Care and Service
oRead the Resident's Bill of Rights. Copies should be made available for you. If you choose a facility, keep a copy of the Bill of Rights on hand.
oSome life care centers have developed a "neighborhood" concept so residents can live and socialize with people who have similar needs and experiences. Are residents with dementia grouped together in one wing or are they spread out?
oIs there a Social Services Worker on staff in the facility? These workers help to make the transition easier for your loved one, as well as help to make their stay comfortable.
oWhat do the meals consist of? Can a special diet be implemented? What steps are taken to ensure the proper foods are given to the right residents?
oLook at the activity noise level and cleanliness of the facility. Is it clean? Is there a healthy amount of background noise?
Safety and Accessibility
oAre safety and accessibility top priorities for the facility?
oWhat precautionary steps are in place for emergencies?
oAre there smoke detectors, how many, are they all working?
oHow often do they have the fire extinguishers checked and if they know where they are located?
oAre safety procedures adequate? Are stairways and exits clearly marked?
oIs it easy to move from one place to another?
oAre halls and toilets wide enough for wheelchairs?
oAre there any floor hazards like being too slippery or having a thick carpet?
oAre the doors operated electronically?
oIs there an emphasis on allowing residents to be as independent as they can be?
oAre there bathing devices available? Are handle rails provided in the bathing area?
oAre there multiple dining rooms and amenities to keep walking distances short?
Amenities and Comfort
oDoes the facility have a “community” feel?
oAre the residents happy, alert, groomed, clean, well-fed, and healthy? Are the interactions between co-workers and between workers and residents caring, friendly, and supportive? Does the staff know the residents by name?
oWhat services does the facility provide?
oA facility dedicated to resident comfort and service should provide laundry facilities on each floor, flat linen service, monthly housekeeping, maintenance and scheduled transportation.
oOther amenities
may include a hair salon, bank, and gift shop.
oEach room should have individually controlled heat and air conditioning with an
emergency response system.
Recreation
oWhat types of activities are provided?
oHow are they supervised? How often are they held?
oAre there social, recreational, spiritual, fitness and wellness programs available?
oWhat kinds of exercise regimes are included?
oDo they provide exercise equipment that is appropriate and easy-to-use?
oIs there a fitness instructor on staff?
oWhat is offered for social and solo activities?
oIs there a computer room, meditation room, library, craft room, game room or wood shop?
oAre there Chaplain Services including visitation, Bible study and worship?
oAre there nature areas, gardens and footpaths?
Health Care Services
oAre different levels of care, from assisted living to health care to short term rehabilitation programs, available? Is there a focus on needs assessment to determine the appropriate level of care for each resident?
oIs there sufficient nursing and personal care, including medication management?
oAre in-home health services available?
oAre nurses always close at hand?
oIf the facility offers short term rehabilitation programs, is there a private wing with private room and dining area.
oDoes the facility offer care for residents with dementia? What kinds of programs are available for these residents?
oAre personal care plans developed by an inter-disciplinary team?
Financial
oIs there a guaranteed refundable entrance fee?
oDo the assisted living and health care services come at no additional monthly fee?
oTo what degree does the life care center manage the residents’ finances?
oAre Medicare and Medicaid plans accepted?
Dedication to Improvements
oAre there programs in place to study processes, re-evaluate services and ask residents and families what might be done better?
oHow often are the findings from these programs implemented into changes for the staff, residents, and administration?
oIs the center dedicated to the continuous training of its staff? How is training implemented? And how often?
oDoes the dedication to improvements carry over into every facet of the facility? For instance, at Keswick Pines, a life care center in Ocean County, New Jersey, each of the following has been implemented:
oThe nursing staff is exploring best practices in the field that might be good to introduce to the community
oHealth Care Aides are creating a personal care manual called “Gentle Touch” that includes tips on dealing with difficult or frail residents.
oThe housekeeping department created a satisfaction survey tool.
oThe Food Service Department has already undergone two independent audits for safety/sanitation and overall food quality and has earned exceptional marks.
oAnd the CEO is creating a task force of hourly workers to discuss what more can be done to fulfill the 7 AAHSA objectives.
Finding the right Lifecare community can be a fulfilling and truly rewarding experience. And going in asking the right questions can mean the difference between good and excellent care for you and your loved ones.
About Keswick Pines
Keswick Pines is an award-winning lifecare center located in Ocean County, NJ. The not-for-profit lifecare community is home to nearly 400 residents, providing three different levels of care. Visit Keswick Pines on the World Wide Web at: www.keswickpines.com.
About the Author
Please visit www.keswickpines.com for more information.
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