Searching for a senior living facility; preparing for the future

Jun. 26--Often when an elderly family member needs assistance, it begins through rehabilitation. They've had a hip or knee replacement or there has been a medical event such as a stroke or heart attack.

Those stints in a rehabilitation facility are meant to be short and to get the person back home as quickly as possible. Yet, the choosing of the facility is left to family members. They are generally at the time, emotional, confused and the decision has to be made quickly.

"Sometimes you don't get a warning, especially in a health event. Families are pressed into making decisions very quickly and the hospitals are pressed to get this person out to another facility fairly quickly," said Nancy Jones, vice president of sales and marketing for Hoosier Village in Zionsville. "The best advice to give someone is to make a plan. The crash course when you've got 48 hours to make a decision isn't helpful."

Though most don't want to have the conversation, sitting down with aging parents or grandparents to discuss what path they would like to take, should an event take place, is imperative.

"People need to know what their parents insurance is; some dictate which facilities you can go to and that narrows down the field for some," Jones said. "Is there a healthcare power of attorney? Are there advanced directives? Just because you've prepared doesn't mean something bad is going to happen but the reality is, most people will need something at some point."

In speaking with several nursing homes and assisted living facilities, they all have one thing in common -- they want you to visit. They routinely give families a tour of the facility and are ready to answer questions, some of which, you may not have thought of.

"I would ask what kind of activities they have and maybe look at a menu," said Cheryl Loux, office manager at Crowne Pointe in Lebanon. "Many people want to know when they get their mail and the typical schedule. These things are important to people moving in because if they aren't going to be at home, they want to know what that will look like."

Asking about staff ratios and the level of licensure staff have could be helpful, given the needs of your loved one. Speak to staff to get a feel for their communication and personalities. Are they friendly and helpful?

"I would encourage families to test the food; what kind of snacks do they have available?" said Bradley Macklin, executive director of Homewood Health Campus in Lebanon. "We often adjust those things for the resident if they have a favorite meal or want something specific."

While a tour to a nursing home may not necessarily be uplifting, family members are encouraged to set aside emotion and look at the facility with a critical eye.

"Look around," said Jones. "Is it clean? It may not be luxurious, but is it clean? There may be a temporary odor because accidents happen, but is there a terrible, underlying odor? The real test is if it's getting cleaned up. Do the residents look okay; are they groomed? Most places try to honor resident's wishes. If they are happy to stay in their bathrobe and don't want to get dressed, that's fine. But men should be shaved, residents should have regular haircuts and basic grooming should be evident. Are residents appropriately covered? Is it calm or noisy?"

Jones said maintaining dignity is more important as loved ones age and staff should feel responsible for protecting residents' dignity.

A phrase rising among senior care facilities is person-centered care. It is the concept of partnering with people using health and social services as equals in planning, developing and monitoring their care. It puts families and residents at the center of the decision making process and working alongside them.

"One question to ask is how meals are handled," Jones said. "Are they served when they're ready to eat? If someone has always slept in, gotten up and had their cup of coffee at 10 a.m., we shouldn't be making them get up at 6 a.m. for that coffee."

Again, planning for facilities, insurance, and financial decisions ahead of time is best. Experts say making snap decisions without all of the pertinent information can lead to problems down the road.

"We really shouldn't let people without clear minds make the decisions. We know what they want, but it may not be realistic," Jones said. "My brother is 75 and our mom is 96. In generations past, 75 was the older generation -- not so much anymore. People are living longer and necessity says they are going to have to think about living arrangements."

Finally, location is not all it's cracked up to be. While family members want to be close by and frequently visit, the comfort and happiness of the resident should take precedence in the decision making process.

"If it works for your family, that's all we're really concerned about," Jones said. "Location is huge, but it shouldn't be everything. I've seen a lot of families pick a place because it's close to home and then they aren't happy with it. It is a consideration, but frankly, I'll drive another 15 minutes so my family member can be in the best place."

Even with pre-planning and knowing what the loved one wants, families do much of the leg work through the process.

"This is a major life event and decision. Would you buy a house in 48 hours? You probably wouldn't take a job with a company you knew nothing about. It's a major decision so we should treat it as such. It's not always fun, but necessary," Jones said.

This is the second in a four-part series. Find out what it takes to stay at home as long as possible and the financial impact home versus senior care facility can have.

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