Finding a Long-Term Care Facility

This article provides a list of the most important questions to ask when choosing a long-term care facility for a parent with dementia or Alzheimer’s.

“Where Do I Even Start?” 

This is often the first question adult children ask themselves when faced with the task of finding the right long term care facility for a parent with dementia or Alzheimer’s.  This question is often quickly followed by “How much does it cost?’ and “Can we afford it?”

As with every other search these days, your search often begins on the internet. Conduct a Google search of the desired location with one or two other words such as “nursing home,” “Alzheimer’s facility” in “(name of town here), or "memory care facility near me.”  Depending on the size of the town or city you are googling, chances are you will turn up several viable options.

Of course, that is just the start. More importantly, a successful search and ultimate placement requires digging into the details of each facility: the living environment, the staff and caregivers, the food, activities, safety features, policies, etc. This requires a visit and tour of each possible facility, with time spent for touring and asking questions, and even staying for lunch to sample the menu.

Persons with Alzheimer’s or Dementia Have Unique Needs

Persons with dementia or Alzheimer’s have unique needs which should be addressed specifically during the process of identifying a facility. Questions to address include:

• What training does the staff have to work with persons with dementia?
• What is the staff to resident ratio?
• How does the staff handle difficult behaviors such as bathing and wandering?
• How often are residents bathed?
• Is special assistance given to persons with feeding problems?
• Do caregivers speak English or the resident’s native language so that communication is effective?
• Are individual care plans maintained for each resident?
• How does a resident get medical attention?
• Is there a doctor available who keeps hours in the facility?
• For outside medical appointments, will staff make those arrangements?
• What other staff is available to residents?
• Are there specific visiting hours for families and visitors, and if so, what are they?
• Is the facility secured for wandering residents?
• How does the staff handle residents going into another resident’s room?
• Is there a support group for family members?
• What is the facility response when a resident is having difficulty adjusting?
• What has been the practice in the past?

Other Questions Apply to Everyone

The above questions are focused on the needs of one with Alzheimer’s or dementia, but there are many more questions, and the following questions apply to anyone, including one with Alzheimer’s or dementia.

• What kinds of structured activities are scheduled throughout the week?
• Are there any religious services in the facility?
• What about day trips?
• Are residents allowed to bring their own furniture and belongings?
• Is there a bus that takes residents to activities?
• Can the kitchen accommodate a special diet?
• Can a resident go into hospice in this facility?
• What reasons would a person have to move somewhere else?
• How often are disaster drills held?

Take a Look Around

• Is the staff pleasant?
• Is the atmosphere warm and friendly?
• Does the staff treat residents like adults?
• Are the residents clean and well groomed?
• Do residents seem unnecessarily medicated?
• Is the facility clean, well lit, at a comfortable temperature and are the grounds well maintained?
• With regard to safety, are fire escapes and ramps wide enough for wheelchairs?
• Are there handrails in the hallways?
• Do the tubs, toilets and showers have grab bars?
• Are the floors clean and non-slippery?
• Ask yourself “Would I want to be here?” 

Administrative Matters

• What are the basic costs and what is covered?
• Are there additional charges for care and what are those?
• What is not covered under the basic charge?
• Is there any reason a resident would be discharged?
• Is the facility license prominently displayed?
• Where are the resident’s rights posted, and what are they?
• How are medications obtained? 

Check the Licensing Authority in Your Area or State

Once you become interested in a facility, be sure to check the licensing authority in your area or state to determine the history of the facility’s inspections.

• When was the last state or county inspection conducted?
• Were there any deficiencies or citations? What were they?
• Have there been any complaints from residents or families?
• How have these been addressed? If necessary, ask the facility to address any concerns you have with the inspection findings.

Finally, Trust Your Instincts

Even if everything you find in your search is presenting well, pay attention to any doubts or uncertainty you are having. There are a lot of excellent choices for one with dementia or Alzheimer’s, but maybe you just have not found the right one yet. Is this the right time? Can care be provided in a different setting? Only you know your loved one. Be sure to consider all your options. You will be glad you did.