Friday, June 12, 2015

7 Tips When Considering A Care Facility For Your Loved One

I'm recovering from a few days of vacation with family. Ken's grandmother died at the end of May, and we had the funeral and family get-together on Wednesday. While it was a sad reason to be together, it was nice to see family and reminisce.

I'm very fortunate to have my good friend Tia here guest posting for me today. While Ken's grandmother was able to spend her last years at home, not all loved ones are so lucky. Tia's got some great advicve to keep in mind if you are ever facing the tough choice to choose assisted living for a family member. Take it away, Tia!

In 2011 my fiance and I became caregivers to his father and our lives were forever changed. Over the last four years, we've learned a lot about healthcare, government assistance for seniors and the disabled, and ourselves. This last week we've been in the process of moving Dad from one care facility to another. In the midst of moving, Scotty (my fiance) remarked to me how much we've learned about care facilities in the last few years. One of us made a comment how it would make a great blog post, and the idea never really left me.

None of us want to face the fact that our parents and loved ones are going to get older, but it happens anyway. Whether it's a sudden illness or the natural aging process, at some point our parents are going to need us to care for them. For our family it happened a little sooner than we had planned, and we were far from prepared. So today, I want to share with you some tips we've learned in the hopes that if you have to make the choice to find a care facility for a relative, you might have a bit more information and insight than we did.

7 Tips When Considering A Care Facility For Your Loved One

1. Take the offered tour, but also drop in unannounced at a random time. Tours are usually during business hours, which are typically when staff is at full capacity. In our experience, the majority of the shortage in care for our dad has come during the "off" hours, when the administration has gone home and staff is at their minimum required by state law. So swing by on a Saturday after dinner. See if it compares to what you saw during your tour.

2. What you see and smell are just as important as what you DON'T see and smell. Some may think a facility that smells like bleach or other cleaning products indicates a clean facility because it doesn't stink or smell dirty. That isn't always the case. Likewise, do you see other residents in the halls? How are staff interacting with them? How do the residents look? At one facility we toured, two residents were sitting in front of the nurses station in their wheelchairs, both with obvious needs. (One had juice spilled all over their front and they were crying.) Meanwhile, the nurse and an aide were both talking with Scotty and I. Neither made the effort to take a moment to help these residents. We were left feeling as though "selling" us on their facility was more important to these workers than actually helping the people who lived there. Not a good feeling.

3. Make sure administration has your contact information and that it's added to Dad's file if you're going to continue to be an advocate or point of contact for him. If you do not have Power of Attorney, you will likely want to get a signed letter from Dad giving staff and medical personnel permission to discuss his care with you. This form should be notarized, and copies kept with you, the facility, and the doctor's office. Without this form, staff is not required to notify you of changes in care or include you in decisions regarding Dad's care because of health privacy laws (HIPAA). Trust me, you never want to be left in the dark when it comes to your loved ones.

4. Think of the little things, too. While your primary concerns will probably be health care related, be conscientious that the daily things may be of more concern to your loved one. It pays to ask them what their top priorities are. They can include things like: quality and variety of food, activities and outings, and whether the facility offers worship services. If you have a family pet, you can look into whether the facility allows pets, or if you can bring them to visit. For us, Dad loves it when we can bring our little doggy Todd to visit him. These seemingly little things can really have an impact on our loved one's emotional and mental well being, and should be considered as important as their physical care.

5. Pay close attention to how easy or difficult it is to communicate with staff. How often do your calls and/or questions get routed to voicemail? How quickly do they return your calls? Do you feel as though you're consistently being transferred to yet another person to get answers? Yes, people are busy, and care facilities staff are exceptionally so. But difficulty communicating when they are essentially trying to "sell" you can be a sign of more troubling difficulties down the road. Nobody wants to be playing phone tag when there's it comes to the care and health of their loved ones.

6. If possible, ask doctors for their opinions and recommendations. Often times doctors will have inside information not usually available, like how well a certain facility cooperates with external medical staff. Recently, we accompanied Dad to his check-up with our family doctor. Scotty and I were shocked to hear that our doctor had been having extreme difficulty in getting Dad's care facility to follow his orders, or to even answer his calls and faxes. This kind of communication breakdown can have a potentially harmful impact on your loved ones care and overall health. When we expressed our shock, our doctor informed us that this wasn't the first time he'd had difficulties with this particular facility. Not a good sign. Had we known to ask him ahead of time, we may made different choices based on his recommendations.

7. Go digging. If you're working with a social worker in looking for a care facility, ask them for the dirt. Social workers usually have access to Medicare ratings and safety reports performed by state officials. Ask for their last three reviews, and how long the facility's current administration has been in place. If shorter than six months, see if the worker can fill you in on whether they have a high turnover rate. Turnover is fairly common in the care field, mostly among the aides and caregivers. But if a facility is on its third director in a year, you want to know why. It could point to deeper trouble. If you're internet savvy, google any potential facilities. In today's age, nearly ever place has a website, as well as posted reviews. Read what other people are saying about these places, they are your peers, and can often point out things you hadn't noticed or known to look for.


I honestly hope it's years before any of you need this information. But if some of what we've learned through a lot of trial and error can help make a hard decision a little easier for your family, I'm happy to share. In my heart of hearts, I know Scotty and I both wish we could have just kept Dad at home and cared for him ourselves. No one knows how to do it better than family, right? Except sometimes our loved ones need care that surpasses what we can provide. At that point, we do the next best thing, which is to become Dad's strongest and loudest advocates. I always tell facilities, "I know you have 50-60 other residents. But we just have one. We have Dad, and he is most important to us. So yes, I will blow up your phone until you give me the answers I need and I will always, ALWAYS fight for him."

Wouldn't you know it? When you word it that way, everyone can relate.


Author Bio: Tia is a mother, spoonie, survivor, advocate, and bonafide groupie. She firmly believes sharing our stories is one of the greatest ways we can inspire change, healing, and hope. She spends her days in the glorious Pacific Northwest with her soon-to-be husband and their adorable therapy doggy, surrounded by her books and his guitars.




  1. These are great tips for having family members at this stage. Also, so sorry Rabia for your loss and sending some hugs and prayers to you.

  2. So sorry for your family's loss Rabia. These re great tips Tia, we are heading down this road with my Mom right now, it's not easy, but it is better to be prepared and understand the process.

  3. I know we all learn along the way, and not everyone's experience will be the same. BUT... We've really had our eyes opened more than once, and with that sometimes comes the sinking guilt that you've failed your loved one. I'm more than happy to pass along anything we've learned if it can help another family have a smoother transition.

  4. Thank you.

    And yes, Rabia I am so sorry to hear of your family's loss. Sending love to you.

  5. My condolences, Rabia. And honestly I haven't even thought about assisted living for my mom. I have no idea what she'd want. Right now she's living with our brother, and we all live very close to one another so hopefully it would be something where she can continue to stay with one of us.

  6. Tamara, it's horrible how much falls through the cracks. And there are a million reasons why. Money, benefits, guidelines, etc...
    Each time we've had to move Dad, we've learned something else. The past 3 weeks as we've worked on this transfer has been the hardest, by far. It's so hard to me to see loved ones being neglected :(

  7. Nina, I hope you do get to keep your mom with family, I know that's preferred. We wish we could have kept Dad at home, but with Scotty working full time and me being disabled myself, it just wasn't feasible. So now we advocate for Dad in every way possible. I am the bull behind the phone making sure he's getting the best care possible. Neither path is easy, but we do for family. This is love.

  8. That's awful! It's like that in childcare sometimes too. The kids (or elderly) can't really tell you what's going on so "care"givers assume no one will find out! :(

  9. You are so lucky that your mom can be with family. We were able to make those kinds of arrangements for my dad's mom, but not my mom's. Fortunately, both had really great care right up until the end!

  10. Thanks, Jen. I wish you much peace in this journey. There are a lot of hard decisions ahead.


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