Facility tours: What questions to ask?

jnmiller324

I am touring facilities this weekend for my mom with EO. What are some important things to consider, what questions should I be asking the facility, and what are some things I should be looking for on the tours? Thanks!

MN Chickadee

I started by getting a list of the MC facilities in my area from my county Agency on Aging (your area probably has one, or call your local Alzheimers Association for a list.) I narrowed it down a lot just by calling around and asking some questions, got the list to about 10 places and toured most of them.

 

Things to ask about include

-staffing ratios

-is there a nurse 24/7 (our first place did not have one on site on the overnight shift, they called a triage nurse off site if something happened. This worked in the earlier stages of dementia, was terrible in stage 6 and part of the reason we moved my LO.)

-staff training in dementia care

-what could force your LO to have to move, what happens when they progress to a higher level of care - feeding assistance, hoyer lifts, 2 person assist, hospice etc.

-do they accept Medicaid if that becomes a need

-is it locked (believe it or not I toured two memory cares that were not locked and it looked like a nightmare waiting to happen....)

-I would taste the food or at least look at it

-do they get people outside, either for outings and/or walks and sunshine

-Covid visiting protocols (hopefully not a concern for too many more months...)

-activities calendar, do they have a staff person for activities or life engagement, make sure the activities actually happen.

-I used say talk to staff to see if they have a few long term staff. Until 2019, some turnover was inevitable but most good places had a few people with longevity. But Covid has really turned the industry upside down and I'm not sure that's a useful or relevant metric at this point in time.

-Most importantly talk to other family members there. If there are none when you tour then hang out in the parking lot and see if you can catch a couple people. They will usually give an honest opinion of the place. Some facilities have family councils (now mandatory in my state of MN) so if a place has one you could ask to speak to someone on the council about their experience.

Word of mouth is often the best way to narrow down places to start, ask around at the hair salon, church, clubs you are part of, neighbors.  There are definitely gong to be some that have a great reputation around town and some with bad reputations. Some places are "hard to judge by the cover" as it were. They may have worn furniture and carpet but have excellent staff, because that's where they put their money. Others have fancy amenities and beautiful decor but sub-par care. You really have to evaluate in depth.

Less important questions that may not matter in choosing a place but you will want to know eventually things like do you need to provide incontinence supplies, do they order prescriptions and have them delivered, is there a visiting physician who does rounds there, podiatrist, hair cuts on site, what if any furniture or linens are provided etc. Good luck!

jfkoc

Training.....both initial and ongoing....get the name of the program used !!!

ask for a copy of their license...they must provide what they are licensed to do

ask for a copy of the contract also

watch for the interraction between person leading the tour/ staff and patients...firt name basis???

how are patients rooms identified

do they have a support group

you do not want "ooie over pooie" dig deep

ask the background of the person giving the tour

covid rules

can you keep your existing

Do they work with a perticular Hospice

harshedbuzz

jnm-

Adding onto Chickadee's list-

What behaviors would result in a resident being asked to leave. Would they be willing to send a resident to a geriatric psych unit for medication and bring them back into the community?

Do they allow clients to age in place? And if they do, what are the expectations around family providing additional care in the form of private-pay aides or engaging hospice or both.

In addition to staffing, ask how often residents are checked on. 

We had mom's CELA review the contract before signing. We were turned off by facilities that had multitier pricing which seemed like an opportunity to bait and switch. One place charged additional based on the number of medications taken, others charged extra for a 2-person lift (trick question- everyone should be treated as a 2 person lift for the safety of all involved) and incontinence care (I could see a scenario where a PWD isn't quite there there yet might be taken off a toileting schedule and put into Depends for financial reasons and ease of care).

Ask about training- what models do the use and how often are trainings held?

I spoke to families in the parking lot for a more candid response. I also checked out the employee lot of each facility I toured- it seemed like the fancier the decor the older the staff's cars were. The place we chose had the best cars and the greatest staff retention. 

Things that didn't matter to me-

Support group? We already had one and were able to be frank about MC issues because it wasn't facilitated by a staff member there.

Nursing? Dad's MCF had an LPN 7am-11pm. When dad died, an RN from the next door SNF came over to confirm. 

HB

jfkoc

looking at staff cars...good idea