Questions for MCF

Jeanne C.

I'm touring a couple of memory care facilities tomorrow.

Here are discussion items I've thought of. What am I missing?

Staffing ratio. How are schedules organized? Weekend staffing.

What kind of assistance/services can we count on? What costs extra? What will I need to manage myself?

Activities and programming

Meals

Medical care onsite.

M1

Ask for a copy of the family handbook. Ask about grounds for eviction.

White Crane

Hi Jeanne, you have come up with some very good questions to ask. Here are a few other suggestions. Ask if the staff has been specially trained to care for dementia patients. Ask how they handle agitated residents. Do they hand feed? Do they lift? Not all facilities do these things. What furnishings do they provide, and what do you have to provide on your own. Some provide a bed, some don’t. Do they accept Medicaid? Do they bill by the day or by the month? Is there a waiting list? How many residents do they care for? These are some things that I have asked when touring memory care, facilities. I hope this helps.

Brenda

Jeanne C.

@M1 @White Crane thank you. I'm struggling with guilt and wanting to make sure he has the care he needs when the time comes. I have help at home, but you have all stressed the importance of a backup plan.

Beachfan

I wanted to be sure my DH could “age in place” at his MCF (in other words, he could stay there until death). He did so, with Hospice care for only 3 1/2 days prior to his passing. He was in a “stand alone” MCF; it served Alz/dementia residents exclusively. Staff were trained in dementia care, costs were all inclusive, all services were offered including hand feeding as he progressed. His MCF was a warm, cozy cottage style setting with only 16 residents when full. Although I missed him desperately from day 1, he was well cared for, content and well loved every day he lived there. I don’t regret any decision I made regarding his care.

Joe C.

As others have said above make sure he can “age in place”, you don’t want to be forced to move him brown the road. Other questions are: Can he remain here if he is no longer ambulatory? Will they crush meds and mix pudding to administer if needed? Ask for a copy of the activity schedule so you can see how thay might keep him engaged.

M1

Let us know how it goes jeanne. Will be thinking of you. You can do this....

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Walter0617

I found it helpful to ask how laundry is handled. Even though the MCF where I placed my DW does laundry, I find myself taking more clothes home since she became incontinent. Even the best places are challenged with keeping residents clothes sorted and returned to the correct resident. I find it is easier to just do it myself, especially since I visit almost daily.

Colt99

Good inputs so far. One aspect I found interesting while researching 7 facilities is how they manage room doors and locks. Most were lock/unlock at your option and resident/family can carry their own key. Others had locked doors at all times. If the resident can’t manage their own key, staff has to open their door for them. Two facilities had Dutch doors where the upper half can remain open and the lower half can be open/closed, locked/unlocked at resident option. The facility I opted for has the Dutch door option. Few residents actually use this option but DW doesn’t like being closed in all the time and enjoys people passing by and saying hello. We have a new resident who is constantly seeking exit. The locked lower half door is enough to deter his attempts to enter.

On the aging in place question just remember the services the facility can provide are determined by their license. Many services required with advanced needs are beyond what the license allows. Hospice providers can provide these services. So a question might be does the facility allow Hospice care or have a restricted number of Hospice residents at any time.

Tough journey but we all work through it best we can.

jfkoc

Please get a copy of the contract and ask for a copy of the license.

Then you want to evaluate training...both initial and ongoing.

A very good source of information is your local support group.

Dio

Just a few more in addition to the ones mentioned above:

• What is the facility's emergency protocol? such as in case of fire, natural disasters.
• What is the facility's experience and protocol in handling difficult or combative residents?
• Under what circumstances will the facility call 911 for police/ambulance, and the protocol afterwards?
• What is the facility's annual rate increase?
• Facilities usually cannot watch residents 24/7, what is their policy in terms of you hiring your own caregiver if your LO needs to be watched 24/7?

Many of these should be spelled out in the contract. However, not all facilities are made the same.

Ernie123

My DW has been in a MC facility for four years. It is overall a wonderful facility, fourteen residents, excellent care. But the factor I see as important is the continuity of staff. PSWs there work 12 hour shifts, 7-7. There are extra helpers during the day but my wife is cared for by the same person from wake up to dinner. The same PSWs work in the same room groups. It is good for my wife to see familiar faces day after day but also the staff get to know their residents really well. There is a low staff turnover. I visit daily and the staff are like family to me. The know my DW as well as I do and have been a great support for me teaching me about how her care is modified as she progresses. If there were frequent staff turnover this would not be possible.

I would also point out that staff/resident ratios must consider the level of care needed by the residents. When my wife moved into the unit it was brand new. Most residents were still able to dress themselves, toilet themselves and had reasonable mobility. At that time a ratio of one worker per seven residents was adequate. Four years later my wife and several others are now in advanced stages, in wheelchairs, need two person care with a lift etc. The facility now has four staff for most of the day to deal with the increased workload.

My DW’s facility also offers hospice/palliative care unless there are exceptional medical requirements. This past year five residents passed in the facility without having to be moved to a different institution for end of life. Extra staff are provided as needed. This is a great comfort for families. Something you could inquire about.

Jeanne C.

Thanks everyone. I saw two places today that I have added to the consideration list and ruled one out completely. Of the two I liked, each had great benefits. One has therapy and geripsych on site.The other had a great homey feel and had SNF on site (we toured that too and it was suprisingly nice). Both are within 15 minutes of our house. I have a few more to see and pros/cons to weigh, but I'm feeling like the backup plan is coming together.

Your suggestions were a huge help!