About assisted living
Title: About assisted living
Date: 6th December, 2010 from Clearwater Resort Hotel Clark Pampanga, highly recommended beach resort for family and company outings, parties and events
How to Choose a Residence
Making the right choice is easier when you thoroughly evaluate residences using these criteria – By Elizabeth Parker Welton MSW, LCSW
Assisted living residences, in both rural and urban areas, allow today’s consumers to be highly discriminating in their choice of a residence. A wide range of choices, however, may produce confusion and anxiety. With choice often comes the implied responsibility for making the ‘right choice.’ Family members engaged in this search sometimes feel like they’re looking for a needle in a haystack without the benefit of a map.
ALFA has developed a complete checklist to be used in the evaluation and selection process. Consider the following elements when searching for that needle in a haystack.
Atmosphere: Family members involved in the selection process must look at the residences they visit through the eyes of the person who will be living there. When touring facilities, family members often comment, ‘I could imagine myself living here.’ Although that is a positive reaction, what is truly relevant is whether they can imagine their loved one living in that setting.
How does the prospective resident react when he or she meets the staff and other residents? Is the decor welcoming and homelike? Do the current residents appear to be compatible with your loved one? Will the particular personality and culture of that setting support the physical, emotional, mental, and spiritual needs of the prospective resident? The answer to that question is critical in determining the success of your and your loved one’s choice.
Make several return visits to the residence on the top of your list to experience staff and residents in a variety of situations. Although crisis sometimes necessitates a more immediate choice, it is always ideal to take the time to make a slower and more informed decision guided by as much information as you can gather.
Physical Features: A residence that is modern and tastefully decorated almost always creates an initial favorable impression. However, an aesthetically pleasing setting that is not designed to maximize comfort and ease in functioning may not be a particularly wise choice. For example, a beautifully decorated unit that does not have doorways wide enough to easily accommodate a wheelchair does not allow for ease and comfort in movement. A bathroom that is too small to permit a wheelchair or walker to enter without precise maneuvering also reflects poor design. Hallways that are long and/or poorly lit without handrails may confuse and overwhelm elderly residents.
It can be extremely helpful to choose a potential unit and have the future resident move about in that space as if he or she is already in residence there. It gives you an excellent opportunity to evaluate how well the space is designed to promote both comfort and ease in movement as well as how it supports independent functioning.
Needs Assessment, Contracts, Costs, and Finances: Assessing the fairness and comprehensiveness of the contractual agreement is important. Most people are accustomed to evaluating and signing contracts fairly routinely. But it will be important to understand any future costs for increased levels of care and service should the resident’s physical and/or cognitive functioning decline. It is reasonable to expect costs will increase over time as independent or minimally assisted functioning declines. Being prepared for that eventuality will help you decide whether that particular residence is financially feasible. Visit ALFA’s Web site (www.alfa.org) to view a standard ‘Consumer Information Statement’ or disclosure form, which identifies questions you should ask specific to fees and services.
Another way to determine the viability of a particular residence is to learn whether each resident has a written care plan. Without such a tool, it’s possible the care needs of residents will be unrecognized and therefore unmet. A comprehensive care plan should be created with the help and input of the resident, all available family members, the family physician, and any staff members who will have direct contact with the resident. This care plan must be reviewed and updated as the resident’s needs change. The process of developing a care plan allows the resident to feel that all of his needs are both recognized and important to those around him. This frequently allays much of the anxiety associated with such a major life change.
Education and Health Care: The majority of people entering an assisted living residence are on at least two daily medications. Many choose this type of setting because medication self administration, among other things, has become difficult. Understand what specific policies are in place for giving medication as well as for any medical emergency that may arise.
Is a licensed nurse available to residents and staff in a full-time capacity? If the prospective resident has chronic hypertension, can you be confident his blood pressure will be taken and recorded on a frequent basis? Does a staff person arrange for visits from a physical therapist, occupational therapist, hospice nurse, etc.? The coordination of services with agencies in the community allows for a full continuum of care to be provided. It not only significantly benefits the health and well being of residents but also establishes the residence as a true member of the outside community. The relationship between the residence and the local community will support the resident in not feeling isolated or sequestered.
Services: Determining as specifically as possible the prospective resident’s daily care needs is a critical step in choosing a residence. Make a detailed list of the type of assistance that will be required with each activity of daily living. For example, will this resident require assistance in dressing and undressing? If so, what specific type of assistance will be required? If her clothes are laid out for her, can she dress herself or will she require assistance in the actual dressing process? Does the staffing pattern allow residents who are wheelchair bound to receive help quickly if they need toileting? Inquire about the staff/resident ratio on all shifts. This information will give some indication of how quickly staff can be available to assist residents.
The ease and availability of transportation to shopping, the hairdresser, and other community activities also is important information. The ability to move relatively effortlessly between the residence and the community is another significant way the resident’s autonomy and independence are valued and encouraged. Transportation provided by the residence may or may not represent an additional monthly charge.
Cognitively impaired adults may need a different type of assistance in their daily functioning. Are safety measures in place to contain possible wandering? Is the staff trained in techniques important to the care and comfort of mentally confused residents? Are specific areas and/or units designed to provide specialized care and programming for those who are cognitively impaired?
Individual Unit Features: Nurturing the spirit and individuality of residents as they move from their home into a residence is both challenging and achievable. The opportunity to have a choice in one’s living space is an important way to achieve this goal. Some people value their privacy and don’t thrive in double-occupancy units. Others may feel too isolated in a unit by themselves and will welcome a roommate.
Bringing some treasured pieces of furniture and pictures from home will greatly facilitate the transition and should be encouraged. The presence of a kitchen area in each unit allows for maximum choice and autonomy. Although most prospective residents will acknowledge that they are excited at the prospect of not cooking, the ability to prepare snacks or even a light meal is an important option. One of the fundamental goals of an assisted living residence is to provide comprehensive care to older adults while preserving their ability to be independent and have as many choices in their environment as is feasible. A future resident’s participation in the choice of a residence, and the various options available within that residence, will have a direct and vital effect on the quality of that resident’s adjustment to his new home.
Social and Recreational Activities: A diverse program of planned activities both within the residence and the community is vital to the happiness and contentment of residents. Does a staff member have sole responsibility to plan and direct social events? Do residents have a voice in planning activities both within and outside the residence? Does the selection of activities reflect the interests and lifestyle of the residents in an appropriate and satisfying way? Are residents who are less social encouraged to participate in activities? Are activities designed to not only nurture the spirit but challenge the intellect? Are activities in the residence consistently well attended by residents?
A well-balanced coordination of activities both within the residence and in the community allows the resident to feel a sense of belonging in both places. Activities are an important way in which social and emotional connections are made in a new setting.
In addition, research shows that the presence of animals in the lives of older adults is another important way of nurturing the spirit. However important and necessary the move to an assisted living residence might be, it involves significant losses. A residence that has a dog or cat viewed as the house pet can provide opportunity for constancy and daily love for someone who may be feeling a sense of loss. Many residences allow a small animal to accompany its owner in the move. When discussing this option with the staff, gain a full understanding of how the animal will be cared for.
Food Service: Food is a significant part of life. We look forward to meals and savor not only the food that we eat but the ambiance in which the food is served. If you polled assisted living residents about what contributes most to their customer satisfaction, food would rank high on their list. One of the universally significant ways in which people feel nurtured is through the food they eat.
Keeping that in mind, food preparation should include fresh, diverse, and interesting ingredients.
At each meal, residents should have a choice of entree and dessert. Because individuals’ tastes in food differ, no one offering can possibly please everyone. Resident input in the menu selection is another important way of promoting choice and respecting individual tastes.
The kitchen’s capacity to provide for special diets that are medically mandated is another critical piece of information to gather. If a resident is feeling too ill to come to the dining room for a meal, can food be delivered to his room?
Is the dining room visually appealing to encourage residents to linger over their meals there? One of the most important avenues for socialization is dining with other people. It represents a natural opportunity to gather and share the events of the day and sometimes a lifetime.
In addition to using the guidelines ALFA has developed for choosing a residence, use your own knowledge of the prospective resident as a guide in making your choice. In what setting will he or she feel most supported and at the same time be able to function most independently? What are the particular and unique physical, mental, emotional, and spiritual needs of this person and in what setting are those needs most likely to be recognized and met?
The goal you set in choosing a residence should not be considered met until a setting has been selected in which the prospective resident can feel physically cared for and can thrive emotionally. Many older adults who are living independently, but struggling each day with physical and/or cognitive disabilities, are isolated and afraid. Moving into the appropriate assisted living residence can relieve the daily struggle to function and release the energy to fully and joyfully engage in life again.
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