It’s time to tour facilities

What to look for and what to ask

You’ve diligently researched facilities and shared some with friends and families and now you have come to a consensus. You hold in your hand a short (or long) list of facilities and you’re ready to take the next step. It’s time to call the contact the facility, interview the contact person on the phone, set up a time to visit and alas, physically tour the facilities. Here is a checklist suggesting what to actively observe and pertinent questions you can ask when walking through each facility.

Because your situation is unique to you, use what questions are pertinent and what is not. Use the list to spark some questions of your own. I’ve listed the most common questions based on my own encounters.

Interview Questions

So you have chosen the senior living model that suits your needs and you’ve diligently researched facilities and shared some with friends and families. Now you have a short, or long, list of facilities and you’re ready to take the next step. It’s time to contact people, interview them on the phone, set up a time to visit them and tour the facilities. Here is a checklist suggesting some pertinent questions you can ask when walking through each facility.

Because your situation is unique to you, use both pertinent and nonpertinent questions. Use the list to spark your own questions. I’ve listed the most common questions based on my own encounters.

General Questions:

Before entering the facility to meet the tour facilitator, remind yourself of the things that make the facility outstanding. At the end of this process, you will have a lot of notes from different facilities. Sometimes, the only thing that can help you arrive at your ultimate decision is the one little thing that makes them different. Keep this tucked away in the back of your mind when starting your tour.

Are there vacancies that work with your timeframe? Is there a waiting list? How often do they have vacancies? What causes vacancies? How many people are living in the community when it’s at full capacity?
Who are their staff members, their accreditations, and what are their roles?
Are you able to bring pets?
Where are meals being served? If you are there during meal time, check whether the meal is balanced and appetizing.
Are references available to you?
What is the complaint process for dissatisfied clients?

Atmosphere, Environment & Current Residents:

When initially stepping in, look around and get a first impression or a gut feeling. Does the facility feel like home? Does it look clean and organized? Is it spacious or too crowded? Is there a scent in the air?

Do the residents seem to be cared for? Do you find people to be friendly? Happy? Is the environment clean?
Does the staff seem professional and respectful to you and others?
Can you see yourself or your loved one feel cozy, comfortable and safe?
Are you able to personalize the room?
Are the current resident’s physical ability, emotional state, and personalities a good fit for you or your loved one? This is very important because the current residents will become essentially your own or your loved one’s roommates.

Cost & Fees:

For larger facilities, fees are fixed and based on a menu of services they provide. It’s up to you to personalize what you want to include in the monthly rate. In smaller facilities, at times the fee is the same for all residents, for others, the fee is based on the level of care. If the fee is based on a level of care, you have to be mindful of how they identify the level of care.

What is the starting price and what is omitted/included in the price?
Do you accept Medicare or Medicaid and what is the policy?
Are cable, wireless internet, and cell phone available? What is the cost?
If you decide on this facility what is the process? Is there a deposit required and what will it hold and for how many days? When is it refundable, when is it nonrefundable?

Care Plan & Assessment:

Is there a continually updated plan of care? Is this document in paper form or electronic form? How frequently is it reviewed, updated, and by whom?
How does the facility assess a resident’s need for service? How often is this assessment addressed? What is the difference between the assessment and the plan of care?
Be sure to describe any special needs such as diabetes, post-stroke, combative behavior, low sodium diet for example. Do they have experience with these needs?
Do they offer an awake staff if you desire one?
Are families invited to joining care conferences and help with establishing resident care?

Activities

Larger facilities tend to have an activity coordinator who organizes scheduled social activities and ensure the quality of the activity. Smaller facilities may have either an activity coordinator or a part-time coordinator. Some facilities don’t offer activities and rely on the daily staff and residents to be the primary source for socialization.

What are examples of planned activities and trips?
Do you have a full time or part-time activities coordinator?
Is the facility friendly to the idea of having a private companion visit, if you desire to hire one privately for your loved one?

Transportation:

Do you provide transportation to local doctor appointments? How about other destinations and activities? If so, where?
What is the mode of transportation? A car, van, bus? Is it wheelchair accessible?

Visitors:

Visiting loved ones is important to maintaining connections and routines if any. However, I have witnessed some rigidity during loved one's visits to different homes where they turn confusing, frustrating, and depressing as well. For individuals with cognitive deficits, long frequent visits may lead to feeling like the visitor is permanently living with them, or is taking him/her home with them. Once the visitor leaves that person may feel abandoned or confused as to why they are being left behind. It’s important to ask the person you are meeting with what they think is a healthy approach to visiting your loved one. Is there a difference in approach when a person just moved in and is going through the transition phase versus when a person is stable in their care?

What are the visiting hours? How long can family members, friends, and young children stay?
Are there areas for private visits?

Health Care Services

Nursing Homes provide in-home health care services such as primary care providers, the ability to conduct laboratory work, registered nurses, mental health specialists, physical therapists, occupational therapists, speech therapists, and social worker. Independent, Assisted, and Residential Care Homes don’t provide this in homes. Rather, they rely on home healthcare services. These agencies provide a medical team suitable to the resident medical needs. The caveat is that the resident has to be considered “homebound.” To be homebound means having the inability to travel due to physical inability, mental or emotional inability. If a person doesn’t qualify to be homebound, then families or the facility will be responsible to ascertain that residents are taken to their medical service providers.

What is the protocol for emergencies? What is the protocol for performing CPR?
In case of emergency, when are you notified?
Do staff members have training in dementia care?
Is there an in-house medical team? If so, what is the structure of their working team and what is your role in this team? How do you fit in the team?

Remember, you are selecting not only the location, the services offered, the amenities of the facility and the facility itself, but also a person and a team who you will entrust your care or your loved one's quality of life. Most important is the relationship you establish in the short time with the person you met and the staff you were introduced to. Do you feel comfortable with them? Do you think you can establish a relationship of honesty and trust? Did they give you a room to be yourself and accept the emotional state you were probably in at the time of your visit? Were they sensitive and empathetic to your circumstance?

The success stories I have are the ones where you, the provider, and the staff of the facility operate as a team. This becomes essential during hospice care when you will dictate your wishes for end of life care. The provider and staff have to respect your decisions and follow your wishes. At the end of the day, the best case scenario is when the facility provider and staff feel like they are part of the family, or at least very close and entrusted friends.

Good luck with touring facilities and don’t be afraid to be yourself and ask questions!

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It's time to tour facilities | Senior Living Link

It's time to tour facilities