What to look for in a long-term care home

When the health or capacity of a loved one deteriorates and the family decides that a nursing home is the best care option, it can be a very traumatic time for both the caregivers and the patient. You want to ensure your parent or friend is placed in a facility where they will get the best possible care in a safe, nurturing environment.

However, depending on the length of waiting lists and where you live, your choices may be very limited. For example, this directory of long-term care providers in Saskatchewan illustrates that in many smaller communities there is only one government-subsidized nursing home. And if a bed becomes available you will likely have to decide whether or not to accept it on very short notice.

Last week we wrote about “What you need to know about residential care for seniors in Saskatchewan” and discussed the difference between retirement homes and nursing homes (special care homes). This week we offer a checklist of things to look for when you are evaluating the suitability of a special care home for your family member.

The Canadian Association of Retired People (CARP) has developed an extensive catalogue of things to look for. Here (in no particular order) are some of my favourites, including questions we asked when my mother recently moved into long-term care.

  1. What is covered in the regular monthly fee and what additional charges can be expected?
  2. Are residents clean, well-groomed and appropriately dressed?
  3. Do they seem happy?
  4. How do family members of current and past residents rate the facility?
  5. What activities are available for residents?
  6. How long have senior staff worked for the residence?
  7. Do staff appear to be happy?
  8. What is the staff-to-patient ratio of PSWs, RPNs and RNs to residents on each shift?
  9. Does the home rotate all staff members or try to keep the person(s) caring for each resident?
  10. Are there any limitations on visiting hours?
  11. How do family members participate in the care plan?
  12. How are care complaints handled and by whom?
  13. Do doctors, physiotherapists, denturists, podiatrists regularly come to the residence for patient care?
  14. Does a hairdresser and manicurist regularly attend to provide personal care?
  15. What resources are available for the care and safety of residents with cognitive impairment?
  16. Are religious holidays and birthdays celebrated? How?
  17. What are the policies and procedures for ensuring that personal clothes and belongings are not lost or stolen?
  18. What is the home’s fall prevention program?
  19. Can the resident bring personal furniture, pictures and other knick knacks?
  20. What are the policies and procedures for handling a resident who is harmful to himself/herself or other residents?
  21. Does the home have a palliative care program?
  22. Will the food appeal to your loved one?
  23. Can a family member have a meal with their loved one? If so, is there a fee?
  24. Are special menus available for people who require soft food or other special diets?
  25. Does the menu suit your loved one’s cultural or religious regulations?

Regardless of the answers you get to these and other preliminary questions, once your loved one moves in, it is important for family and friends to visit as often as possible at various times of the day and in the evening both to keep his/her spirits up and monitor the actual care he/she is receiving. In many cases elderly or infirm patients are incapable of advocating for themselves.

Generally we are very happy with the facility we chose for Mom, but we have to stay on top of things. For example:

  • When she returned to the residence after she broke her hip we had to encourage staff to get her up and walking so she didn’t totally lose her mobility.
  • She is supposed to get her hair done every week and a manicure every two weeks but inexplicably, her name sometimes doesn’t make it onto the list.
  • There is lots of staff, but they are rotated and often it seems like the right hand doesn’t know what the left hand is doing!

By understanding the rules and limitations of the special care home where your loved one resides, you can monitor care more effectively and provide additional support as needed.

Written by Sheryl Smolkin
Sheryl Smolkin LLB., LLM is a retired pension lawyer and President of Sheryl Smolkin & Associates Ltd. For over a decade, she has enjoyed a successful encore career as a freelance writer specializing in retirement, employee benefits and workplace issues. Sheryl and her husband Joel are empty-nesters, residing in Toronto with their cockapoo Rufus.

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