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1. What is your first impression of the facility during your tour?
Don't get wrapped up in elaborate décor or distracted by needless bells and whistles. Instead, focus your attention on basic cleanliness, necessary amenities, and staff.
- Did the facility accommodate your family with making tour arrangements?
- Are you greeted by warm and friendly staff that are eager to show you around?
- Is the facility location convenient for visiting, shopping, and health care?
- Do you notice residents socializing among each other and do they seem content?
- Are the common areas clean, free of odors, and adequately heated/cooled?
- Is the facility floor plan easy to navigate and does it feel “warm and cozy”?
- Do the staff address residents and their family in a friendly and respectful manner?
2. How is the dining experience?
Don't overlook the importance of a good meal and a pleasant dining experience. It should also come as no surprise that good food really matters a great deal to your parent.
- Is your family invited and encouraged to stay for a meal during your visit?
- Do you observe residents and staff interacting during mealtimes in the dining area?
- Can you view daily/weekly menus offering variety and good nutritional meals?
- Is the food presented in an appetizing manner with adequate selections?
- Does the food taste good? Did your senior genuinely enjoy the meal?
- Does a qualified dietitian plan or approve menus? How are special diets accommodated?
- Does the dining room environment encourage residents to relax and socialize?
- How many meals are served daily and is tray service to rooms available when ill?
- Do more dependent residents receive extra help needed with eating?
3. Are you free to visit and talk with staff, residents, and other families?
Expect to have private, unsupervised conversations with whomever you choose. Staff should encourage communications, surprise visits, and not tolerate any “hush-hush” nonsense.
- Do visitors seem welcome and are they comfortable with the staff?
- Are you able to meet the DON (Director of Nursing) and talk with staff freely during your visit?
- Are visiting hours flexible to accommodate your schedule?
- Are you free to talk openly with residents and families in an unsupervised setting?
- Are you allowed to make an unscheduled visit and do you feel welcome when popping in?
- Do staff interact with residents and each other politely when unaware of your presence?
4. What social and recreational activities are of interest to your parent?
Socializing is often a big reason for moving into a senior facility. Explore which activities offered might spark some interest for your mom or dad.
- Is a "Daily Events and Activities” calendar posted and is the facility following this schedule?
- Are there classes and supplies for arts and crafts, music, games, computers, gardening, and cooking?
- Is there pet therapy or are residents allowed to bring their pets to stay with them?
- Are there special events with guest speakers, social dances, and holiday celebrations?
- Does the facility schedule trips and provide transportation to events off premises?
- Are religious services held on the premises or are arrangements available to attend nearby services?
- Are there fitness facilities as well as regularly scheduled exercise classes?
- Are there outdoor common areas for gatherings?
5. Does the facility feel safe and secure?
Many seniors, including your parents, may be afraid and feel unsafe living alone. Safety and security are often big motives for relocating to a facility.
- Does the facility provide ample security in the way of guards, locked doors, and alarms?
- What is the facility's means of security if a resident should wander?
- Is there an emergency evacuation plan in place?
- Is the facility well-lit with emergency devices throughout if help is needed?
- Is a 24-hour emergency response system accessible from the units with its own lockable door?
- Do all the bathrooms have an emergency pull cord in event of an accident?
6. What are your parents' choices for living accommodations?
Facilities range from spacious apartments to single rooms. Your parents will want to have a say in their living space.
- Are there different sizes and types of units to pick from with optional floor plans?
- Are single units available or are there cheaper double units for sharing with another resident?
- Does the facility have furnished/unfurnished rooms and what can be brought from home?
- May your senior decorate his or her own room and is there adequate storage space?
- Are bathrooms private with handicapped accommodations for wheelchairs and walkers?
- Do all the units have a telephone, cable TV, and internet access?
- Does kitchen unit have refrigerator/sink/cooking element for preparing food in the room?
7. How much does it cost and what's involved with the moving in and out?
The needs assessment determines whether your loved one is a good match for the facility. Affordability may ultimately be the deciding factor of the facility being a good match for your loved one.
- Does the assessment process include the potential resident, family, facility staff, along with the physician?
- Is there a written plan of care for each resident and a process for assessing changes in needs?
- Will the room be held/reserved should your loved one requires a hospital/ nursing home stay?
- Is there a written statement available of the resident rights and responsibilities?
- Does contractual agreement disclose all services, accommodations, and associated fees?
- What is the basic monthly fee and what are specific costs for various levels of services?
- What additional services and staff are not included but available if needs change?
- When may a contract be terminated and what are the policies for refunds and transfers?
- Is the unit rented or owned by the resident and who is responsible for utilities, internet, cable, and phone?
8. Does the facility offer the personal care and health services needed?
It's a deal breaker if the facility can't provide the help your mom or dad require. Make certain the care offered can meet your parent's needs now as well as in the future, to avoid relocation as their needs evolve.
- Is staff available to assist with activities of daily living (ADLs include bathing, dressing, grooming, eating, and help with walking)? Is staff available to assist with ADLs 24-hours a day if needed?
- Does the facility have programs for Alzheimer's and other dementia needs? Are there specialized areas dedicated to memory care residents?
- How are medical emergencies handled and what is protocol for responding to them?
- May a resident take his or her own medications or get assistance should need arise?
- Does the facility have a pharmacy; if so does it review medicines regularly?
- Does staff assist in arrangements to provide nursing and/or other medical care?
- What wellness care and medical services are provided onsite?
- Are physical, occupational, or speech therapy services available onsite or via an agency?
- Are housekeeping, linen service, and personal laundry included?
- Does the facility provide transportation to doctor appointments and shopping?
- Is there a hair salon and barber onsite or is transport provided to outside shops?
9. Is the staff professional, kind, and qualified to care for your parents?
Make no mistake that it is the caregivers that matter most when it comes to deciding where your parents will be happy. Look for caregivers that seem genuinely content with their jobs.
- What is the facility's practices and philosophy regarding staffing?
- What are the hiring procedures and requirements for employment?
- Are criminal background checks, references, and certifications required on all employees?
- Is there a staff-training program in place and what does it entail?
- Is the staff courteous to each other as well as to residents and their families?
- Do you observe if requests for assistance by residents are responded to in a timely and respectful manner?
- Is the appropriate staff or supervisor available to answer questions or discuss problems?
- Would you be comfortable dealing with current administrators and staff daily?
10. Investigate the facility licensure, certifications, and reputation in the community.
Be sure the facility meets your state requirements as they vary a lot. Word of mouth is always a good way to find out first-hand about the reputation of the facility in your community.
- If your state requires the facility and its director to be licensed and/or certified, does it have a current license/certification displayed?
- Is the facility accredited by the Joint Commission and what professional associations do they voluntarily belong to?
- What do community health professionals, church members, and family caregivers say about the facility's reputation?
- How long has facility been in business to determine stability and financial health?
- Who or what corporation manages the facility and is it a profit or nonprofit organization?
- Is there a resident council for residents/family to have a means of voicing their views on the management of the community?
About the Author
Clare Absher is a Registered Nurse with 43 years of experience. Most of her experience is in home health serving as a caregiver, educator, patient advocate, and liaison between families and community resources. She has also worked in acute care, assisted living, and retirement settings. She is passionate about helping families care for their elderly loved ones at home.