Congratulations. You’ve made the tough and probably emotional decision to help your loved one transition to a senior living environment. You’ve visited a number of Tennessee assisted living communities, interviewed key staff and collected detailed information. It’s likely that you’re struggling to decide among a few finalists.
To help you choose which community is the best fit for your mom or dad, it’s helpful to identify the assisted living attributes that are most important to you and your loved one, decide what weight they will have, and then rank the finalists using these weighted attributes. This process will provide you with an objective and logical final selection.
Choosing assisted living attributes
Create a checklist to help you record information on each community so you can easily recall details later. Here are six attributes which many people use to make their community selection.
- Location: the geographic location of the community; proximity to family, friends and shopping; community amenities, safety and size/ layout of the apartment.
- Staff: impressions you form of the executive team; friendliness of the staff; willingness to answer your questions; staff treatment of residents and their observed interactions; staff hours and availability.
- Activities: activities calendar; personality and demeanor of the activities director; amenities related to activities including transportation, game rooms and other entertainment; availability of modern technology tools.
- Quality of care: the experience of the nursing staff; proximity to fire, hospital and emergency services; rehabilitation rooms and quality of the therapists; medication management protocols; whether a written plan of care is provided for each resident
- Cost: total monthly cost of community at the level of care required for your loved one; availability of a comprehensive residency agreement spelling out all services, fees, and move-in or move-out provisions; policies on refunds and transfers
- Gut feeling: we are all given instincts, or intuition, for a reason. Listen to that inner voice.
Now that you have a group of attributes (and you might think of others) against which you can measure your finalists, add a measure of importance, or weight, to each one. This process is valuable because you probably have strong opinions about the relative importance of one or more of these assisted living attributes over others. For example, you might place a great deal of emphasis on the quality of care because of the fragile health status of your mom or dad. In this case, you would want to highly weight that attribute. Give weights to each attribute by assigning a percentage from 0-100%. Those you feel most strongly about would get the highest percentage weight. Make sure the total of all attributes equals 100%.
Then rank each community for each of your selected attributes. For example, you might feel that community #1 offers the best quality of care, so you would rank it a “1” for that attribute. Once you’ve done the ranking, you can now compare the communities against each other. Do this by multiplying the weight of the attribute by the ranking you gave that community on that attribute, and then add these numbers. Since a “1” is the best ranking a community can receive, the community with the lowest combined score total is the one that best meets your criteria.
Finding the best Tennessee assisted living community for your loved one is an important goal. You can make the very best decision possible by identifying attributes, weighting each one, and ranking communities for each attribute.
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Though your loved one has been diagnosed with dementia, you understand that your mom or dad is still able to experience joy, fun, pain, affection and meaning in the activities of daily life. This is why it’s vital that you find an assisted living community with a high-quality dementia care program based on the “person-centered care” model. This is care tailored to the unique abilities and needs of each resident.
Consider these key care areas during your community tours:
1. Mealtimes
Staff should make sure each resident gets the proper amount of food and fluid; inadequate or inappropriate consumption can negatively impact resident’s health, warns the Alzheimer’s Association. Visit during mealtimes and see if staff makes mealtime a pleasant and enjoyable time; coercive or demanding staff behavior is a red flag. Ask to see the week’s meal plan and find out how the community defines a nutritious meal. Observe the help residents get with proper fluid intake; do staff help them drink if needed? Does the residence customize meals based on the medical needs of each resident? Does the community do a family interview to find out what foods the loved one likes and dislikes? Oftentimes, a resident who repeatedly refuses food may simply be a picky eater who doesn’t like specific foods.
2. Resident engagement
Engagement in meaningful activities is one of the critical elements of a good dementia care program. Residents are better able to maintain functional abilities, gain a sense of community and enjoy their day. On your tour, look at what activities are going on and how staff engage with residents. A room full of residents sitting alone with no staff interaction may be a red flag to investigate.
3. Physical environment
A good dementia care program pays attention to the residence’s physical layout. A positive environment offers easy-to-find dining, activity and restroom areas as well as other cues and physical assistance tools to help residents safely navigate the residence. Does it offer good lighting, handrails along hallways, pleasant music, comfortable chairs and couches, and a happy, clean and homelike décor?
4. Wandering safety
It’s important for your loved ones to be able to go outdoors by themselves, if they are capable, and to enjoy sunshine and flower gardens. However, dementia patients often begin wandering and can put themselves at great risk if the community isn’t properly secured. Make sure it provides a safe and secure setting so residents can wander without endangering themselves. Ask about around-the-clock staffing, and check out the physical security provided; fully-fenced communities, password gate entries, locks, and cameras are common security features.
5. Communication with residents
Caregivers should provide a failure-free communication environment. How staff communicates with residents and how residents communicate with staff are important overall care cues you should look for. Staff should speak in simple, direct language, be patient and compassionate and provide positive physical contact. Dementia sufferers are often confused about time and place and may think they are living at their old home, or their parent’s home. Staff should not correct these impressions, but rather offer a reassuring smile, a friendly comment or a hand to be held.
6. Cleanliness
Look at how clean the resident’s clothes are. See if hair looks freshly shampooed and brushed. Do a smell-check to see if you detect unpleasant odors that might point to an unsanitary residence.
During a tour, collect information that helps you decide which residence is right for your loved one. What do you think is most important?
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Although assisted living serves a wonderful purpose, they are still businesses. And while most sales and marketing directors genuinely want each family to make the best decision, some unfortunately realize that emotional families are easy sales.
It’s your job to avoid this trap, kick the tires to ensure you’re buying the “product” that’s best for you and your family. This means being prepared to ask some tough questions. If you you’re not prepared, you’ll leave with nothing but a sense of completion and a shiny new brochure. What you won’t leave with is any useful information that will help you either eliminate that community from contention or move it on to the next round of consideration.
Preparing for Your Assisted Living Visit
Before you go, take a notebook and write the same questions you’ll ask on different pages. This will ensure you’ll ask the same questions at each community, and it will help you compare later.
Below are six people to question during your initial evaluation of assisted living. For each individual, think of the questions that matter most for you.
1. Sales and marketing director
The sales and marketing director will likely be your primary contact at the community. At many communities, this person is also responsible for admissions. Expect to get the pros, but not a complete picture of the cons during your discussion--unless you ask. Leverage this person’s knowledge of the staff to learn more about their backgrounds.
2. Activities director
The job of the activities director is to provide entertaining and stimulating activities for the residents. The demeanor and attitude of this person is tremendously important. Their patience, creativity and tenderness can make a world of difference in your loved one’s daily life. Find a grumpy one, and your loved one could be looking at days killing time rather than engaging their mind and sense of pride.
3. Medication manager
The medication manager (also called a “med-tech”) is responsible for getting all medications to your family member on schedule. In assisted living, residents are usually not allowed to keep medications in their rooms – over-the-counter or prescription. Spend some time with the medication manager to understand their experience and communication skills. Make sure the
night shift med-techs have the same training and language skills as the day shift.
4. Physical therapist
Depending on your family member’s ambulatory skills, the physical therapist may, or may not be, of value. Speak to the therapist to get a feel for the experience they have working with seniors. If you family member has a specific condition, make sure they have successfully worked with that condition.
5. Head chef
The head chef is responsible for planning the menu and managing the cooks. Look at the menu and ask how they plan for sodium, cholesterol and sugar-restricted diets. Ask to taste the food The sales and marketing director should happy to let you dine at the community. And that’s a great opportunity to observe the residents and check out the “feel” of the community.
6. Executive director
The executive director has ultimate authority over all aspects of the community and is responsible for maintaining records for state health inspections. You’ll run across executive directors that are all business. While it’s obviously important to take a business approach to the community, make sure this demeanor doesn’t come at the expense of the patience and compassion required to make the residents happy.
What other people do you think would be important to meet? Leave your comments below and let’s discuss it.
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