It probably started with niggling thoughts chasing themselves through your brain.
Mom looks unkept. She’d never allow anyone to see her with her hair unsettled before. She seems frail, too. I wonder if she’s eating enough.
From there, perhaps you made an off comment to a sibling or other family member.
“How do you think Mom’s doing?”
Eventually, a more formal meeting with others responsible for care start to ask the question, “Is it time?” Difficult conversations with your elder ensue until everyone is somewhat on the same page. Or maybe not, but you keep moving forward, because it’s the best choice among not great choices.
Now, you need to look for a place for Mom to call home for the rest of her life. No pressure. How can you possibly know?
Set geographic criteria
Before you start, look at the basics. What geographic area should you look in? Think of the family and friends most likely to visit and with whom your elder has the closest relationship. Set a perimeter that is reasonable for frequent visits. The best home in the world is no good if it’s too far away.
Prepare a list of “what matters.”
Personally, for me, the single most important factor is the resident to care staff ratio. Your government will have one standard, but in most cases, look for a place that exceeds them. Here are some factors to consider:
- Some places quote a number which includes dietary and housekeeping staff. Although these people help with care, the number you want is personal, hands on care. How many residents does each personal support worker take care of in a shift?
- The care needs of a resident change through out the day. Day staff, who generally come on at 7 a.m., are responsible for waking, dressing, bathing, helping with both breakfast and lunch and other duties. Afternoon staff also are responsible for bathing, dinner and helping to bed. Night staff oversee, change and toilet and sometimes have an early morning shower. The reason it’s important to know this is the ratios change (or should) per shift. Generally, day staff should have a slightly smaller number than afternoon staff, and night staff may oversee as many has half the floor. It’s important to know these numbers.
In the “what matters” category, talk among yourselves and to your elder. How much does decor matter? What about gardens and the ability to access them? How much variety is there in the activities which happen during the day? Do they have an active volunteer program? (Covid will have had an impact on this, so perhaps ask their recovery plan.) Do they offer private rooms only, or are you looking at a roommate situation? What costs, besides the basics of the room, are extras?
Ask around
Word of mouth is the single best indicator. People who have had experience with a home are happy to share their thoughts, good and bad. If you don’t know anyone, put the word out there on social media. Someone knows someone. Make sure your information is current, as one vital staff change can make a huge difference.
Visiting
Use your senses. Does it smell sweet? In a place where incontinence is the norm, accidents happen, but for the most part, it should neither smell like an outhouse or a hospital. Is it clean? Kept in good shape? (An occasional wheelchair gouge in a wall can be expected. You have no idea how often that happens!) Do both staff and residents, for the most part, seem happy? How is the interaction between them? Do staff seem to enjoy working together? What do you hear when no one is noticing you are listening? And finally, how is the food? Meals will be a huge part of life, so they better be tasty and well-presented.
At the end of the day, you make the best possible decision, and then you do everything possible to make it work.
No place is perfect, but with support and care, it can be perfect for your elder.
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