Choosing the best-fit residential care facility (alternately called nursing home care) for someone is daunting.
So much so that the phrase, “I need to look at residential care options for my mom” is probably THE phrase that most of us hope we will never have to say.
Unfortunately, many of us will.
Millions of people already require in-home care.
According to the AARP, there are 34.2 million people in the U.S. who have been caregivers; providing care to someone over 50 years old who is ill, disabled or aged. Not all of those people who are receiving care will be able to stay in the home as their care needs begin to increase.
If, or when, that time comes, just the thought of starting to look at residential care options can be overwhelming.
Why? One reason is that there are many different types of care facilities within the umbrella term ‘residential care.’
So, where in the world do you start?
Ask these three valuable questions!
Best-Fit Residential Care Question 1: What is the current care-level need?
The care-level of need determines the type of facility.
Therefore, talk to your loved one’s healthcare providers to gather this critical information:
a. Does your loved one need skilled care (nursing, physical therapy or occupational therapy)? OR
b. Does your loved one need unskilled care (are they able to complete activities of daily living independently)?
These questions will help you identify what level of housing you should explore.** The need for skilled care is a critical piece.
Pro Tip: The first step to finding the best fit residential care facility is to identify your loved one’s care level need(s).
The Two Types of Residential Care Facilities
A. There are facilities for people who need skilled care (without being in a hospital):
Skilled Care (may be called a skilled nursing facility, nursing home, residential care center, and older names may be convalescent hospitals or rest homes). The Medicare Survey Results can provide insight into the care provided and help with your selection.
This type of facility is usually large, so it will probably provide a casual but hospital-like setting. Private rooms are sometimes available.
The standard services may include:
- Skilled medical services
- 24-hour nursing care
- Help with daily activities
- Recreation activities
- Rehabilitative care (e.g., physical therapy, occupational therapy and sometimes speech therapy).
B. There are facilities for people who need unskilled care (they are somewhat independent but do not require skilled care, they just need help with a little of their care; usually activities of daily living):
Board and Care Homes
This type of facility is typically quite small. Moreover, due to the size, it will provide a family-style caregiving environment.
The standard services may include:
- Meals
- Help with daily activities (bathing, dressing, oral care)
- Limited nursing care (such as medication administration)
- Socialization activities (entertainment options)
Assisted Living Facilities
This type of facility is large, and it may even provide an apartment-style environment. It is considered more private compared to the board and care home.
The standard services may include:
- Meals
- Housekeeping (like in a hotel)
- Help with daily activities
- Transportation to appointments (and recreation as a group)
- Some may provide some limited nursing care (such as medication reminders or administration)
- Some may provide some socialization and recreational activities
- 24-hour supervision
As you identify care needs (particularly skilled care), you can usually choose one type of housing and completely rule out the other housing categories.
**However, the decision process can still be confusing due to the mixed terminology. Some of these terms may also change a little bit state to state. Especially relevant to mention is that the cost will vary between facilities, even at the same level. Another important point is the variety of size in same types of facilities. Some facilities will be small while others will be quite large. As a result, there will be some slight variation in the types of services offered within each type of housing. The best thing to do is to call and start asking questions. Ask to speak to the admissions coordinator to obtain cost and coverage information and start a list. A spreadsheet is a great way to record your findings.
Thankfully, however, even with all of that, when you have a complete list of needs, you will begin to discover what is important for your loved one as you compare these housing options.
Best-Fit Residential Care Question 2: What Are Cognitive & Social Requirements?
Cognitive and social requirements are critical for safety and comfort. The two questions that can help you find the best fit for your loved include:
a. Is your loved one cognitively impaired?
b. Does your loved one prefer lots of privacy or lots of socialization?
For residents who are cognitively impaired, little things, like signage, way-finding and care providers who offer verbal cueing can ensure the best cognitive fit.
Some residents, though, may require special ‘secured’ wings and specially dementia-trained personnel for the best fit.
Placing your loved one in a housing facility that is ‘too low-level care’ for them may be a safety risk.
Furthermore, social requirements (of those with intact cognition) are one of the most important (but frequently missed) questions to ask to find the best fit for housing.
Putting a person who prefers privacy in an environment with little privacy will create discomfort for the resident.
The same goes for an individual who prefers socialization.
Therefore, preferred socialization is a key question for success during this traumatic transition. Although it may be cost-prohibitive to completely meet this need, knowing their preference can provide insight to other options to make them more comfortable.
Best-Fit Residential Care Question 3: What is the Needed Length of Stay?
If you are like me, you look at situations with the hope that the need is temporary. Sometimes, like after surgery, for example, it may truly be the case.
However, more times (rather than less), the need is unknown, or it may become a longer stay than we would like.
Therefore, it is important to consider the possibility of the need for long-term care (or longer than a few weeks) to ensure that you look at all of the comfort requirements for your loved one.
It might be easier to skip over some of the harder decisions if we tell ourselves it is only a ‘little while.’ However, what if it is the opposite situation?
Spend just a little bit longer working to answer the hard questions! It will pay off by finding the best choice of housing, given the situation, for your loved one.
In Conclusion, Remember to Start with These 3 Questions when you are selecting the best-fit residential care!
While it is true that starting the search for a residential care facility is an overwhelming task, there is a place to begin when we launch into the search process.
The best case scenario can be true by using the three questions listed.
Remember the steps.
First, identify whether there is a skilled need.
Second, determine whether there is a cognitive impairment. Then determine the social requirement.
Third, consider the need for the length of stay.
And, most of all, trust your heart and gut on the journey.
As much as we all want to do what is best for our loved ones, there are many decisions we must make. Starting with these 3 questions when looking for best-fit residential care will help you feel like you are on the right track.
Be sure to grab your FREE Self-care Starter Guide! Lisa Kimrey is a 33-year veteran registered nurse (RN), speaker, and author of the Bible study, The Self-care Impact: Motivation and Inspiration for Wellness. At Mylifenurse, Lisa combines her nursing expertise with Scripture-based encouragement to show readers who serve and care for others how to begin and maintain their self-care journey – without feeling guilty or overwhelmed – to feel happy, healthy, and rejuvenated.