Moving to an aged care facility can be a daunting experience, especially if its a decision made with urgency due to a change in personal circumstances, but that doesn’t mean it can’t be an empowering experience or you don’t have choices in where you live.
If you are investigating care homes for any reasons– consider some of the following points;
1.Trust your gut – How does it feel when you walk in there? Are you greeted with a smile, do residents and staff look happy? Do you get a sense of community? The culture of an organisation is often palpable so…..
If it doesn’t feel right, trust that it might not be the place for you or your loved one.
2. Leadership –Isthe Director of Nursing or CEO a leader or a boss. You want someone that inspires and encourages staff to shine. You want leaders who are emotionally intelligent and can deliver the changes required of the new aged care standards. Are the management teams top heavy and divided from the rest of the team or are do they work hard to include and support residents and staff in all that they do? Micro managers, inflated ego’s and dictators should be a thing of the past!
3. How does it smell? – If it smells nice and odour free – then you can tell that the staff are caring for the residents in a manner that you would want for yourself, or a loved one, that they take pride in caring for others, and the cleaning staff are doing a great job.
4. How do staff look? – Are they in uniform with a name badge, do they have the right communication equipment on them. If it’s a non-uniform facility do, they look neat in appearance. Do they look tired or grumpy – ratio’s and staff moral might not be at its best if they look worn out. Do they sit with the residents and engage with them, do they make chit chat when they walk by? Or do they hurry past – task orientated staff will not help you live your best lives. Are there lots of agency staff? High staff turn over can indicate an unstable culture.
5. How do staff make you feel? Do the front office staff greet you kindly, take your calls with warmth and patience and guide you through the myriad of paperwork. Do carers smile as you walk by? Have you met the DON or CEO? Is there a social worker or chaplain to talk to about your journey if required?
6. Are staff valued? Where do staff sit on the organisational chart? Does the facility have an empowering mission and vision statement? – Look for words like person centred care, best lives, dignity, independence, partnership, community and respect. You want to know it’s a culture that strives for excellence in all they do. Are they engaged culture change program’s such as The Eden Alternative, Montessori, Butterfly Program or one of their own? It’s a great sign if they are. Have you considered a small scale model like Group Homes Australia or The Green House Project in the US?
7. Are residents visible? – Strike up a conversation with a resident or family member (they will tell you what it’s like, don’t worry) but do ask a few for balance if you can. Do they have a residents committee or, are the residents invited to be involved in Board meetings and the staff onboarding process?
8. Dementia care – What’s the dementia area called? As my friend Tim England recently stated – the name says a lot about the culture, and he’s right – Dementia unit or wing doesn’t entice me to live there. Does the language spoken by staff empower or hinder people with dementia? Is it a locked unit – do they have guided gardens to walk in with ease if it is? Are residents sitting around on chairs with a tv blasting or are they engaged with a meaningful activity, staff and each other? Is it a small-scale environment or will they get lost in large spaces and winding corridors?
What are the antipsychotic use numbers at the site – just ask: they will have a list. Do the have alternatives to using them – they should be the last thing they turn to if someone living there is having a hard time.
Do they talk about person centred care? What dementia training do they staff have? All questions I would be asking. Dementia is a specialty area of nursing and care and should be treated as such.
9. Do they have a lifestyle team – What activities are on offer? Do they suit your likes, and are they willing to add more if they don’t? Do they have weekend activities and sundowning programs? Can you see them in action when you walk around the site? Do they bring the community to the residents – like intergenerational programs or book clubs. Keeping people connected to their community is so important.
10. Dining experience – Do they have extended mealtimes and access to food outside of meal times. Is there a chef or are the meals frozen and brought in from elsewhere? Will they cater to your food tastes – example vegan or gluten free menu.
11. Medical & Palliative Care – What are the RN ratios’? Is there a visiting GP? Will you feel supported if your heath declines or will you be sent to hospital every time you are unwell. If you become palliative, will you be able to die at home? I know it’s an icky one to think about, but this is so important. Will they assist you with advanced care planning? Do they have palliative care meetings on a regular basis?
Will they be confident and prepared when the time comes? These are some important factors when it comes to choosing the right home for you or a loved one.
12. Complaints handling – No-one likes to complain, but will they take it seriously when you do? Will you feel ostracized for speaking up? What is their complaint handling process and response time frames? Are the open to feedback and suggestions?
13. Audits – Do they audit themselves frequently? Are they a best practice organisation? Do they have wound, palliative, nutrition, oral health and governance meetings. Do they seek 360 feedback?
You want to know you are getting the best care possible.
Communication, culture and good leadership are the keys to a successful aged care facility, It’s not possible to get things right 100 percent of the time, but if they are open to communication, have an ethos that empowers residents and staff and are a learning environment – you are on the right track to choosing the care home for you!
It’s time to make aged care better.
Founder Community Café Health & Wellness