There are many considerations when choosing a care home for yourself or a loved one. And most likely you are already over burdened. Our current culture and standards of living often do not leave extra time and resources to quickly take on what is often another part-time or full-time job caring for an elderly relative. And researching these homes can seem daunting, not knowing what to ask or look for in a good quality care home. I have compiled a few considerations and approaches to make the task easier.

First and foremost, I want to advocate for the idea of keeping seniors in their homes for as long as absolutely possible. Familiarity and comfort are the most important factors to all seniors. Often times, over health or safety. This desire should be respected to the highest. And at the same time, if you are considering a care home, you must feel responsible for your own or your loved one’s health and safety. Several studies show close to 100 percent of senior Canadians prefer to stay in their own homes. Often, with a little family help and some professional help at key points throughout the day, I would argue that it is the best option 99.9% of the time. I have also been told by geriatric physicians that moving is very physically and mentally hard on seniors, often not surviving more than one move. They urge careful consideration when choosing a facility. That being said, sometimes the choice to move to a care facility is the best option for you and your family.

It seems like a simple idea. Move yourself or your loved one into a care facility, and you/they will be cared for, alleviating burdens. Unfortunately, this can be far from the truth. As you navigate care homes keep the following in mind:

Philosphy

Facilities have very different company philosophies on how they run and treat clients. For instance, some run strict schedules, meal times and food, and care. Some facilities let the clients run their own schedules and can be accommodating about food choices. This can become important in circumstances of dementia and Alzheimer’s disease. Your loved one may benefit from a daily routine that helps, or they may struggle daily with a strict schedule and staff will want to medicate or force routines. Do they let clients decide their own care or do they decide for them?

Cleanliness

Ask for a tour and visit several rooms. Look behind employee desks and under beds. Ask to use the restroom and show you where they are. During covid, this may be challenging, however if they are not willing to “show you around” I would be very concerned. Cleanliness should be the base of their foundation, in which you can tell if staff can care for clients in a safe way.

Privacy

Would you be in a shared environment or in your own room? This often depends on budget and client needs. Are there places that you can visit with your loved ones privately? Can you hang your pictures up, bring in your own belongings, and cultural/religious belongings? Are you able to tell staff what you need for privacy and your care wishes, and they be respected?

Staff rotation and certifications

Is there regular staff or a rotation of staff through other facilities? Are they all certified in BC and up to date, including CPR? Does the staff have time to be social with you, or are they understaffed and rushed? This may be hard to get a truthful answer, but you can often get a sense from walking around or asking current clients. Under staffing leads to poor hygiene, poor care, over medicating for compliance, and other unnecessary measures. While you are taking a tour, stop and ask staff members what their day is like or what they enjoy about the care home. Are they able to sit and eat with the staff?

Facility Layout

This can tie into the facility philosophy also. Does the facility have different sections of level of care or is everyone housed together no matter what their needs are? Would you rather have your loved one separated with others that need specialized care, or would you prefer their social life be exposed to all people while receiving that care? Will you be moved if something changes or can you stay in your same room?

Food services

When is food available and served? What kinds of meals are served? Are dietary restrictions available? Do you have a choice of meals? This can be very important to seniors. Ask to meet the chef and get a sense of the kitchen. Are they stressed trying work within a tight budget, or are they looking to create tasty meals for their clients?

Location and family access

Are you within driving distance and have easy access to your loved ones? If you cannot find a good fit close to home, is there one close to their work, that they could pop in to or from work? Would it be a better fit if you were closer to your grandchildren, who might visit more, even over your formal decision maker?

Consider covid protocols and if they work with your family. Many families ended up taking their loved ones out of facilities in BC because they lost physical access to them during covid. Loneliness and quick viral transmission became a problem, with families needing to make tough decisions.

Medical Services

What kinds of medical services are on site? Do they provide an on-call doctor and/or nursing staff? Is there podiatry care or will you need to bring someone in? Do they provide transportation for medical appointments or procedures? Is there hospice care? Hospice support may not seem like an appropriate conversation at this time, however whether it is an unexpected event or many years down the road, you may not want to be moved again or transferred to a hospital bed for your last days. It can be traumatic for you and families to witness you in an unfamiliar and cold hospital setting.

Social Programs

Are their social programs and would you have any interest in them? Are there weekly schedules, exercise programs or planned events? Are there Christmas/Valentine’s Parties etc.? Is there available transportation to shopping or appointments? Are you able to access your current social activities? Are you obligated to participate in theirs?

Budget

This industry is very much a get what you pay for industry.

For those with a minimal budget, one can enroll in their local health authority senior care. There is a fee and it is based on income levels. There is a waiting list, you do not get to pick your facility (it is first bed open, first filled), and you will usually be sharing a room with several other people. Cleanliness and staffing are a problem. Food services are strict. Benefits include nursing staff and doctors available daily.

On the higher end, there are wonderful, clean rooms available throughout the lower mainland with private nurses and doctors on-call. They are service oriented with the highest standards in cleanliness, care, and facility services. They are extremely pricey.

The many in between. Those with mid-range budgets will find the above considerations/questions and facility tours most helpful to narrow down the best fit for you. You may find yourself trying to decide between a couple of good choices. Never ignore your gut instinct if you are having trouble deciding. Sometimes the warm feelings you get from the staff may over shadow that you noticed the floors weren’t swept that day. Or you may prefer that your home is cleaned impeccably, and not care about staff contact, as you would rather be in a good book anyway. After working in this field for many years, I have decided that if I was to live in a care home, my number one priority would be excellent food! I wouldn’t mind much about anything else.

This may seem like a lot, but after the first or second visit, you’ll be a pro! Ask away and advocate your needs and wants.

I wish you all the best navigating these decisions. They are not easy and usually filled with unwanted learning experiences. My prayer for you would be for you to be healthy, joyful, treated with respect and cared for lovingly.

Please reach out to me if you have any questions or would like a more in-depth discussion. Again, I would stress the importance of seniors staying in-home and would enjoy discussing ideas of how to make that happen, sometimes with my out-of-the-box ideas.

- Maureen Landucci