1. What’s your overarching goal in caring for my loved one?
Personally, I’d like to hear that the home under consideration has, as its top priority, ensuring my loved one of a comfortable, safe, loving and stimulating environment for the rest of his or her life.
And I’d like to know how this place demonstrates it. For example, does its Activities staff go to great lengths to keep residents’ creative juices flowing? Does Dietary bend over backwards to tempt even fussy eaters? Does the Physical Therapy team specialize in my loved one’s problems?
In short, ask the admission director what’s extraordinary about his or her facility, and how that might impact your loved one.
2. What exactly can you do for us?
It never hurts to ask an admissions director to spell out the advantages this facility offers residents.
You might ask him or her what they tell government inspectors about their capabilities – and to translate this language into plain English to communicate what it means to your loved one.
For example, how many clinical staff hours does each resident receives per day? What is this home’s track record on minimizing falls or choking events, or hastening the diagnosis and treatment of UTIs? Then the clincher: what steps are being taken to further improve this facility's performance in each of these areas?
This is the kind of detail that can reveal a great deal about how much a particular SNF team cares about its residents.
3. What can’t you do?
Some residents' families assume that their loved ones will remain under 24-hour-a-day observation in a skilled nursing facility. Then, when something bad happens beyond the staff’s field of view, thoughts of neglect or abuse leap to their minds.
What’s more, some families blame the SNF for things that are totally out of any facility’s control – especially when the government has tied its hands. In Wisconsin, for instance, bed rails cannot be provided until a resident has actually fallen out of bed and hurt himself. The reason: it smacks of restraint.
Such restrictions mean that occasional falls are almost inevitable in even the finest nursing homes. Don’t let your expectations get out of whack. Instead, determine up front what the rules are, and what this particular facility is doing to keep its residents safe and sound in spite of the most confounding restrictions.
4. Are you trying to rip us off?
Many people feel like they’re being ripped off by nursing homes–and indeed, it may seem like they’re all in cahoots, charging similarly exorbitant fees.
Why not discuss the financial nitty gritty up front? Find out what private, round-the-clock care would cost in your home, and compare those numbers with each prospective nursing home's. You may be surprised to find out just how cost-effective a nursing home can be; it's all relative, after all.
Then ask each admissions director what hidden extras you'd be getting for your buck. For instance, what kind of investment does this SNF make in continuous staff training each year? In keeping the place spotless? In maintaining a warm and inviting environment? In keeping up with ever-evolving regulations?
And then how about exploring the financial realities of nursing-home P&L? Specifically, what proportion of a private-pay resident’s “rent” goes to subsidize someone who can’t pay his or her own way? Whichever side of this equation you’re on at the moment, you’re likely to be pleasantly surprised to learn that your loved one will continue to receive quality care even if he or she runs out of money. But beware: not all facilities offer this distinct advantage.
5. If we have a complaint, what do we do?
If your loved one is in a home for any length of time, issues will undoubtedly arise. So ask what you should do if you have concerns or complaints. Whose job is it to advocate and intervene for your family? And if that doesn’t work, what’s your next step?
What am I forgetting?
If you have other less-obvious questions that should be asked before signing a loved one up for SNF living, please drop me a note. I'll then begin compiling Good Questions, Part 2.