All About Long-Term Care: Choosing Personal Care/Assisted Living

All About Long-Term Care:

With our aging population, personal care homes (also called assisted living residences) have become a popular housing option. There are approximately 1,600 licensed personal care homes serving more than 51,000 residents in Pennsylvania.

Personal care homes offer seniors a community setting with the opportunity to remain independent — with the added benefit of nearby assistance whenever it’s needed. Facilities can design programs to meet individual needs — for short-term stays when support services are required and for permanent residency when chronic conditions exist.

Personal care homes often offer these services and activities:

  • 24-hour supervision;
  • Three meals a day, often served in a group dining room; and
  • A range of services that promote the quality of life and independence of the individual such as:
    • Personal care services (help with bathing, dressing, toileting, etc.)
    • Medication management, or assistance with self-administration of medicine;
    • Social services;
    • Supervision and assistance for persons with Alzheimer’s or other dementias and disabilities;
    • Recreational and spiritual activities;
    • Exercise and wellness programs;
    • Laundry and linen service;
    • Housekeeping and maintenance; and,
    • Arrangements for transportation.

Choosing Personal Care/Assisted Living

When you are looking for an assisted living or residential care setting for yourself or a loved one, please consider the following checklist to help you make the best choice. Thank you to the American Health Care Association/National Center for Assisted Living for providing this valuable information.

Checklist For Consumers And Prospective Residents

Service Planning:

  • Are the family and the resident involved in the service planning process? How often are residents’ needs assessed? Who completes the assessment?
  • Are there special programs for memory-impaired residents and residents with dementia? Are there accommodations for memory-impaired residents to be outside and exercise?
  • Are there special programs for residents with disabilities?
  • How are emergency situations managed? What is the protocol for such events?
  • What happens if the health-care needs of a resident change? Under what conditions are residents asked to move if there is a change in health status?

Services and Activities:

  • Does staff assist residents in administration of medication? If so, what kind of staff?
  • Does the residence generally use a particular pharmacy? If applicable, does that pharmacy participate in the individual’s Medicare Part D prescription drug plan or private insurance?
  • Are there professional nursing services on site? If not, does the staff assist residents and families in making arrangements?
  • Are the services of a physical, occupational or speech therapist available or arranged?
  • Does the facility provide laundry service?
  • Are there beauty shop services available on site?
  • What recreational and spiritual activities are available? Obtain or review a copy of the activities calendar.
  • Are the activity supplies available for resident use outside of scheduled programs?
  • Is transportation provided for medical appointments and recreational purposes? Is there a fee?
  • Are there resident and family councils? How often do they meet?
  • What are the suggestion, complaint or grievance procedures?
  • Can hospice care be offered? If so, does the facility coordinate that care with the physician and family?

Staff:

  • Ask about the residence’s staffing patterns and philosophy about staffing.
  • What training and qualifications are required for staff? Are there ongoing training programs provided for staff?
  • Observe staff and resident interactions. Are they positive? Courteous?
  • Does staff handle resident requests in a timely way?
  • Can private duty companions be hired? What is the procedure for that type of service?
  • Does the facility have a volunteer program? If yes, what types of activities do the volunteers perform?
  • Does the administrator/director practice an “open door” policy?

Moving In:

  • What does the moving in process entail? What are the paperwork requirements and the timeframes involved?
  • How is the initial assessment managed? Who completes the assessment?
  • Is the residence affiliated with a hospital or nursing home should acute or long-term care be needed? If so, is there a priority admission process?
  • If you need hospital or nursing home care, is your room held? What are the associated fees? Is there a discount for unused services (e.g. meals)?
  • Does the residence subscribe to a set of resident rights and responsibilities? Are printed copies of resident rights and responsibilities available?

Costs and Fees:

  • What is included in the basic monthly cost?
  • Are there charges for additional services?
  • Is there a security deposit? What is the refund policy?
  • Can service agreements and or contracts be amended or modified?

Dining and Food Services:

  • Does the residence accommodate special diets?
  • How often do the menus rotate? Are residents and families involved in the menu planning?
  • Are residents allowed to have guests for meals? Is there a separate guest dining room?
  • What are the criteria for residents to eat meals in their rooms?

Living Space and Accommodations:

  • Are there adequate community areas for resident use?
  • Are the resident rooms furnished or unfurnished?
  • What is the policy about personal belongings?
  • What is the policy for overnight guests? Are there guestrooms available? What are the guest fees?
  • Is additional storage space available? Is there an extra fee?
  • Does the residence meet the rules for people with disabilities?
  • Can residents have automobiles? Is there assigned parking? Is there an extra fee?
  • Are there patios and courtyards available for resident use? Is there an area for resident gardening?
  • Does the residence provide security?
  • Are pets allowed to reside in the residence? If so, are there additional fees and or deposits? If not, are pets allowed to visit?

Licensure and Certification:

  • Is the residence licensed? Ask to review the last inspection report.
  • Does the facility participate in a professional association, such as the Pennsylvania Health Care Association?

Safety:

  • Does the facility have a fire sprinkler system throughout the facility?
  • Where are smoke detectors located?
  • How often does the facility have fire drills?
  • Does the facility have an emergency preparedness plan?
  • How are emergency and evacuation plans reviewed with resident after admission to reinforce their memory?
  • What systems are used to keep residents with dementia or Alzheimer’s secure from successful exit strategies?

Location:

  • Is the location of the residence convenient to shopping, medical services, and entertainment areas?
  • Can family members and visitors easily locate the residence for visiting?

Final Checklist Prior to Signing the Service Contract:

This checklist is provided to the family and prospective resident as a final tool once an assisted living residence has been chosen. Use this as a reminder for issues that need to be addressed and fully understood.

Make sure you:

  • Know what the basic service package includes
  • Know all costs associated with your service package
  • Know about additional services and their associated fees (e.g., medication management)
  • Know the circumstances why fees might change and how much notice is given to families and residents
  • Understand the services planning process
  • Understand the service contract
  • Know about the criteria and policies associated with discharge
  • Understand resident rights and responsibilities
  • Know the residence’s grievance policy and procedure
  • Understand how many staff are available and their qualifications
  • Have the name and telephone number of the staff contact person