As our loved ones age, choosing the best senior care can feel overwhelming. You’re entrusting the care and well-being of someone you love to strangers, and you want those caregivers and facilities to be the best possible choice.
With many senior care facilities, all you have to go on are their own marketing materials and a tour where they show themselves at their best. There must be a more comprehensive way you can really know that you are choosing a home where your loved one’s senior care needs will be met.
Often, the most valuable details can be found not in what a facility gets right, but in what areas it falls short. Keep reading to learn more about red flags to look out for when seeking senior care, from behind-the-scenes factors to what you can sense during an in-person visit and tour.
Lack of Accreditation
While senior care facilities are licensed by the states in which they operate, they can also elect to pursue additional accreditation. This voluntary process ensures that a facility has met specific standards for safety and quality of care. The primary accrediting organizations are the Commission on Accreditation of Rehabilitation Facilities (CARF) or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
Regardless of accreditation status, any quality assisted living facility should offer your loved one safety, security, and the confidence that they’ll receive adequate care.
With a keen eye for detail, you can spot an untrustworthy facility. Watch for an apparent lack of qualified medical professionals on site. There should be enough doctors, nurses, and caregivers to quickly attend to the well-being of all patients. Additionally, security measures such as locking doors and monitored cameras should be present and in good working order.
If a facility doesn’t offer you a written contract with rates, firm start and end dates, and descriptions of care, that could also be a sign that their operations aren’t on the up-and-up. Insist on thorough and official paperwork to lay out the terms of care.
Negative Reviews, Violations, or Complaints
While nothing can replace touring a facility, reviews can help you with the complete picture of daily operations and resident experiences. They can give you insights into the staff’s attitudes, responsiveness, and overall atmosphere. Positive reviews will mention great staff, compassionate care, and clean environments.
You can find online reviews from individual families, state assisted-living records, or the state’s long-term care ombudsman, whose job is to investigate residential care complaints. To find reports, search online using keywords such as “facility name + inspection report”, “reviews”, or “Medicare rating.” You can easily find personal reviews on sites like Caring.com, Yelp, or Google. For more thorough data, research your state’s assisted living records or contact the ombudsman.
Finding a few complaints on any facility isn’t uncommon. However, take a close look at the types of complaints, their frequency, and how they were addressed. Consistent trends or themes across multiple reviews can be a reliable predictor of the quality of care your loved one will receive. Look out for repeated complaints about deficiencies, staffing levels, and quality measures.
Poor Management & Staff Service
Staff actions and attitudes can be one of the most reliable mirrors of the overall living conditions at a facility. When you pay attention to interactions with residents, responsiveness, and staff demeanor, you’ll learn much of what you need to know about your loved one’s possible experience in senior care.
Ask Them Questions
Get curious and ask about their typical routines and responsibilities. How do they handle resident complaints? What are typical staff-to-resident ratios during different times of day? What’s the protocol in emergency situations? If they hesitate to answer or get defensive, it could be cause for concern.
Gauge Their Attitude
As you tour a facility, observe the staff’s responsiveness to residents. Take note of how long residents wait for assistance, if staff knows residents’ names and routines, and how staff communicates with patients. If the staff is consistently rushed or stressed, you may want to look elsewhere for long-term care.
Find Employee Turnover Rate
Ask the facility for turnover rates and data for the past two to three years. A 40-50% turnover rate is typical for nursing home staff, so anything higher could indicate a persistent problem with management or care quality. Additionally, high turnover in key positions like medical or nursing director could be a red flag.
Your 5 Senses Feel Off
Visiting a long-term care facility and experiencing its daily operations in person is one of the most important steps in choosing the best future residence for your loved one. Being onsite and taking a thorough tour allows you to notice aspects you might otherwise miss.
Can you see enough residents enjoying themselves?
Observe the people who already live in the facility and strike up conversations with them, if you can. Ask them if they enjoy living there and what their days are like. Notice if they seem friendly and responsive. After all, these could be your loved one’s fellow residents and neighbors.
Are there lively sounds or uncomfortable quietness?
Too much quiet could indicate that residents are unhappy or neglected. If you’re visiting in the morning, notice if staff are getting people up and ready for the day. Are people engaging in activities and conversation? If everything appears quiet, ask the staff if that’s typical or if residents are out for the day.
Does it smell stale or fresh?
Your nose knows if a facility is well-maintained and cleaned regularly. Fresh or neutral smells in shared spaces and pleasant kitchen smells at mealtimes are positive signs. However, strong urine or fecal odors, musty smells, or overpowering air fresheners can indicate less-than-stellar sanitation standards.
How do the amenities feel when you interact with them?
Updated, well-maintained facilities make any community a more enjoyable place to live. Check for pleasant and orderly common spaces, comfortable furnishings, and on-site adaptive equipment. You’ll also want plentiful communal amenities and private areas where residents can meet with visitors.
Is the lighting at a comfortable brightness?
Proper lighting can significantly impact well-being and safety, so carefully assess it. Look for abundant natural light, well-lit stairwells and halls, and adjustable lighting in residents’ rooms. Conversely, dim or flickering lights in communal spaces, harsh institutional lighting, or lack of natural light should give you pause.
Your Loved One Doesn’t Approve
Before Selecting a Care Facility
Speaking to your loved one can be a very challenging part of the process. Some people may have difficulty admitting they’re no longer able to live on their own or prefer for family members to be their caregivers. However, they will feel much happier in their new home if they can participate in the decision.
Be sympathetic and patient as they process their feelings, and consider their point of view and wishes when choosing a residential facility. Be open and honest when sharing your concerns for their health and well-being so they can understand that you only want the best for them.
After Living in a Chosen Care Facility
Once your loved one is settled, keep the lines of communication open. An adjustment period is normal, but they may also be unhappy with the facility itself. Listen to what they have to say about their new living situation and notice how they talk about the care they’re receiving.
Keep in mind that they may not tell you directly about their dissatisfaction. Some people worry about being a burden or upsetting their families, so they don’t say anything. Watch for telltale signs that something is wrong, such as withdrawal, isolation, or self-neglect. If you have cause for concern, speak to management and resolve things quickly.
