# Searching for Senior Care - What questions to ask placement agency?



## eo360 (Dec 11, 2020)

I'm researching Senior Care options. What are the main criteria when starting the search?

Distance from medical facilities
Cost
Languages: Staff + Residents
Reviews
Complaints from State
Capacity of the facility 
Condition of facility 
Housing: Private Room, Shared Room 
Caregiver to Resident Ratio


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## Butterfly (Dec 11, 2020)

If possible, when you've narrowed it down to the final few, visit them and talk to families of other patients who are there  and patients themselves if that's feasible.


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## Aunt Bea (Dec 12, 2020)

All good things to consider.

I would take the complaints to the state with a grain of salt and balance them against the answers to your other questions.  I found that one of the nicer care facilities in my area had a higher ratio of complaints than some of the more basic facilities.  It turned out that the residents of the very expensive self-pay facility were more vocal about minor issues than the people in facilities where the majority of the residents were covered by Medicaid.

Go and visit each of the facilities, how does it smell, is it well maintained, how are the meals and the assistance in the dining room, do the residents seem listless or are they alert and engaged, how does the staff interact with residents, etc...  Sometimes a gut feeling is just as important as the statistics.

Good luck!


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## MarciKS (Dec 12, 2020)

eo360 said:


> I'm researching Senior Care options. What are the main criteria when starting the search?
> 
> Distance from medical facilities
> Cost
> ...


Look at the residents. Look to see if they're well kept or look miserable. Look to see if anyone is paying any attention to them.


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## Leann (Dec 14, 2020)

I'm looking down the road for senior communities, too. At almost 65, I still like living on my own but I can also see that things will get more difficult and expensive in the ensuing years. I'd rather continue living in my home but I'm a realist.

Your list of things is excellent. I would add that you should inquire if there is a buy-in or deposit required. Also, what is included in the monthly fee? Is there a nurse onsite every day? Is transportation provided to shops, appointments, etc?


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## Aneeda72 (Dec 14, 2020)

Diet is very important.  If you plan on eating their food, does the place make accommodations for dietary requirements.  I was in a nursing home for one day, ugh.  The meals were high carb and I had to go on insulin 3 times a day in order to eat.

The chairs in the room were deep and soft and non lift.  Due to spinal issues I need a hard chair or a lift chair and there was neither so I had to lay or sit on the bed.  Aides would have helped me out of a chair, but if they were busy, I was stuck.

Check the shower, mine was hard to work and sprayed everywhere.  Took a sponge bath.  My place was clean, though.  The beds were old and high and narrow.  I was terrified I would fall off it when asleep.  No railings and they forgot to supply my oxygen.

It was hell.  Stayed 24 hours, was supposed to stay 2 months, it was a nursing home.  Never again, never again.


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## officerripley (Dec 14, 2020)

Another thing to consider, and it depends on the area probably, but find out how long the waiting list is. The better the place, the longer the waiting list. (A co-worker had her mother on a waiting list for 2 years for the only skilled nursing facility in the area.)


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## Aunt Bea (Dec 15, 2020)

Make sure that the facility is conveniently situated for you, your family, and your loved ones' friends to make it as easy as possible to visit, oversee the care, respond to emergencies, etc...

A frail vulnerable person alone in an institution can never have too many active advocates keeping an eye on them and their caregivers.


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## Manatee (Jan 15, 2021)

First decide what sort of community you are looking for.   There are 55+, independent living,  assisted living, dementia care,  nursing homes and hospice.  They are not the same and there are probably regional differences as well.   A lot of them have web sites with pictures and information.
Another possibility is having visiting senior care in your own house, apartment or condo.  There is much to learn before one commits.


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## Geezerette (Jan 18, 2021)

If you are dealing with a placement or referral agency, find out if they are on retainer, commission, how they are compensated by the places they refer people to.They aren’t doing it for free, even is they claim to be non profit.I had an experience where I found out after the fact that one guy who was shilling for a certain assisted living actually had been  barred from operating in another state. Even if a hospital or facility social worker is making a recommendation, assume nothing!


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## Lethe200 (Feb 2, 2021)

Look at staff turnover ratio, in addition to the ratio of staff:residents. Also, what type of staff is on hand in the evenings and weekends? You'd be surprised how many facilities have "daytime/weekday only" med technician help.

Decide if you are looking for Asst Lvg only or a full-services seniorcare facility. Always ask about how they charge for services. What's included, and what is not? Most facilities have set up "tiers" of services, and quite often it is THEY who decide what tier you have to pay for, not the resident!

Be aware that almost every contract includes an arbitration clause. Many people are unpleasantly surprised to find out they have signed away their right to sue in court.

If part of a big chain, the facility is probably for-profit. Nothing wrong with that, but generally customer satisfaction AND resident care rates higher at non-profits. 

On the bad side, for-profit chains very often buy up non-profit facilities! And when they do, all legal agreements go out the door. The new policies are whatever the for-profit contract says.

Ask what the policy is for moving from Asst Lvg to Skilled Care Nursing. Then ask what the company policy is if you run out of money. The Sunrise chain of seniorcare facilities, for example, is quite nice - but if you run out of $$$$, you're out the door. By law they have to keep you until a Medicaid bed can be found for you, but you have no ability to decline a transfer even if it is to a location far away. Tough luck if it's inconvenient for your friends or family to see you.

In contrast, some facilities instead will apply for Medicaid on the resident's behalf, then use funds from their specially earmarked fund for indigent residents to make up the remainder. Either way, you want to know ahead of time how the facility you are interested in, is going to handle things when your health takes a turn for the worse.

I cannot urge strongly enough how *multiple visits to ANY facility that makes your 'final list' are important. Ask to watch activity classes, eat in the dining room (at least twice if you can), visit at "off hours" at least once. *

We took my MIL's friend home one evening, who lived in a different (and more expensive senior facility). Spouse walked her inside and up to her front door, so used the elevator and went down the hallway. 

He said afterwards he was glad his mom didn't live in such a facility. Said that compared to the lovely facility we had found for her, her friend's facility was dark in the hallways, and there was only one staffperson on duty on the floor, looking bored and totally uninterested in their arrival. He found it a huge contrast to the well-lit halls and friendly smiling staff we always encountered, regardless of the hour, at MIL's facility, where there is never any less than two staff on duty 24/7 on each floor.


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## Marie5656 (Feb 2, 2021)

*I live in a senior apartment building, one question I asked was how they handled lock-down last year, and other COVID related questions.  I think others here have give great questions, I cannot add anything else.   
Maybe ask about things of interest to your specific needs. Recreational activities. If appropriate to you, ask if you are allowed to have your car there.*


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## Manatee (Feb 4, 2021)

Check the cost first, if you can't afford it the rest is moot.


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