Is This A Factor In Choosing An Assisted Living Home For My Mother?

April 26, 2024 2:36 AM

I have been looking for Assisted Living homes for my mother. How concerned should I be about the dingy external appearance of a location?

In my province (Saskatchewan) the government looks after long-term care homes (where residents need a significant amount of help in their daily lives) but not Assisted Living homes (where residents need some help but not necessarily help with showering or using the toilet, etc.). My mother is in excellent physical health but her dementia has reached a level where the home care workers are recommending that she move to an Assisted Living location. So I am looking for options.

I went to inspect one location and the owner seems knowledgeable about senior care/memory care. They seem to have a good mix of activities and a good policy on visiting and so forth. He will give me references.

However, the outside of the location is dingy: broken and unpainted fence, back step unpainted, door frames unfinished, all paint flaking. Nothing looks to be hazardous, just . . . not kept up. The inside seems ok--not fancy, but clean and with no noticeable undone repairs. Still, I'm having a hard time getting the rundown exterior out of my mind as I'm wondering if it's indicative of some hidden factor in the running of the location that I wouldn't be exposed to on a tour.

I am continuing to explore my other options, of course, but so far this one is the best in terms of price/services that I've found. What are your thoughts? Am I fussing about nothing?

posted by purplesludge to Grab Bag (8 answers total)

I used to be a contract provider in care homes, admittedly in the US. I found low staff turnover to be a better indicator of quality than external appearances.

There are exceptions (looking at you, place responsible for new state law with literally an abandoned horror movie floor) but if money is going to floor staff and patient boring goods, versus chandeliers and administration's car, I saw less wounds.
posted by cobaltnine at 4:19 AM on April 26 [11 favorites]

I'm coming from a US perspective, I would much much rather have a place with an place with a not so great outside and knowledgeable, responsive staff inside than a great outside and a bunch of clueless non responsive staff inside.

If the staff ratios are good, they feel comfortable working with people with dementia until they need to move to a higher level of care, the residence itself is in good working order then that's really good.

Overall, So many places don't meet that standard which should just be the bare minimum of care.

One of the questions i don't see you mentioning here is how do staff check in with your mom? How is the food? Can they provide meal supplements like ensures if needed ( this is example is specific to an issue I had with my MIL based on a US event that may not be applicable to you)

If the place meets other requirements that you need such as being close to visiting family or friends, costs ect, then it's likely a good fit to you.
posted by AlexiaSky at 7:31 AM on April 26 [1 favorite]

I think facility niceness is correlated with care quality, but agree that staff tenure is by far the most important factor. Find the nurse's station in the unit you're considering, and ask for the head nurse or charge nurse (sorry, I don't know the Canadian term). There will be someone who's in charge. Ask that person how long each of the staff you see have been there. If they're all contract ("traveling") staff, or the answer is a month or two, that's very bad. If more than half have been there there more than a year, that's good.
posted by wnissen at 9:14 AM on April 26 [1 favorite]

My mother spent the last ten years of her life in an assisted-living facility. I'm here to echo the "low staff turnover" as an indicator of quality. For her first five years, her residence experienced little turnover and things were great. Then the place was bought out by a conglomerate, which must have been shitty to work for because suddenly there was tons of turnover. And when the turnover started, the quality declined. I never paid any attention to the outside of the building (although, to be fair, it was newish construction).
posted by jdroth at 9:16 AM on April 26 [1 favorite]

Best answer: Two of my relatives have lived in U.S. facilities in recent years. Neither facility looked like much from the outside, although there wasn't anything visibly broken. We chose places we felt were clean (although they looked old and sometimes worn), had natural light, and smelled ok. As mentioned by others, we paid even more attention to staffing ratios and models. We also reviewed our federal regulatory body reports for violations, infection rates, etc. If your government has that, I'd suggest reviewing.

I understand how you feel about the building appearance, though. You want to feel good about where you are placing your loved one. I will just mention, that when we were looking for a place for one of my relatives, we decided against a prominent local facility that has a gorgeous exterior and interior. We did some digging and found out that they had been fined for several violations, had constant infectious disease outbreaks, and had many resident complaints. Looks don't always tell the whole story. This is a tough decision, good luck.
posted by fies at 4:23 PM on April 26

Best answer: I would look at the inspection reports

http://personalcarehomes.saskatchewan.ca/

When you’re reading, bear in mind that issues that seem small like skin wounds can be fatal to seniors.

I’d of course Google the name of the home for any news about it. (Do a search within News). Reddit too.

I would ask around. Everyone you know. Neighbours, friends of friends, any healthcare providers especially (paramedics probably could tell you everything).

Ask the director how many staff per resident they have for days and for nights. Ask how many nurses there are and how often the doctor visits. Ask what % of residents are medically complex. What are their policies on staff-on-resident and resident-on-resident violence. Ask if anything has happened recently (and check the answer against reports and news).
posted by cotton dress sock at 8:58 AM on April 27

Best answer: Ask how long the average resident lives there (longer is better, answer should be years not months). How often do places open up (if it’s quick there are bad reasons for that). What’s their policy on antipsychotics for sedation and what is their plan to avoid them. How do they handle UTIs (guaranteed to happen a lot).

Check employee reviews of the place on indeed and Glassdoor too.
posted by cotton dress sock at 9:00 AM on April 27

Response by poster: Thank you everyone! All of your answers were helpful, and cotton dress sock, your suggestion re: researching inspection reports was genius. It definitively ruled out the one location I'd been hesitant about that I mentioned in my question.
posted by purplesludge at 6:19 PM on April 28 [1 favorite]