Practical Hints for Choosing Alternative Living Facilities

When the time comes for you or a loved one to consider making other living arrangements than a private home or apartment, here are some questions to ask and some things to keep in mind, says care manager Sharon Holder. She is director of the ARISE Consultation Center of The University of Texas-Houston Center on Aging. The ARISE Center specializes in aging care management, helping individuals and families find appropriate housing and help for an aging population.

Licensing

• Does the facility/residence have the appropriate licensing and are the licenses posted?
• Is information on the last survey by the Texas Department of Human Services available to look over?
• Are the facility/residence's policies and procedures available for review?

Costs

• What are the monthly fees (exactly what is included and what is extra)?
• What has the increase in monthly fees been over the past three years and what sort of increase, if any, is expected in the coming year?
• Can contracts be terminated?
• Under what conditions?
• What is the refund policy?

Assessing the Facility

(keep these things in mind as you tour the property)
• Homelike features in rooms
• Is there adequate room space for maneuvering a walker or wheelchair?
• Is there privacy for the resident?
• Is there a sense of community?
• Is there attractive landscaping for walking or sitting in?

Environment/atmosphere in the facility

• Do you like the location and outward appearance?
• Is the décor attractive, homelike and clean?
• Are the buildings and furnishings in good condition?
• Are pathways and hallways clear; handrails and good lighting for safe movement?

Staff

• Are they knowledgeable, professional, friendly and caring?
• Do they appear to have a warm relationship with residents and guests?
• Do they seem to like their jobs (talk with them about working in the facility)?
• Ask about the staff-to-resident ratio and about the staff turnover rate.

Current residents

• Are they well groomed and well dressed?
• Are they involved in activities based on their abilities?
• Are the activities dignified and appropriate to their age?
• What sort of transportation is available to residents?

Services

• Is a list of services available?
• Does the facility provide 24-hour assistance with activities of daily living?
• Are care plans personalized to meet individual needs?
• Are care plans reviewed on a regular basis to reassess individual needs?
• Are special diets prepared, if required?
• Do dining room menus vary?

Medical

• Does the facility/residence have a clearly stated procedure for responding to residents' medical emergencies?
• Are there specific policies about medications?
• What are the restraint policies?
• Are physicians and nurses available around the clock?
• Is it near a hospital?

Holder says not to look for perfection in the TDHS survey report, but to check for repeat violations, especially those that directly affect the residents' well-being, such as failure to follow a "plan of care" or over use of restraints or medication errors.

She also says to ask about any violations that concerned residents or the family of the resident. "The way the staff members answer residents' or family members' questions - whether they are direct and apologetic or indifferent - will tell you a great deal about how they regard their mission."

- Pamela Lewis

The Houston/Harris County Area Agency on Aging has been providing social and nutritional services to adults 60 years of age and older since 1977 as mandated by the Older Americans Act of 1965. Part of the City of Houston Department of Health and Human Services, the agency's services include nutrition and transportation services as well as in-home support, including personal care, homemaker and chore assistance. Preventative health services for vision and hearing are also provided. Benefits counseling, case management and an information and assistance service are also available through the agency. In addition, the agency offers a long-term care Ombudsman program.

The Houston/Harris County Area Agency on Aging makes available two publications that are resources for older adults and their families: the Directory of Services for Older Adults, a list of organizations in Harris County that provide services to older adults; and A Profile of Health Care Financing Administration (HCFA) Approved Medicare Health Maintenance Organizations (HMOs) in Harris County, a resource to assist older adults and their caregivers in making an informed decision about Medicare and Medicare HMOs.

For more information about the Area Agency on Aging, its services and publications, call 713-794-9001.

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©2006 Texas Medical Center

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