Seniors Housing is successful–both for the provider and for the residents–when the former successfully meets the needs of the clientele to whom they are providing housing. That calls for commitment. They cannot “go halfway.”
Twice in the past few months we have had concerns about the response from senior personnel in two different Seniors residences to the needs of our clients who were residing in those buildings. Both residences market themselves as independent living, but also are registered as providing assisted living. This means that they are able to provide personal care services such as assistance with bathing, dressing, medication reminders, and more. Both are on the high end in terms of costs and the clients to which they appeal.
Any residence which provides support services is going to have residents with cognitive impairment. Either these people enter with the impairment, or as they age they become impaired.One of the reasons people choose to live there is because they are able to have these services, and, at least to some extent, age in place.
It would seem logical that if a residence is accepting clients with dementia, or allows residents to remain in the care home as they become impaired, then the facility would have the appropriate structures in place to meet those needs. Unfortunately, neither of the residences referenced above appeared to have such structures in place. Further, the administrators of both homes told us such care would not be forthcoming as the residence is an independent living facility. In fact, both residences have been registered as assisted living facilities.
If you are a loved one is considering seniors housing, it is critical that you familiarize yourself with types of housing and the requirements and services provided by each type of residence.
A few examples of to what an assisted living residence needs to do:
People who are cognitively impaired may be able to participate in most recreation programmes, but they also have differing needs. At the very least, they may need a higher degree of structure to be able to take advantage of what is available. For instance, they may need more reminding to come to a programme, they may need more instruction during the programme, a simpler version, or an opportunity for a longer response time. We believe that it is the Residence’s responsibility to respond to these needs.
This type of additional structure is also necessary in other areas. For instance in a dining room, a cognitively impaired resident with diabetes may need the serving personnel to offer them a diabetic dessert as a first choice or at least as an alternative. They may need to be brought a diabetic main course, or at least instructed about the main course. This helps them to adhere to a diet. This means that dining room personnel need to know who is diabetic and who is cognitively impaired. It suggests a certain level of training and responsibility.
People with dementia often have impairments in what we call executive function. Whereas they may be able to tell us what they would like and be able to respond appropriately in emergency evacuation but may not have the insight, judgment, and awareness they need to make informed decisions about their care needs. Someone needs to help them and arrange for a structure to insure needs are adequately and safely met. The residence must be aware of the needs and have a system in place. They must be ready to involve family or other caregivers when necessary. It is not reasonable for the residence to depend on the resident to make decisions which he or she is not capable of making.
The common thread in the above examples is the willingness of the Residence to respond to the needs of the residents they say they are able to accommodate. It speaks to an attitude and an awareness, as well as an understanding of their clientele.
When considering a move to Seniors housing, be aware of present and future needs. Ask the residence how they will meet those needs. How will it respond if a resident develops dementia or loses their sight? How does their programming reflect the needs of impaired residents? How does management cope with these needs as they arise? What do they see as their responsibility?
If a Residence does not have nursing care, so is not a nursing home, they will ask a resident to leave if the individual’s needs become too high. When you are taking a tour, be quite clear that you want to know what that point is, and how they will handle it.
Asking questions about how a Residence functions is one way to help caregivers understand what their present and future role and responsibilities will be. Living in Seniors housing is a great solution for a lot of people, but it does not solve all of the concerns that caregivers have.
Choosing Seniors Housing: What to Look For
One of the most important areas to inquire about when choosing Seniors housing is social/recreational activities. When you are taking a tour, make sure to obtain a copy of a recreation schedule for a month, take a good look at it, and consider these points:
- Are there programmes that you/your loved one will enjoy?
- Do programmes meet needs and deficits ?
- Even though there may be a number of programmes listed, who is able to take part in them? There may be six activities listed, but they may all be on different floors, for different residents, or for a very limited number of residents.
- Are there programmes on weekends and statutory holidays? We were shocked to see that a very expensive private facility had recently cut it’s staffing completely on statutory holidays. At prices ranging up to $9,000 per month, there should be a number of programmes every day of the year.
- How many recreation staff do they have, both full and part time, and what does that mean in terms of actual programmes? What is their training?
- Do they have their own bus and trips ? How often? Who can go? Does one have to sign up, or will staff ask if they wish to go?
- Is there a volunteer programme? How many volunteers do they have, how often do they come, and what do they do?