Checklist for ‘Mom’!

In the past few months, I’ve had different friends ask me about how to evaluate selecting accommodations for a loved one with memory impairment. As I was re-assembling a list of questions, I thought others may benefit from this type of checklist as well. Please find the following questions that I would start asking, if I was searching for the right place for my Mom.

1. Ask to speak to other resident families

2. When meeting with a group, the marketing folks are fine, but I would recommend interviewing the executive director, the social worker, a dining services person, a housekeeper, and a CNA/GNA (Certified Nursing Assistant/Geriatric Nursing Assistant) within a memory care setting.

3. I would ask the following questions:
    a. Are you embracing resident-centered care initiatives? If they look at you funny, you know that they haven’t the slightest idea of what you are speaking about, and you can go to the next place on the listing.
    b. How much time per day is spent with the CNA/GNA (? What is the ratio of CNA to residents on all shifts)? You would like the hands-on care staff to consistently care for the same residents over a period of time. So limiting the number of residents that they are responsible for is the best way to do this. So the small house or household model is very appealing, because staff works with specific residents that are the same. Basically the more a care staff member knows about your loved one, the better it is for her (meeting needs, etc.).
    c. Can my loved one choose when she wakes up in the morning? What are your policies about sleeping and waking?
    d. Can my loved one choose to eat when she wants to during each meal time? Does she have choices?
    e. When an intake is completed, in additional to a physical assessment for medical conditions, what other types of assessments are completed? Such as, do you make note of my mother in-laws current/past hobbies, what are her favorite things to do, what are her favorite foods and what foods does she dislike, what is her favorite color, and how does she like to have her clothing cared for? Basically, I call it a “Life Plan”, so that the staff knows as much as possible, “celebrating” her uniqueness, instead of treating her like a medical diagnosis.
    f. What types of restorative care and therapy is available to provide interventions for incontinence issues? 
    g. What types of activities are designed to assist your loved one with participation, despite their memory impairment and encourage participation?

4. Note the physical environment, as it can often tell you a lot about the consistency of care:
    a. Is everything clean?
    b. Did you notice any distinctive odor (urine or musty smell)? Or even too much Clorox can be overpowering as well.
    c. Is the seating arranged for conversational groups, instead of lined up against the wall?
    d. Does the interior look like 1980’s with shiny floors and glaring lights or is it diffused lighting and feels warm and comfortable?
    e. Are the staff smiling and happy? Or do they seem ill-tempered and not happy? This is a true sign that management and staff don’t work well together, immediately impacting the care level.
    f. Does your loved one have access to the outside?