In my life, I took care of my bedridden mother as a child. As an adult I worked for about 4 years in an assisted living facility, I cared for developmentally delayed adults in group homes. I was a job developer for those same DD adults. And I was an administrator of an alzheimer's unit.

The decision to put your loved one in a care facility is never easy. It is also a completely exhausting experience for the ones making the decision. There are many factors to consider and I will try to help the process.

The first consideration is cost. It doesn't seem right that this is the first thing to consider, but honestly, if you can't afford a facility, then it does not matter how wonderful it is.

Once you have narrowed your list down to facilities that are within your price range, facilities need to be visited... and questions need to be asked.

• Is there a nurse on call 24/7?
• How many hours is an RN present in any given week?
• How many residents are in the facility?
• What is the ratio of staff to residents on EACH shift?
• What amenities are available in each resident's room?
• What training do the staff receive... I will cover this more in a bit.
• What is in place for the residents to seek help, i.e. pull cords in rooms and bathrooms to alert staff, phones, a monitoring system of some sort.
• Look at sample menus, join them for a meal if possible.
• Look closely at the cleanliness of the facility
• What type of activities are available for the residents?
• Will staff help to ensure that your loved one is at meals, offered help to get to activities, can receive meals in rooms if not feeling well.
• Look around at residents. Are they similar to your loved one? Are they generally the same age and ability? Are there at least a few of the same age and ability?
• What in house laundry facilities are available?
• How often is laundry done?
• If your loved one is very independent, can they do their own laundry?
• Does the facility have it's own van or bus?
• In the event of an emergency evacuation for any reason, what plan is in place to get all residents to safety?
• How often are fire drills conducted and are there fire safe doors so that the residents can get to a safe area (especially important on a multi-level building when elevators don't work in a fire situation) to wait for paremedics to respond?

All staff in these facilities should be CPR/1st Aid certified. In some states, it's required that staff be Certified Nurses Aides. In the facility I worked in, we had no CNA's. However, we had a lot of in depth training with an excellent RN. She spent many hours making sure that we had all of the abilities we needed to take care of our residents. And after we were able to dispense medications she checked our work frequently.

In that sort of situation, the med aides are functioning under the RN's license. That makes the RN liable for any mistake made. Her license is at stake. Perhaps this will make the RN more diligent (as it did with ours), but in the wrong setting this could be quite scary. Ok, off of that tangent.

If your loved one is able, you should consider having them visit one or two facilities after you've narrowed them down.

Good luck to you! If you have questions, please feel free to contact me.