How to choose a memory care home
The hard part of choosing is not comparing places. It is not knowing what you are supposed to be comparing. Every website says warm and compassionate, every set of photographs has a garden in it, and by the third visit they have all blurred together.
What follows is the list of questions that genuinely separates one home from another, including several we would not come out best on. If you use it on us, use it on everyone else too.
Ask about the people before you ask about the building
A memory care home is its staff. The carpet does not care for anyone. So: is there a registered nurse, and what is that nurse's name. Is the nurse employed by the home or contracted through an agency. Who is awake overnight, and how many of them.
Ask for the staff-to-resident ratio as a number, for the day shift and for the night shift separately. If you get a number, write it down. If you get a superlative instead of a figure, that is also an answer, and it is worth asking again until a number arrives.
Then ask how long the caregivers have worked there. Turnover is the thing residents feel most, because for someone whose memory is failing, a familiar face is not a nicety.
Ask what happens when things get worse
Every home has a point at which it will ask someone to leave. Ask what theirs is, in plain terms, and ask them to show you where it is written down. If a home cannot tell you, that is not because the point does not exist.
Ask specifically about the end. Does care continue in the house, or is there a stage at which the person moves to a nursing home or a hospital. A second move, at the worst possible moment, is the outcome most families would pay to avoid, and it is far easier to ask about now than to discover later.
At Gianna Homes, care continues through the end of life. Our admission and discharge policies are published, and they include the circumstances in which we would not be the right home for someone.
Ask about the day, not the activities calendar
Every home has a laminated calendar and it tells you very little. Better questions: what happens between two and four in the afternoon, which is when the day most often falls apart. What happens if someone does not want to join in. What does a person who prefers to sit quietly do all day, and is that allowed.
Ask what a resident ate yesterday, and who chose it. Ask whether anybody goes outside in January. Ask what happens when someone is awake and distressed at three in the morning, because that is the shift nobody shows you.
The questions we would not win on
If what you want is a large community, sixty neighbors, a gym and a hair salon on site, we are not that and a bigger building will suit your mother better. We run two houses.
If your father does not have a dementia diagnosis, we cannot admit him, however much we might want to. Admission to either house requires a diagnosis of some form of dementia.
And if you need a campus where a couple can stay together while one of them needs memory care and the other does not, we cannot offer that either. Both of ours are houses, not campuses.
What to do on the visit itself
Go at a time that is not convenient. Late afternoon rather than eleven in the morning. If a home will only see you at one particular hour, ask why.
Then use your senses rather than your notebook. Does it smell like a home, or like cleaning products covering something. Is anyone talking to a resident, or only about them. Are residents dressed the way an adult dresses themselves, or the way a busy shift dresses eight people. When a caregiver passes someone in a chair, do they touch a shoulder and use a name.
Ask a caregiver, not the director, what they like about working there and what they would change. The pause before the answer tells you more than the answer does.
Comparing what you were told
Write the answers down the same day, before the places blur. On money, compare like for like or not at all: ask each home for the all-in monthly figure for a person with your mother's actual needs, not the headline rate for a person with none. One home's number includes a nurse's time, haircuts and incontinence supplies. Another adds each of them separately and ends up higher.
Then go back to the two you liked, at a different time of day. Almost nobody does this, and it is the visit that tells you the truth.
You can arrange a visit to either of our houses by calling Cari Doucette at 952-443-6113.