This worksheet acts as a simple guideline for people considering admission to a retirement home or to a frail care centre for either themselves or someone they love and care for. Emphasis is on the practical considerations. You are, however, encouraged to look at the emotional implications of your decision and discuss these with someone you trust and can confide in.
It is important to ensure that the home is registered with the Department of Social Development, as registration is required in accordance with the Older Persons Act. The certificate of registration should be visible, displayed in a prominent place.
Of course, no home will meet all these requirements and deciding to enter or admit someone else to such a facility is one of the most difficult decisions one can be called on to make. At our regional offices and on our helpline we have staff and volunteers who can support you as you make this decision and any other important decisions that Alzheimer’s challenges us to make.
ACCESSIBILITY OF THE HOME
- Is it close to family and friends?
- Is it close enough to essential community activities e.g. church, shopping centre, hospital?
- Is it in a familiar environment or a new area?
- Will the resident be able to meet his/her spiritual needs at the home?
- Is it a mixed-sex residence?
- Is the property secure and are there visible security staff?
- Can a resident wander around freely and can the resident leave the grounds undetected?
- Is there a security system at the front door?
- Is the home linked to an armed response company?
- Friendliness of staff on your arrival
- Is the interior clean and attractive, with functional and comfortable furniture and decorations?
- Are there bad odours (especially urine)?
- Do the residents appear clean and appropriately dressed for the weather?
- Do the residents seem to be happy and occupied or are they sitting staring into space?
- Did you see staff and residents sitting talking to each other?
- Does the staff appear to be respectful and caring?
- Are there any birds or animals? Are pets allowed to visit?
- Noise – Are the sounds at a normal level and is there soft music playing?
- Is there a lounge with television and one without?
- Are there demarcated smoking and non-smoking areas?
FUNDING OF THE HOME
- Who are the major funders of the home?
- Is it a profit or non-profit organisation?
- Is there any form of financial assistance if frail care is needed or additional care that the residents may not be able to afford?
- Will you be able to afford the fees, possibly for an indefinite period?
- What is the annual increase in fees?
- If you have medical aid/disability cover/insurance, will it cover any of the costs?
- Are there additional costs that are not part of the monthly rate?
- How is ‘pocket money’ handled?
RULES AND REGULATIONS
- Are the rules and regulations made for the benefit of the residents or are they regimented e.g. fixed bedtimes and strictly enforced visiting hours?
- How much is the family involved in the individual managed care programme of the resident?
- Is there a residents’ committee?
- Are there channels for residents’ complaints?
- What means of communication are available to the residents e.g. telephones, facsimiles, e-mail?
- Is there privacy available for telephone calls?
- Is there transport to a hospital, clinic, shops etc?
- Are residents encouraged to remain physically and mentally active and to see to their own needs where possible and suitable?
- Are residents allowed to assist in the chores/activities of the home?
- Are residents called by name by the staff?
- Do residents have a choice of food and quantity? Are second helpings allowed?
- Are residents allowed to be sexually active?
- Own or shared?
- Bath and/or shower that has been adapted to the needs of the older person?
- Is there easy access to the bathroom, for a wheelchair?
FOOD AND KITCHENS
- Is the food of good quality and varied?
- Is provision made for special diets e.g. diabetic, low fat, halaal, kosher etc?
- Are the services of a dietician available?
- Are desserts and fruit part of the regular menu?
- Are there separate areas for food preparation, dishwashing and garbage disposal?
- Are visitors allowed to have meals in the dining room and at what cost?
- Are there ever any special meals e.g. Christmas, birthdays etc?
- Are there regular teatimes, with tea supplied by the home? Is anything served with the tea?
- At what times are the meals served?
- Is the garden easily accessible and available to residents?
- Are more active residents encouraged to assist in the garden?
- Are there benches outside?
- Is there a suitable safe path to walk on, in the garden?
- Are frail residents helped to gain access to the garden?
- Are residents allowed to go out for days/weekends and/or holidays?
- Can visitors come and visit at any time or strictly only at visiting time?
- Is there a private room for visitors?
- Do visitors have to sign in on arrival?
- Are relatives/friends encouraged to participate in the care of the resident?
- There needs to be good staff-resident interaction
- Are there enough caregivers on duty for every shift?
- Is there a Registered Nurse on each shift?
- Does the staff receive on-going training?
- Is there a resident doctor? Are you required to use him or may you use your own?
- What specialist medical services are available e.g. doctor, podiatrist, occupational therapist, physiotherapist?
- Have senior staff and management been trained in institutional management and care of the elderly and frail?
SAFETY AWARENESS, EMERGENCY PROCEDURES
- Is there adequate lighting in the home?
- Are there safety rails in the corridors?
- Are the floor surfaces non-slip?
- Are there easily accessible panic buttons, especially in the bathrooms?
- Is there a disaster plan for evacuating the home?
- Are there visible and accessible fire hydrants?
- Are there smoke alarms?
- Do they have regular fire drills in the home?
- What emergency medical equipment is available on the premises?
- Are there procedures to deal with elder abuse?
- What part does the family play in these procedures?
- Is there a view from the room?
- Is there adequate lighting?
- Is there a problem with damp in the room?
- What personal furniture and belongings are allowed?
- Is it a single or double room?
- Are the rooms shared? What happens if someone does not like the person with whom s/he is sharing?
- Is there an emergency bell in the room?
- Are there enough cupboards and drawers in the room?
- Is the resident allowed to have a kettle, toaster etc in the room?
- Are there enough plug points for bedside light, kettle, hairdryer, radio, TV etc? If not, are adaptors allowed?
WHAT ADDITIONAL SERVICES ARE PROVIDED BY THE HOME?
- Podiatrists (foot care)?
- Hairdressing facilities?
- Tuck shop or canteen?
- Day clinic/examination room?
- Are there activity rooms?
- Is there a regular activity programme?
- Taking into consideration their capabilities, do frail residents receive physical and social stimulation?
- Are residents encouraged to learn new skills?
- Are outside trips, outings or shows arranged?
- Is there any community involvement?
- Does the home use volunteers?
- Is the laundry done on the premises or contracted out?
Compiled by Lindy Smit, Loraine Schirlinger and staff of the national Alzheimers SA office