Memory care assisted living differs from regular assisted living in the special training required, the nature of the care provided, and the level of acuity. In an assisted living facility, the residents are able to verbalize their needs, manage some of their own needs, and be an advocate for themselves. However, with the dementia patient, many of these abilities are compromised. Before you trust your loved one to any facility that claims to provide memory care, read over this list of things you should look for.
One of the first things you should ask about in a perspective facility of any sort is what training the staff has. Whether it is up to each employee or if the facility hosts training, both have their benefits. In a memory care setting, the staff should all have additional training to prepare them to work with the special population. Continuing education should be required at set intervals, such as quarterly or annually. If you ask to see credentials and training checklists and the facility does not have anything to show or mentions staff meetings as their only avenue for training, it’s time to seek out other options.
A common practice and a real concern for those with cognitive impairments is the use of restraints when they begin to get restless or aggressive. These behaviors are common in those who suffer from dementia due to confusion and the inability to identify or express their needs. While having locked doors in hallways and entrances is common, this helps prevent wandering away from the facility and does not act as a restraint for any one individual.
Ask the staff member who gives you a tour, about the restraint policy and how frequently they are used or in what circumstances they are used. Putting all sides of a hospital bed’s rails up, using Posey belts or locking tray tables on chairs are also considered restraints as it prevents the person in the bed or chair from moving. Overt restraints include soft wrist and ankle restraints and sedating medications.
Some patients may be prescribed haloperidol or Ativan to help control symptoms of anxiety and reduce angry outbursts, but should not be used at staff convenience to keep residents sedated or sleeping. Also, ask about the use of narcotic pain medications, sleep aids, and Benadryl as these are common medications used to sedate people. Ask about the policy for calming or containing a combative or aggressive resident and form your opinions on whether you would feel comfortable with your loved one being subjected to it.
Are they proactive or reactive?
Check to see if the facility has a schedule for the resident’s routines and what is on the staff’s rounding checklists. A quality facility will get residents up, dressed, and assist with personal hygiene before bringing them to the dining room for breakfast. If a facility feeds most of the residents in their rooms or brings residents to breakfast disheveled, continue to look for other facilities.
The memory care assisted living facility should have a rotating schedule for assisting with toileting or checking and changing incontinent residents or residents with assistive devices such as colostomies and foley catheters. No resident should be expected to toilet in their beds or use a bedpan, unless for special circumstances. Residents’ positions and views should constantly be changed, and residents should spend most of the day out of their beds and preferably out of their rooms engaged in activities.
A proactive facility will address the resident’s needs before they are uncomfortable or begin to exhibit signs that they are uncomfortable. A reactive facility will wait until a resident requests assistance and when a person is memory or cognitively impaired, this may manifest as aggression.
A point of contact.
Every assisted living facility should provide families with a point of contact. If you are told that you can always speak to the staff on shift, you should be wary of the facility’s commitment to your loved one. Many facilities will have a designated person to be an advocate and a liaison between staff and families for residents. This can be an admissions person, a volunteer ombudsman, or the facility’s administrator, but you should have a point of contact that you can call for status updates or with questions or concerns, in addition to discussing care with the staff and medical providers.
Stay tuned for the next part of this three-part series. While this is a lot of information, nothing should be overlooked when it comes to someone else taking care of your loved one who cannot advocate for themselves.
When it comes to caring for your loved one who suffers from cognitive deficits, it is important to ensure they are in hands that you can trust. At Serenity Gardens Memory Care Assisted Living Facility, we provide quality memory care in a homelike setting. With 16 resident apartments, our residents become our family. Our transparency and skilled staff will make you feel confident in our ability to care for your loved one. Contact us to schedule a tour of the facility.