selection

What You Don't Know May Hurt You

An Insider's Guide To Retirement Home Selection

If you are about to begin looking for a retirement residence for your parent, don't rush out the door until you are armed with some very powerful information, not only regarding your parent, but about retirement residences in general. With these tools, you will feel more empowered to conduct your search with confidence.

"I have seen so many adult children stressed to the point that they are incapable of making an intelligent, informed decision. Preparing the ground work dilutes a great deal of emotional turmoil"

Write a brief bio of your parent, in point form, for easy reference. Describe current lifestyle, a diagnosis of condition including medications, interests, personality type, language spoken, religious observances, ambulatory devices (walkers, etc), health aides (hearing, oxygen), and dietary preferences. Don't get bogged down in detail; this is a guide to assist you in communicating with future Administrators. The detail comes when you meet with the Director of Care in the Pre-Admission Interview.

Next, more writing. Remember, you are arming yourself for information overload. You want to make a Wish List of two parts: the must haves and it would be nice if.

Must Have: choice of accommodation, cuisine of preference, religious services, location, type of security, hands-on, caring staff, varied activities and outings, visiting privileges. You can choose from any of these examples or devise your own. At this point, try not to make the list so long that you exclude what might be some excellent facilities.

It Would Be Nice: specific activities (euchre, bingo), kitchen facilities in suite, pasta every night, freedom for the resident to come and go at will, allow power scooters in the front lobby. This list will be less rigid than the first, but make sure that you are approaching it from the parental viewpoint, and not your own.

"Regarding 'must have and it would be nice': an active 90 year old moved from one residence to another because his bridge club was cancelled. A 'must' for him, a 'would be nice' for the daughter."

"Absolute needs are pivotal to choice. Your mother uses a wheelchair. You need to ensure that the residence of choice has wheelchair access to all doors. Some facilities do not provide this important feature."

"You have found the perfect residence: close by, elegant in design, and has a caring staff. Your parent could eat pasta every night. The residence never serves it. The other 60 residents won't eat it. As meals are a very important aspect of senior life, this could be a major drawback."

"Location can be of prime importance. Our residence was centrally located, with many conveniences at hand, and easy access to public transportation.

An extremely active 84 year old senior chose our facility for that reason. I would see her at breakfast, and then she was on her way for the rest of the day. The location was in perfect balance with her lifestyle."

Now, the sticky wicket. Have you involved your parent in the above process so far? If not, what is stopping you? Is she experiencing memory loss? Would she be confused by your raising the topic of leaving her home? Are you afraid you will be greeted with stubborn disregard at the suggestion that it is time to live in more secure surroundings? Are there even more personal reasons? Is there sibling conflict in the decision making? Every adult child has to answer these questions individually, and no two families are the same.

You know your parent best, so it is advisable to weigh all the options before wading into troubled waters. For instance, if your parent has occasional confusion, it might be best to have a few facilities in mind first. Then you can present her with photographs and information on the residence that will help ease her mind. If she is unwilling to consider moving, arrange lunch reservations in the main dining room with the administrator, and if she is enjoying herself, stay for a tour.

The important point is that, whenever possible, the parent should be involved in every step of the process. I had a resident whose daughters made every single decision, regardless of how small, without informing their mother. This woman moved from a large house that had been her home for years, into a suite of 3 rooms. Her daughters had even chosen the furniture she would bring. While this might sound like a laudable act on their part, the woman suffered severe disorientation for 2 weeks until we could familiarize her with the building layout, meal times, and activity schedule. This situation needn't have arisen had the daughters brought her to lunch a few times, showed her the new suite each time, and let her contribute to furniture choices.

If you are a novice in this search process, and feeling very much alone, be reassured that you are not. One rich resource to tap is the recommendation of friends, co-workers, and neighbours who are familiar with the process. Your local Community Care Access Centre (CCAC) has access to information regarding retirement residences in your area. See the Health section of your phone book. Every province has a Residential Care Association (in Ontario, The Ontario Residential Care Association, ORCA 1-800-361-7254). Facilities with Association membership must meet criteria developed by the Associations. These associations hold detailed information on all their member facilities. So that you are not overwhelmed with materials, ask them for brochures with residences in a specific county, within 25 miles of your home, or whatever issue is central to your search. Once again, a note of caution: don't narrow your search criteria to the point where you have little or no choice.

And now, perhaps the largest hurdle of all: finances. Who is funding this new lifestyle? Has your parent reserved funds for just this purpose? Would
the proceeds from the sale of a house support the new venture? Maybe you are the one who is paying for everything. Decide on a monthly amount that you can comfortably live with. Review the brochures you've been sent, and discard any that are too far out of your range.

"Prior to meeting me, a client, with a limit of $1800 per month, began taking his mother on tours of high end homes. One place, filled to the rafters with authentic antiques, was where she wanted to live. It cost $4000 per month, and had a 3 year waiting list. Don't do this."

Prices vary throughout the country, of course, but it would be fair to say that the limits are within $1500 and $6000 per month. Scrutinize your brochure material with care. If your parent is in need of a personal assistance programme, is it included in your monthly cost? What services are you getting in your package? Some packages include personal laundry; others will charge up to $16.00 per month. Extra payment for Cable is the norm rather than the exception. Phone lines are always extra. Incontinence products are always extra.

While it is up to the facility to tell you exactly what your payment will be, it is also up to you to get clarity on any cost you find confusing, and to be absolutely honest about your parent's needs in the Pre-Admission Interview.

" A mother and daughter sat in my office, answering my questions. When it came to incontinence management, they both assured me that the mother could manage independently. The day after she moved in, I went to her room to welcome her. The first thing that hit me was the odour; the second was the sight of cartons of pull-ups along one wall. This significant incident altered her care package costs."

It is now time to pick up the phone and ask the facility manager your key questions. "My mother has had a mini-stroke and her speech has been affected. Do you accept people with this condition?" "My father gets around in awheelchair. Is your facility wheel chair accessible?" If you receive negative responses, move on to the next, until you are satisfied that your key concern has been addressed with confidence.

Remember, at this point, you still haven't left the house. You are armed with your parent's bio, your wish list, your budget, and have pared down your choices to a select few. You still have all your energy and can begin to pursue the search from a very positive position.

After settling his father in his suite, a lawyer collapsed in my visitors' chair, and said, "I would rather be involved in a 6 month court case than ever have to go through that again!"

Linda MacDonald, RPN is an independent Retirement Lifestyle Specialist, with
a background in nursing and retirement administration, and can be reached at
lmacdon@sympatico.ca