Making The Right Move

Deciding on a nursing home for oneself or a family member is not simple and should not be done without knowing all the options and risks. Making the Right Move has been written both for seniors considering moving into a care facility and for anyone considering housing options for someone he or she loves.

Acknowledgments viii
Introduction: Making an Informed Choice ix
About This Book ix
Who This Book Is For x
Underlying Principles xii
Language xiii
Aging in place xiii
Definition of health xiv
Client centeredness xiv
Conclusion xiv
Part One: Choosing the Care That Is Right for You 1
Chapter 1: Aging Successfully 3
Making the Choice to Age Successfully 5
Dealing with the Physical Effects of Aging 6
How to enhance your physical well-being 7
Dealing with the Mental Effects of Aging 9
How to enhance your mental well-being 9
Dealing with the Spiritual Effects of Aging 10
How to enhance your spiritual well-being 11
Chapter 2: The Health Care System 13
The Health Care System in the United States 14
The Health Care System in Canada 15
Supportive Health Care Services 20
Case management services 20
In-home support homemaker services 21
Residential care services 22
Shared supportive living services 22
Adult day-care programs 23
Special support services 23
How to Get in Touch with Health Care Services 32
Chapter 3: Assessment Levels 34
Personal Care 35
iii
Intermediate Care Level 1 36
Intermediate Care Level 2 36
Intermediate Care Level 3 (Special Care) 37
Extended Care 39
Special Care 40
The Care Plan 40
Chapter 4: Options for Living Independently 48
Supportive Housing 51
Retirement Villages or Communities 53
Congregate or Subsidized Senior Housing 54
Abbeyfield Housing 55
Home Sharing 57
Granny Flats/Accessory Dwelling Units (ADUs) 58
Smart Houses 58
Program of All-Inclusive Care for the Elderly (PACE) 59
Chapter 5: Supportive Housing Options with Care 60
Family Care/Adult Family Homes 61
Personal Care/Board and Group Homes 61
Assisted Living Facilities/Intermediate Care Homes 63
Skilled Nursing Facilities (US) 64
Special/Dementia Care Unit 64
Extended Care Facilities 66
Specialized Facilities 67
Subacute Care Facilities 67
Private Hospitals 68
Hospice 68
Multilevel Care Facilities/Continuing Care
Retirement Communities (CCRCs) 69
Part Two: Finding the Home That Is Right for You 71
Chapter 6: Getting Quality Care 73
Client-Centered Care 73
Elder-Friendly Environments 76
Accreditation in the United States 79
Accreditation in Canada 81
iv Making the Right Move: Housing Options for Seniors
Chapter 7: Who Will Be Caring for You 83
Administrator 83
Director of Care 84
Registered Nurses 84
Nurse Practitioners 85
Clinical Nurse Specialist 85
Resident Care Aides 86
Dietician 86
Cook 86
Maintenance Director 87
Receptionist 87
Physician 88
Pharmacist 88
Social Worker 88
Recreation Therapist 88
Other Staff 89
Chapter 8: Choosing a Nursing Home 95
How to Use the Questionnaires 96
Location 97
Outdoor Environment 98
Indoor Environment: The Facility 99
Indoor Environment: Individual Rooms 101
Care Aspects 102
Special Care Aspects 105
Questionnaire 1: Choosing a Nursing Home 107
How to Score 118
Chapter 9: How to Rate the Care 119
Accessibility, Type, and Cost of Rooms 119
External Environment 120
Internal Environment: Care Components 121
Meals 121
Physical care 122
Emotional care 123
Services, equipment, and programs 125
Policies 125
Procedures 128
Contents v
Staff policies 131
Questionnaire 2: Rating the Care 133
How to Score 151
Staff Ratios 151
How to Score and Rate the Questionnaires 151
Questionnaire 3: Staff Ratios 152
Chapter 10: How to Be Admitted to a Nursing Home 162
Determining Eligibility 163
Getting on the Wait List 164
Being Admitted 164
Making the Move 165
Settling In 166
Chapter 11: Legal Matters and Decisions 167
Who Will Make Decisions for You If You
Become Incapacitated? 168
Power of Attorney 169
Advance Directives for Health Care 169
Wills 170
Chapter 12: Making Complaints and Dealing with Abuse 172
How to Complain in a Nursing Home 176
Dealing with Elder Abuse 178
Physical abuse 179
Financial abuse 179
Psychological and emotional abuse 179
Sexual abuse 180
Medication abuse 181
Violation of civil and human rights 181
Use of Restraints in Nursing Homes 184
Least-Restraint Policy 185
Choices and Risk 186
Table 1: A Quick Guide to Levels of Care 41
Appendix: Resources 187