Shopping for a Nursing Home – Part 2

December 24, 2015

Rehabilitation facilities vary widely and choosing the right one can mean the difference between returning to a full independent lifestyle, or a future much different. Moreover, the patient’s environment plays an important role in how well they rehab, so a visit to the facility should include a top to bottom tour, not just the therapy department.

When you visit, try to schedule it for a time during the day when the gyms are typically most active. In most cases, that will be daytime hours, starting around 9AM and wrapping up between 4 and 5 PM. Don’t be shy about asking any questions that come to mind. Look for smiles on the faces of the patients and the staff and see if you can imagine yourself or your family member thriving there. Does the gym feel vibrant and motivating? Is there upbeat music playing? Does it have an inspirational feel to it? Do you hear a lot of chatter between patients and staff and do you observe enough one-to-one therapy? Patients who have the fullest recovery usually point to the fact that their therapists developed a plan that was tailored to them, so ask the therapist about that.

As you visit facilities, be alert for rehab “factories” that offer nothing more than a static routine of exercises. These “factories” are usually crowded with patients that all look like they are doing the same things. If the therapist seems dis-engaged and most of the residents are doing similar, simple exercises, that should spark a discussion of care plans. All patients should be treated individually. A rehab evaluation should be the first step and from that a customized treatment plan with goals and milestones should be created for each patient. The therapist working with you to create that plan should be considering factors well beyond just the doctor’s prescription. They should look at the patient’s pre-surgical condition or physical abilities before they arrived, their post-surgical condition, individual goals, tolerance for discomfort during therapy, personal attitude and more. Ask to see a personal care plan so you know what to expect, and so the therapist knows what you expect.

Always ask about the extent of therapy. In some facilities, therapy adheres strictly to the doctor’s prescription. Others take a more holistic approach and routinely include modalities to help the patient maintain and improve balance, flexibility, mobility, and muscle tone. Of course you should realize that even if the doctor tells you you’ll be “up and around and walking the halls in five days”, therapists are required by law to adhere to the doctors written prescription, even when the doctor’s written instructions and his or her parting words of encouragement to the patient are not exactly the same. If you already have the doctor’s instructions, share that with the therapist so you will both have a better understanding of what your facility evaluation should cover.

One thing you’re looking for is a therapy department whose operation is not strictly limited to a focus on the immediate injury. Even areas not directly related to your surgery but integral to your recovery should be considered and the patient should be able to participate in developing their own plan of care.

Don’t be shy about asking questions related to the staff’s level of overall experience and time at the facility you are considering. Does there appear to be a high level of staff turnover and is there a good mix of enthusiastic young therapists and experienced leaders?

As you tour the facility, ask about any specific therapies that may impact your loved one’s rehabilitation including occupational therapy, speech therapy, cardiac recovery and stroke rehabilitation. Is there a definite specialty within the therapy department? And make sure you and your loved one both feel comfortable. If English is not your first language, ask if there staffers who are sufficiently fluent in your language. If not, inquire as to how the staff communicates effectively with patients who don’t speak English. If there are staff members who speak your language, ask to meet them and have the conversation in your language.

Before leaving to tour other areas, ask about the hours and days of the week that rehab is provided. Are they open on holidays? Under what circumstances might there be an extended closure of the therapy facility? If the resident is a “morning person”, can they get their rehab work in early, vice-versa?

Most of all, there is no reason to be shy. No questions are off-limits when making a decision as important as this, and that includes feeling free ask a resident how their therapy is progressing, if they like it, and if they recommend the facility. If you’d like to download our Choosing the Right Facility checklist, click here.

Join us next week for Part 3 of Shopping for a Nursing Home, where we’ll discuss what to look for in the accommodations.

Heart. Health. Home.

More Blog