Choosing the right aged care home for yourself or a loved one must be one of the most difficult and confronting things any of us will ever have to do. Often the move is initiated under pressure and or in a situation fraught with sadness, anxiety and confusion. Even with careful planning, just knowing where to start and what to look for can be challenging. Unfortunately, the process can be made more difficult by the gatekeeping behaviour of staff at some aged care homes.
First impressions are everything – the feel, the look and the smell of the place. But it is very hard to get the feel of an aged care facility if you can’t get through the door to have a look.
It is surprising how many aged care homes ask families to complete a full application, including a direct debit form, before they have even stepped inside the foyer, let alone seen a room. Often, they will only give you a tour of the place if a room is available. Others will have marketing or customer relations staff who march potential residents or their families up and down corridors in near silence, focusing on the price of a room and offering almost no information about the size of the facility, the number of residents, care staff or nurses they employ, or the activities on offer.
Yet this important information can be a deal breaker for whether a person chooses a particular aged care home, particularly when potentially they are asked to part with more than half a million dollars If the move is to be directly from the hospital, families may be asked to apply to six preferred facilities, involving multiple applications and tours for families and individuals, making the prospect of moving even more daunting. So how do you choose? Proximity to family and friends is often a starting point for where to look. Availability of a room and the cost can be important, but if there are any positives in the aged care system, it is that rooms regularly become available and there are a multitude of ways to meet the accommodation and care costs.
Statistically, residential care vacancies are on the rise, so there may be several accommodation options – from grand hotel-like establishments with extra hotel type services, to older, more established facilities with a more homely feel. The outside appearance of what could potentially be your new home will certainly matter to some; but it is what is going on inside that really counts.
The introduction last year of a star ratings system for aged care gives potential residents and their families further insight into the quality and staffing levels of a facility and a further starting point for what they might consider.
Published on the My Aged Care website, the star ratings are based on four key subcategories: residents experience, staffing levels, compliance and quality measures.
A one star rating indicates significant improvement needed, two stars indicates improvement needed, three stars indicates an acceptable quality of care, four stars indicates a good quality of care and a five star rating indicates an excellent quality of care.
However, nothing beats visiting a place; having the opportunity to take in the look, feel and smell. I can accompany individuals and families on visits to three places and they know the minute they walk in the door whether it will be suitable. Organising a tour is a chance to see the rooms and try to picture some of your furniture and personal possessions will look. It also shows you the layout and geography of the place – whether there are any pleasant breakout areas where you or your visitors could sit; whether there is plenty of light; the dining room set up, and whether there is easy access to the outdoors.
A visit to the facility also gives you a chance to see what residents are up to, and whether they look relaxed or well cared for, are well dressed and wearing clean clothes. It also lets you see whether residents are engaged in activities with each other and whether staff are interacting with them. The quality of care must be a top priority, so the questions to ask might include how many carers and registered nurses are in the building at any time over a 24 hour period.
It’s now mandatory to have at least one registered nurse on duty 24/7. Care staff numbers are also vital. Without mandatory staff-to-resident ratios it is hard to get a good grip on this, but it would be a worry not to see any staff during a tour. What is becoming common is for facilities to talk in terms of daily care minutes spent with a resident. Mandatory minimums start this October.
While meal times might be a good time to socialise, not everyone wants to eat every meal with the same people and may prefer to eat in their room. Sometimes, places with smaller dining areas appeal more than the larger ones. Access to outdoor areas, either directly from a room or a common area, may be an important factor. Other people will prefer not to be on ground level, so might look for a balcony to access or furnish. You may be left with a very long list of questions to ask the facility – and hopefully you’ll get truthful answers that will help guide your decisions. It is not uncommon to only get to speak to the marketing or client liaison staff rather than the manager or care team leader, so some answers may need a follow up with the right people.
Additional questions around care may include what level of input a family has in the care plan of an individual, as well as which allied health professionals – such as dieticians, physiotherapists and occupational therapists are available and how often. Another important question might be for the facility to outline the communication process with family when someone is unwell? Visiting podiatrists are common and most places have a hairdresser on site several days a week. Most facilities prefer to get medication delivered from their chemist of choice. Questions around the protocols for infection control are particularly relevant, including what is their plan if COVID-19 or RSV or gastroenteritis does strike their facility?
Aged care is one of those areas most people know little about until they have to. Once you know you need it and enter the aged care system, the questions can be endless – as they should be.