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Okay, I'm having problems posting again.    Sections are jamming, or disappearing, so this response is a bit disjointed.

I've gotten lists of home care agencies as well as rehabs from the Alzheimers Assn. and the AAA.  The latter took a whole week to put together a list.  The AA emailed list in generally less than 45 min, sometimes only about 1/2 hour.

I also had a special benefit; one of my nursing friends had worked part time at rehabs while also working full time as a Head Start nurse.   She gave me a lot of good insights.

I'm unclear though whether or not your father will be going to a rehab facility for interim treatment before coming home.   Rehab would definitely be dictated in this situation; it's an interim level of healing before coming home, and it gives you time to then search for home care agencies.   

For rehabs, I eventually learned to inquire about size and diversity of staff, especially speech therapists.   For home care agencies, size can be an issue, as sometimes there were only a few aides in some categories, which could be a problem if one becomes unavailable. 

Contact local rehabs after checking out their websites (but which are always glowing with praise), ask for a tour.  Someone suggested to me that going during mealtime presents an opportunity to see the residents in a dining room, observe interactions between staff and patients, but also to observe post-dining activity and support from the staff.

This could be critical; I interviewed one rehab facility and was overwhelmingly impressed until my father called the next day day and said "GET ME OUT OF HERE!!!"  The positive presentation disappeared when post-meal time revealed a drastic shortage of personnel.    Multiple people eating in their rooms needed bathroom assistance, but an inadequate number of aides were tied up and...well, you can guess the rest.  Not pleasant! 

In addition, he food was totally inedible.  I've never seen anything so gross.   The fish looked and felt like plaster.  I had to bring food from home until I could get Dad moved a few days later.

One question to ask is the ratio of staff (nurses, aides) to patients.  I don't remember for sure what an ideal ratio was, but I think it was no more than 12 patients to a staffer (I also don't remember if that was to a nurse, or an aide).

When you interview, look for activity rooms, patients sitting alone (not a good sign), libraries, nice clean cafeteria, and whatever else you think should be in a good facility.

But do create a checklist of questions, and contact the ones that interest you before selecting one. In my experience choices of rehabs can be heavily influenced by the hospital discharge planners.   After a few rounds of that nonsense, I chose my own rehabs, but I did ask the discharge planner to interview any rehabs that had staff reps at the hospital.  That was how I found what I considered to be the better than average rehabs.  

The reps were professional; we usually spend 1/2 to 3/4 hour discussing what I wanted to discuss.  It's also a good way to learn how a particular rehab represents itself.

In my experience social workers at rehab are charged with assisting caregivers with finding home care, as the next step in recovery.  Typically a few brochures are handed out, reflecting that the agencies are top notch and great for everything.   This is when you have to start researching, calling with a checklist, and making decisions.

The best rehab facility we had sent an OT and PT home with us one day before discharge to review Dad's home and make suggestions on safety issues as well as what to expect from home care.    But there was one home care agency that was tops; it was affiliated with a Catholic hospital in an area known for its quality medical treatment.   I wish every agency were that professional!
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mjp369 Mar 2021
Thank you for your insight! It was very helpful.
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I'm going to post what is in your profile because I think the info is pertinent to how people answer the question:

"My sister and I are caring for our father with the help of in home caregivers. I live an hour away from him, so I can't get there quickly. He is blind and cannot do anything for himself except eat. We are having a hard time trying to deciding what to do next.

He is currently in the hospital to remove fluid from him and we are told he should go into rehab. He has congestive heart failure and is very weak.

We want him to be comfortable and peaceful."

My suggestion would be to join Nextdoor.com for your area, then ask those in your community with first-hand current experience for their input. At least you will know the reviews and ratings are real, and you will get more nuanced insights. Good luck!
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