I can't imagine not having a 24 x 7 registered nurse. In our state, they are the only ones qualified to report certain test results that lesser certification cannot do. The registered nurse fills out the paperwork that is required to go with the person to the emergency room.
Monday to Friday office hours? Ummmm.....I don't mind sales and accounting having Monday through Friday office hours. If there is an emergency or a change in doctor's orders or the ability to return after a hospital/rehab stay, I sure hope that it is more than just Monday-Friday 8-5. When Medicare will no longer pay for the hospital stay, it could happen on a Saturday, Sunday or holiday.
When my Mom came from out of the hospital, we didn't find out that she was being released until 1 pm. By the time we got the medication and all the paperwork, she still didn't show up there until after 4 pm.
I think you need to ask more questions. Ask them what happens if she falls. Who determines whether she can stay or whether she needs to be checked out at the ER. If she temporarily goes to the hospital, can she return back to MC on a Saturday or Sunday or holiday and what is required for her return? Which hospital would they take her to?
A friend of ours as looking for placement for his Mom but her long term care policy required an RN to be on site at all times. There were 2 facilities in town that qualified, both very expensive. She ended up staying in her own apartment. Be careful with longterm care policies. Myself, I would prefer an RN on staff and in the facility most of the time. A lot of the emergencies my Mom had seemed to be nights and evenings. It was reassuring to have an experienced nurse evaluating her.
Give it a LOT of weight, but also check to see if there is an after-hours phone number that correctly connects to that nurse's desk. Many nursing facilities have an overnight nurse, but no way to reach her. Their phone number continues ringing at the front desk, which often closes at 5:00. It wouldn't even let me leave a message. My loved one was suffering from delirium after very serious heart surgery and called me from his cell phone (in his room) eight times in a single night because he was panicked—he didn't know where he was and a lady across the hall kept screaming and making strange noises. I tried to calm him but couldn't. Finally, I got in the car at 3 am and drove 10 miles to the nursing home. I could see the nurse through the window but couldn't get her to notice me. And meanwhile my poor fiance was terrified but didn't call again so I guess he fell asleep. The next day I called the Manager and also out-of-town corporate management to tell them what had happened. They told me it is standard practice not to be able to call the nurse on duty after hours. If this is the case, that policy needs to change! They said the nurse made the rounds twice a night, but she didn't see my fiance and didn't calm his fears. It would have been so easy for me to call her and ask her to go check on him and try to sooth him, if I had had an after-hours number.
Trust but verify. To verify, ask if the services they are boasting are in writing. If not, that’s just hot air. If in writing, you can refer back to it later if nothing is carried out as advertised. One of the places I looked at for my husband bragged that they would assign a caregiver to be with him in the yard whenever he wished to go out. I pressed how that would be possible when one caregiver was responsible for 10-12 patients a day? They didn’t have an answer. I crossed that place off my list pronto.
agree. often there have a "residents handbook" and they may give you a copy ahead of time, before you sign up/ sign contract. Take a look through those details
I wouldn't use the word 'boasts' as this one of the services offered. In my experience, is standard policy - during night time to offer checks - usually twice during the middle-of-the-night shift. To me, it is important. Ask if (as I believe) the employees doing these checks are caregivers, have training working directly with memory care residents.
What you do not want: I (presume) that front office hours might mean a receptionist (which could often be a temporary on call person) is not trained / experienced on caregiving and/or is not a CNA (Certified nursing assistant). They are an office hours person. Unless you mean day time / night shift personnel.
Ask to get in writing a list of their services - and the training and/or certification required to work directly with the residents in memory care.
In my experience, any medical emergency 'after hours' may require them calling 911. During the days, they had / have med techs to manage / assess needs.
I would look first at the Medicare website and see what violations the facility has, any comments and what was done to correct the problem. I would contact the local Health Department and if they do Food Service inspection ask for reports (should be available through Freedom of Information.) I would look at staff retention. I think one of the last concerns I would have is if they have a Nurse on 24/7. The likelihood of needing a Nurse after "normal" hours is slim to none and the ability to call a Nurse or 911 is there.
Have you visited MC facilities? I visited five in my state and NONE had a full-time RN there at all! NOT required by the state. Memory Care is NOT a nursing home. They do not provide medical care, but you can hire medical(and dental for extra money, to come in and perform exams). All they do that is medical is give out prescribed meds. There are major differences between dependent care, memory care, and nursing home care. Hope you know the difference. Good luck.
I sure agree with you, ArtistDaughter, on the Board and Care model. For some it is wonderful. Often fewer people at 6 to 8, often family run and family in feeling, often better caring and better cooking and better all the way around. My friend's Mom was in one and was very happy there.
The best care my mom got was in a very small home facility where the owners lived and cared for the residents. The other caregiver was an RN, who preferred that kind of work to her previous hospital work. She worked 5 days a week and was on call for weekends. There were a couple of part time aides who helped with bathing and cooking. The largest number of residents was 6. When my mom was there they had only 2 residents. Except for the nursing home toward the end, I always chose very small places for her. She and I did not like the corporate feel of many of the larger facilities. The problem with my choices was only that when she had to move from assisted living to memory care and then to nursing home I had a lot of work to do. But I'm still glad she was in smaller home-like facilities. In a memory care, different from the one I mentioned before, the nurse visited each of the 12 residents once a week and was otherwise on call. A dentist and a doctor came to the facility as well. Mom did not have to be taken out for those visits.
These are called Board and Care. Homes where a person rents out rooms and cares for a small group of clients. They do not have medical staff on site. Although for all housing placements, it is necessary / important to ask about their services. Gena / Touch Matters
24/7 RN is nice but you need to know if they evaluate before calling 911 and calling you first for complaints from your loved one. ALSO, it is really important to be able to have a video camera in the room of your mom so you can evaluate her movements and activities. It takes a team and I was very glad when my mom complained of chest pain, she was evaluated by the RN and they called me with the results-which were not indicative of heart issues. My mom has GERD and that is pain in the chest. I told them to give her a peppermint and she was satisfied and went to bed. THE last facility had 24/7 nurses but they did nothing preventative and I HAD to take mom to the hospital to get her evaluated. It was GERD!
The most worrisome thing I have heard over the years is that some LTC insurance policies demand an on site RN. That just doesn't happen. So, will they not cover if there isn't one? Be careful of these policies.
Are companies allowed to change such rules at will? If this requirement did not exist or was not spelled out at the time of contract, can they simply require it now.
Very few ALF or MC have an RN there regularly 9-5 weekdays. Almost all MC do have them on call and frequently visiting and checking things. Otherwise it is usually LPN/LVN and med techs doing the daily oversite, with the DON managing things, sometimes at more than one facility. So this is unusual. And I cannot to be frank, with good med techs and competent staff, imagine why 24/7 onsite would actually be REQUIRED or needed. I can see certain instances when there may be value in assessment of injury and etc. But nothing a trained LVN could not do as well. So were I to be paying a horrific amount increase, I wouldn't set much stock in it and I AM/WAS an RN before retirement.
Things vary WIDELY in MC especially. So the question is one for you to ask each facility you explore. RNs typically ARE present in SNF care.
Some have an LPN on duty at all times . I placed my LO’s in facilities that had a nurse (most often an LPN ) on duty on the unit 24/7. Each of these facilities I used had an RN director in the building during the week 8 hours a day 5 days a week and on call. This RN was not at multiple facilities, therefore she/he knew the residents well .
Not only does a (good ) nurse on duty help to identify and correctly address medical issues and falls , it can also be a deterrent to laziness by the other workers .
I think it’s helpful, also depending on the medical needs of your LO for example, the other weekend I was out of town and on a sat my dad had a red and sore eye. There was debate about having him taken to ER, which would have been a big ordeal , especially without me in town. It turned out in the end to just be an eyelash in the eye. If there was a weekend onsite nurse , the nurse would have figured that out and solved it
Monday to Friday office hours? Ummmm.....I don't mind sales and accounting having Monday through Friday office hours. If there is an emergency or a change in doctor's orders or the ability to return after a hospital/rehab stay, I sure hope that it is more than just Monday-Friday 8-5. When Medicare will no longer pay for the hospital stay, it could happen on a Saturday, Sunday or holiday.
When my Mom came from out of the hospital, we didn't find out that she was being released until 1 pm. By the time we got the medication and all the paperwork, she still didn't show up there until after 4 pm.
I think you need to ask more questions. Ask them what happens if she falls. Who determines whether she can stay or whether she needs to be checked out at the ER. If she temporarily goes to the hospital, can she return back to MC on a Saturday or Sunday or holiday and what is required for her return? Which hospital would they take her to?
This is a strange dilemma....
Just thoughts
Myself, I would prefer an RN on staff and in the facility most of the time. A lot of the emergencies my Mom had seemed to be nights and evenings. It was reassuring to have an experienced nurse evaluating her.
My loved one was suffering from delirium after very serious heart surgery and called me from his cell phone (in his room) eight times in a single night because he was panicked—he didn't know where he was and a lady across the hall kept screaming and making strange noises. I tried to calm him but couldn't. Finally, I got in the car at 3 am and drove 10 miles to the nursing home. I could see the nurse through the window but couldn't get her to notice me. And meanwhile my poor fiance was terrified but didn't call again so I guess he fell asleep. The next day I called the Manager and also out-of-town corporate management to tell them what had happened. They told me it is standard practice not to be able to call the nurse on duty after hours. If this is the case, that policy needs to change! They said the nurse made the rounds twice a night, but she didn't see my fiance and didn't calm his fears. It would have been so easy for me to call her and ask her to go check on him and try to sooth him, if I had had an after-hours number.
sometimes the advertising / "boasts" are not really true.
Eg some AL's say " all day dining". but when you ask for the details, they really really push you to come to eat at specified times.
What you do not want: I (presume) that front office hours might mean a receptionist (which could often be a temporary on call person) is not trained / experienced on caregiving and/or is not a CNA (Certified nursing assistant). They are an office hours person. Unless you mean day time / night shift personnel.
Ask to get in writing a list of their services - and the training and/or certification required to work directly with the residents in memory care.
In my experience, any medical emergency 'after hours' may require them calling 911. During the days, they had / have med techs to manage / assess needs.
Gena / Touch Matters
I would contact the local Health Department and if they do Food Service inspection ask for reports (should be available through Freedom of Information.)
I would look at staff retention.
I think one of the last concerns I would have is if they have a Nurse on 24/7. The likelihood of needing a Nurse after "normal" hours is slim to none and the ability to call a Nurse or 911 is there.
My friend's Mom was in one and was very happy there.
Things vary WIDELY in MC especially.
So the question is one for you to ask each facility you explore.
RNs typically ARE present in SNF care.
for example, the other weekend I was out of town and on a sat my dad had a red and sore eye. There was debate about having him taken to ER, which would have been a big ordeal , especially without me in town. It turned out in the end to just be an eyelash in the eye. If there was a weekend onsite nurse , the nurse would have figured that out and solved it