Questions to ask when selecting elder care

“Remember that seniors want to hold on to autonomy as long as they can.”

Gwen Harris, geriatric care manager for Seniors at Home

Before partners and adult children can start thinking about which elder care option is the best for a loved one, they need to sit down and ask — and answer — a few difficult questions to help identify critical needs.

Gwen Harris, geriatric care manager for Seniors at Home, an inhome care service from Jewish Family and Children’s Services in San Francisco, recently explained what some of these questions should be.

WHAT ARE MY LOVED ONE’S NEEDS?

One good way to determine a senior’s needs is to see if they can achieve what Harris called the six Activities of Daily Living ( ADLs) independently. In no particular order, these comprise bathing, toileting, transferring ( which means getting from laying position to sitting position and then standing), feeding, walking and dressing.

“You can’t live independently if you can’t do those things for yourself,” Harris said.

She added that another process evaluates the extent to which a senior can perform “instrumental” ADLs independently. These include taking care of finances, phoning a child or 911, scheduling a doctor appointment, managing medication and basic housekeeping.

HOW CLOSELY DO I WANT MY LOVED ONE MONITORED?

According to Harris, families also must ask themselves how often they feel their loved one should be monitored by professionals. If a senior is perfectly healthy, they likely do not need monitoring beyond physical safety. If a senior has health issues, those needs will be different depending on the situation.

“The answer to a question like this will help a family determine how much oneonone care their loved one requires,” she said.

WHAT IS MY BUDGET?

Money is always an important issue, and Harris said it should be among one of the first questions a family asks as it begins to evaluate elder care options for the long haul. In the interest of full disclosure, this proposition isn’t cheap — some facilities can cost upward of $ 6,000 to $ 7,000 a month — or more.

Some prospective residents may qualify for financial assistance or partial payment through Medicaid, longterm care insurance or veterans’ benefits.

“You want to have your finances and budget straightened out before you start a search,” she said.

HOW FAR AWAY SHOULD MY LOVED ONE BE LOCATED?

Just like in real estate, perhaps the most important issue when selecting elder care facilities is location, location, location. Most families want their beloved senior close by, so they don’t have to drive great lengths to visit. For other families, particularly those where maybe relations are a bit icier, exactly the opposite is true — and the distance can act as some sort of buffer.

There are other specific questions that partners and adult children should ask when evaluating facilities. Some of these supplemental queries include things like: What is the stafftopatient ratio? How many other residents are there? To what extent are there restrictions on visitors or the resident leaving the facility? To what extent does the facility offer wraparound services such as estate planning? What specifics are in the contract? What if the arrangement doesn’t work out?

Finally, Harris noted that as families are making these decisions, it’s important for partners and adult children to be kind.

“Remember that seniors want to hold on to autonomy as long as they can,” she said. “Asking good questions is a big part of this process, but it also is just as important to sit back, observe, and give the senior in your life enough room and space to work through this life change peacefully and on their own terms.”