The challenge of choosing a long- term care facility
Families must figure out needs of their loved one, then research homes to find best fit — all while coping with the shock of the disease
It can be nerve- racking to choose one of the 28 long- term care homes in the Ottawa area. To help families make the choice, the Alzheimer Society, with several other health care agencies, has set up the Partnership in Transitional Care. Through workshops, this pilot project has been designed to help families choose long- term care and prepare for the transition.
The Ottawa Community Care Access Centre helps families decide what their relative’s care needs are, and when or if to put them on the waiting list. A caseworker from the CCAC will help determine whether a person is eligible for long- term care. That designation would mean they need nursing care or supervision 24 hours a day, along with daily assistance with activities such as grooming, bathing, nutrition and orientation; or he or she is at risk of emotional, financial or physical abuse at home; or is a risk to other people in their current residence.
If a caseworker determines the patient is a “ Category 1,” meaning in an emergency situation, he or she would get a bed as soon as it is available, in any long- term care home. In Category 2, the patient is expected to need a long- term care bed within three to six months. The person is placed on a waiting list for up to three nursing homes of their choice; when they are offered a spot in one of those homes, they have to accept or face a wait of six months before starting the process all over again. Category 3 means the need for a long- term care bed is not imminent.
There is some flexibility even within the categories because the disease progresses differently for each person. Also, the caregiver figures into the equation, as it did with Barbara Schulman’s mother, Viola. Because Ms. Schulman could not always be there to see that her mom did not make the toilet overflow by stuffing objects in it, her mom got moved up to Category 1.
“ We had no choice because she really couldn’t stay in her apartment anymore,” she said. Making the decision to move into a home was “ heartwrenching” for Ms. Schulman, but, after some difficulty settling in, her mother “ adapted extremely well.”
Once a person is designated a Category 2 patient, their family must face the challenge of selecting a home.
The Partnership in Transitional Care has prepared a four- page guide that helps in the comparison of homes by providing a series of questions relatives can ask. It covers topics such as the quality of the residents’ rooms, training of caregivers, and the availability and quality of programs and activities.
A workshop called “ Preparing for the Move” helps families deal with feelings around putting a loved one in long- term care, as well as the logistics of making the move. It provides them with a checklist to get ready.
“ It is definitely one of the hardest things that someone will ever have to do in their life,” says Ms. Marg Eisner, director of programs and services for the Alzheimer Society of Ottawa.