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What Are Key Questions

to Ask the Staff in Assisted Living Communities to Find Out if They Provide Person-Directed Care?

There is a need to ask more specific questions about person-directed care and what the assisted living community is doing, if anything, with person-directed care. Listed below are some general and specific things to ask and to listen for in the response. These are not the only "correct" responses, but they will give you a general idea of what you might hear that indicates work toward creating home for residents.

  • How do you welcome a new resident?

    Listen for: "We have a welcoming committee made up of residents and staff that makes a new resident feel special – that everyone is so glad he or she is there. For the first few weeks, a welcoming committee „buddy‟ stays in close contact with the new resident making sure that he or she is adjusting well, meeting new people, etc."

  • How will you get to know me/my loved one? (or whoever is the potential resident)

    Listen for: "It is very important for us to really get to know each person who lives here. We have a questionnaire for the resident to fill out that helps us get started. If he or she is not able to do this (because of memory loss, for example), we want you to help us get to know them. Then we will talk with them and spend time together. We learn about their preferences, their past, what they enjoy doing now and their goals and wishes for the future. Everyone on the staff will get to know them when they move in and on an ongoing basis."


  • Do you provide training for your staff on how to provide person-directed care?

    Listen for: "Yes, when we hire staff, our philosophy and practice of person-directed care is emphasized in their orientation and we provide training for our staff on person-directed care and other topics. Staff are evaluated on their ability to provide this level of care and attention."


  • Are residents involved in developing their individualized service plan so it is based on their needs and preferences?

    Listen for: "Each resident (and/or family member if appropriate) participates in the development of the resident‟s service plan to ensure that the specific choices and preferences of the resident form the basis for the plan."


  • For those residents needing personal care, is the same caregiver consistently assigned to them?

    Listen for: "With few exceptions, our caregivers care for the same group of residents each time they come to work." This is called "consistent assignment".


  • How are a resident's sleep and wake times chosen?

    Listen for: "Each resident wakes up and goes to bed whenever he or she wants. Breakfast is available for residents whenever they are ready in the morning."


  • How and when does a resident receive bathing assistance if she or he needs it?

    Listen for: We can accommodate a person‟s lifelong pattern of bathing. For example, if a resident prefers to shower at night before she goes to sleep, we will assist her in doing so. Plus, we understand about the special needs of person with dementia. We have many creative ways to keep people clean, so we can adapt to their preferences and comfort and still maintain cleanliness."


  • What kind of meal service do you offer and do residents have many choices as to what to eat?

    Listen for: "A variety of dining choices exist including restaurant, buffet and family style, according to resident preference. Multiple menu items are available at every meal. There is a monthly meeting to discuss menus and meal planning, which is open to all residents."


  • Can residents have a snack or unscheduled meal 24 hours a day?

    Listen for: "Yes, snacks are available 24 hours a day; there is a refrigerator and cupboards in the dining room/common area that residents can access." In small homes this may be direct kitchen access with assistance as needed.


  • What types of recreational activities are offered here? What if a resident prefers an activity that hasn't been offered in the past?

    Listen for: "Here is this month‟s activities calendar. It is important to us that are activities are meaningful and enjoyable to the individuals who live here. As you can see we have a wide variety of activities and consult our residents regularly to find out what group activities they would like to have and we find out from individual residents what they would like to do whether by themselves or in a group." Look at the types of activities that are on the calendar. Activities should be diverse. Look for opportunities for residents to be: intellectually thoughtful, physically engaged, involved in the local community, intergenerational, looking into politics, learning something new, engaged in conversation, spiritual, etc. Look for activities that provide assistance to do some things that may have become too hard such as sewing club, model train club, gardening.


  • How do you build a sense of community?

    Listen for: "Residents and staff are encouraged to get to know each other and develop relationships. This happens one on one and in groups. There are informal and formal opportunities for residents to get together with other residents, as well as residents and staff to spend time together. Residents are encouraged to maintain ties with the community outside the assisted living community. Family members and friends are welcome to visit and join in on meals, events, celebrations, etc."


  • How do you give those who live here a voice in the decisions about how things are done?

    Listen for: "Residents are part of the team. We have an active Resident Council (Listen for how the council is used) The Resident Council runs their meetings and agenda- staff support them as needed. Town hall meetings and small Neighborhood Council meetings are held with all residents, staff and family members on a weekly basis. In small homes there is a weekly "kitchen chat" or some such event where anything can be brought up (birthdays, events in the community, etc.) so no aspect of life is overlooked."


  • What is the role of family members?

    Listen for: "Family members may visit here any time, volunteer and participate in our activities. Family members can always speak to any member of our staff to discuss their loved one‟s needs and preferences." Some assisted living communities may have Family Councils in which families come together to share ideas and concerns with residents and staff.


  • How do you meet the special needs of people who have some type of memory loss?

    Listen for: "We educate our staff on how to best communicate with people with memory loss. Because we have consistent assignments, staff knows the residents well and can anticipate and meet their needs in flexible, creative ways. We also support and teach staff how to problem-solve difficult situations and how to notice subtle changes in residents‟ responses and function."


  • Do you measure resident satisfaction each year?

    Listen for: "Yes. We measure the satisfaction of our residents by using a survey and by meeting with them in small groups. We use what we learn to make improvements." Ask to see the survey form and ask residents about this.


  • Do you measure family satisfaction each year?

    Listen for: "We measure the satisfaction of our families by using a survey. However, we understand that our "customer" is the person living here." Ask to see the survey form.

    Show up 10 minutes early for the tour and sit and wait patiently and observe general feel of place and environment. Talk to residents and families when you are visiting. Ask them how they feel about the place and if they would recommend it. Remember that if you ask in the presence of a staff person, individuals may fear sharing negative comments and so may give you an inaccurate impression. Ask to see the assisted living community‟s most recent state survey-even if you have already seen it online

    If after the tour, you are sincerely interested in the place, return for an unannounced visit preferably during a meal or scheduled activity. How does the staff handle your surprise visit? Do things look different than they did during the tour? Talk to residents and family members without staff present to find out how they like the place.


  • What to look for during a tour of the assisted living community

    Show up 10 minutes early for the tour and sit and wait patiently and observe general feel of place and environment. Talk to residents and families when you are visiting. Ask them how they feel about the place and if they would recommend it. Remember that if you ask in the presence of a staff person, individuals may fear sharing negative comments and so may give you an inaccurate impression. Ask to see the assisted living community's most recent state survey--even if you have already seen it online.

    If after the tour, you are sincerely interested in the place, return for an unannounced visit preferably during a meal or scheduled activity. How does the staff handle your surprise visit? Do things look different than they did during the tour? Talk to residents and family members without staff present to find out how they like the place.

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