All memory care centers aren’t created equal. In fact, according to Kansas Advocates for Better Care executive director Mitzi McFatrich, “There are no consistent standards for memory care.”
The takeaway: Finding a trustworthy community can make a significant difference in the quality of life for your aging loved one. Wondering what to be aware of during the selection process? Keep an eye out for these seven red flags while touring prospective memory care centers.
1. It’s unclean.
Cleanliness is critical to both safety and comfort in memory care. In addition to checking the lobby and common areas for cleanliness, ask to tour an occupied room. Is it clean, as well? A strong heavy cleaning chemical smell, however, may indicate an attempt to cover up a problem.
In addition to gathering and living spaces, the cleanliness of the residents themselves is also something to look for. Disheveled or unkempt appearances may reveal poor care.
2. It’s understaffed.
While some staff turnover is to be expected, too much can indicate issues with the culture of a memory care community. Not only that, but as people with dementia often function better with consistent caregiving and consistent routines, excessive turnover can be detrimental in many ways. It can even compromise the health of residents.
"One of the most frequent and insidious signs of neglectful nursing home care is dehydration,” University of Wisconsin School of Medicine and Public Health assistant professor in geriatrics Amy Jo Haavisto Kind tells U.S. News & World Report. “If a nursing home does not have the adequate number of high-quality staff, residents in that home may not receive all of the food or fluids they need to remain hydrated and nutritionally sound. Meals may even be completely missed.”
Staff to resident ratio is also a telling factor. Is the atmosphere more chaotic than calm? Are residents parked in front of the television set while telephones ring and call lights flash? If so, a staffing deficiency may exist.
In addition to paying attention to staff numbers, also inquire about staff qualifications and credentials. Have staff undergone dementia-specific training?
And remember: staff attitudes say a lot. Do staff members acknowledge you? Do they call residents by name and are they patient with them? If they’re rude or ambivalent when you're present, you can be certain they're worse when no one is looking.
Lastly, inquire as to whether the director is on-site and available during your visit.
"I have never seen a place with strong, involved leadership that had bad care," associate dean for research at the University of Wisconsin-Madison's School of Nursing Barbara Bowers tells U.S. News & World Report.
3. There are limited activities for residents.
People with dementia can deteriorate quickly when they’re not engaged. During your visit, inquire about resident activities. Is there enough going on, including at night when many people with dementia are wide awake? Do the residents appear to be thriving? If not, insufficient programming may be to blame.
4. The food is unappetizing.
Fresh, healthy and delicious food is essential to senior health and happiness. Ask to participate in a meal at prospective memory care centers.
In addition to tasting the food, observe the residents. Are they eating their meals and do they appear to be enjoying themselves? Is there enough staff available to help residents during meals? If possible, talk to residents. After all, what better way to learn than through their first-hand experience?
5. Resident safety is not a priority.
Windows with safety locks; smoke detectors in rooms, hallways and common areas; handrails and non-slip materials; and ample lighting are must-haves for resident safety. If a memory care center lacks these basics, it’s a major warning sign.
Additionally, memory care centers should have emergency plans in place, as well as emergency generators for use during power outages.
“If medications are used to treat behavioral symptoms of dementia in place of good care, this may be a form of chemical restraint and is prohibited by Federal law”
Meanwhile, while locked doors may initially appear to be a safety measure, they may do more harm than good.
Explains G. Allen Power, MD, author of Dementia Beyond Drugs: Changing the Culture of Care and Dementia Beyond Disease: Enhancing Well-Being, “The desire to move about freely doesn’t go away just because someone has dementia and is in a nursing home. We need to create a safe environment where people can move freely, but have their needs met so they aren’t compelled to leave due to distress or lack of well-being.”
The same applies to the use of antipsychotics, which are not generally indicated for treating dementia patients.
“If medications are used to treat behavioral symptoms of dementia in place of good care, this may be a form of chemical restraint and is prohibited by Federal law,” cautions the Long Term Care Community Coalition.
A positive sign that a memory care center puts residents first? Their Resident Bill of Rights and state license is on display in the lobby.
6. Your questions aren’t answered.
It’s perfectly fine if staff members can’t answer all of your questions off the top of their heads. However, if your questions are being deflected or remain unanswered, a memory care community may be hiding something.
Continues Kind, "If staff are evasive with your questions, unable to answer your questions, or refuse to discuss your loved one's care with you, this is a big red flag that care may be suboptimal.”
7. Unannounced visits are not welcome.
An unplanned visit may offer very different insights into a memory care center than a scheduled tour. If a prospective memory care center doesn’t allow you to drop by, this is a serious warning sign. The best time to visit? On the weekends or at night when staffing may be low.
One final thing to keep in mind when visiting memory care centers: Even if you can’t pinpoint a precise reason, experts say to go with your gut when vetting memory care centers.
Advises Elisa Gil-Pires, section chief of geriatric medicine and palliative care at Hartford, Connecticut’s Saint Francis Hospital and Medical Center, "Most of these warning signs will be the family member's concern that something is not right, or a feeling of uneasiness when they visit.”
If you’re considering memory care communities for your elderly loved one, we invite you to schedule a visit to our recently renovated memory care neighborhoods at Episcopal Church Home, enjoy a meal in our dining room and talk to our staff. At ECH, we believe each resident deserves to live with dignity and respect, and we’d love for you to see that for yourself.