Achieving Quality Care
By Esther Goldstein, B. Sc, B.S.W., RSW
Relocating your loved one to a care facility is a difficult, stressful and emotional process. Finding the ‘best place’ that can provide quality care for a loved one takes time and tremendous effort. Even then, until they are settled in, worry prevails. Helping them adjust to their new ‘home’ and ensuring the care they receive is good are the main issues of concern once the move has happened.
As a first step, you want to establish a primary person who can be your contact if a problem arises. If there are any concerns, discuss them promptly with facility staff. Be available as much as possible during the settling-in phase.
Keep in mind that change is scary – allow for an adjustment period for both of you. Don’t be afraid to give feedback to staff, and remember that positive feedback is important, too. Often we get so caught up in conveying problems that we forget that everyone needs to hear when they are doing a good job as well.
Take the time to ask questions – speak to the staff when you visit to find out how the person is adjusting and help the staff get to know your loved one. Share important things about them – such as their likes and dislikes, hobbies, etc – that will help in the adjustment process. If cognitive impairment is involved, you may want to pass along some coping strategies that work for you. There are likely several shifts of staff each of whom needs to get to know the person, so you may want to post some information on the wall/room bulletin board or on a side table to help them work with your loved one.
To ensure appropriate care is being provided, it is advisable to take the time, especially during your early visits, to observe interactions between staff and residents to ascertain if residents are treated in a respectful way, and if needs are met promptly and with care and kindness. For example, check your loved one’s clothing when you visit. Is it being washed properly? Is it their clothing as opposed to someone else’s? Are they in clean clothes when you visit?
Speak to your loved one often to find out how things are going. Allow them to talk and listen carefully to what they are saying. In the early days, it might be a bit difficult to determine which issues are related to simply adjusting to a new surrounding and to being in a care facility, and which are due to relevant care issues.
That being said, it’s important not to discount any concerns that are related to care and comfort. To determine how significant the concerns are, you may need to be present a bit more often to observe the situations where there are concerns or to approach staff gently to discuss issues in a non-threatening way. If your loved one is cognitively impaired and not able to convey care issues, ensuring quality care will involve significant observation and discussions with staff.
It’s important to be aware of regulations and residents’ rights in care facilities. If your loved one is in a retirement home, you should become familiar with the Tenant Protection Act.
Take the time, especially during your early visits,
to observe interactions between staff and residents
to ascertain if residents are treated in a
respectful way, and if needs are met promptly
and with care and kindness
If they are in long-term care, learn the applicable governing legislation: in Ontario, there are three – the Nursing Home Act, Homes for the Aged and Rest Homes Act and the Charitable Institutions Act.
The most important factor in determining quality of care in any residence or care situation is that of the staff. The quality of the staff is what separates a good home from a bad one. You can determine this easily if you take the time to watch and listen during your visits.
Watch other residents when you visit. Get to know them, their families and regular visitors, and talk to them. Developing relationships with both staff and residents in the home is important and will ensure that, if there are issues, you are notified of them.
Focus on the food quality, cleanliness and staff attitude. Get to know the routine of the place. Visit at mealtimes, and check the food and menus when possible. Join a Family Council if there is one, or encourage your loved one to join a Residents’ Council if they are able to participate.
If you have the time, participate in activities in the residence. This is a way to help your loved one adjust, while creating opportunities for you to get to know the residents and staff by observing and interacting. Request monthly meetings with staff to review any issues. Attend all meetings that are arranged, and if possible, ensure your loved one participates in these meetings if they are able.
As difficult as the process of relocation is for both the caregiver and the ‘new resident’, it’s important to keep in mind that you are still a caregiver even if you are not doing the ‘tasks’ you were required to do before. The way in which you ‘give care’ may have changed, but your new role is equally important and necessary.
Let your loved one know you are always available for them and will do your best to ensure they receive the best care possible in their new home.
Esther Goldstein, B.Sc., B.S.W., RSW is a former acute care hospital social worker and the author of the “Comprehensive Guide to Retirement Living®” now in its 13th edition. She also administers the affiliated national website www.senioropolis.com and lectures on Eldercare issues in various venues. For further information on this and other topics related to seniors and relocation, visit senioropolis.com.
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