Anonymous wrote:Be aware that assisted living provides very little care. My mom once ended up on the floor of her assisted living apartment for 24 plus hours in extreme pain, with a broken collarbone. Be sure they have a way to regularly check up on residents. Also, look for signs of overmedication (lots of residents parked with open-hanging mouths and blank eyes).

I am so sorry that happened to your mother -- that is appalling! Levels off service must differ between places. At my parents' place, if they don't turn up for a meal, the staff calls or checks on them. They also get meds twice daily and if they don't come to the nurse's station for that, they'd get a call. The other day my dad ordered lunch but left to go to the nurse's station for something, and just went back to his apartment afterwards. Fifteen minutes later one of the dining room staff knocked on the door -- she had his food that they'd kept warm for him. They are also not over-medicating anyone -- once when the doctor prescribed something, the staff requested a conference call with us because they were concerned that that category of medications is sometimes considered chemical restraints and they were not fully comfortable with it.

I'm 00:58. Also re: treats for staff- lots of families bring sweets, so individual bags of salty snacks are appreciated. I always give a popcorn canister at Christmas, per staff request.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:CNA's that seem to be actually engaging the patients. This is job one! The CNAs are on the front lines.
Choose one near your home so you can drop in regularly and provide little special treats for the CNAs whenever you go, or tip on the sly. Don't just show up on weekends.
Those who have regular visitors who are kind to staff get considerably better treatment.
Don't be taken in by a lot of fancy decorating and activity rooms. The CNAs and their attitude is the key.

Please don't tip staff on the sly. At many places, if staff is caught accepting gifts or money from patients/families, they will be fired. That said , treats for everyone are welcome. I do agree though, CNAs are really the most important thing at a SNF. They are way more involved in the patients care than an RN and a bad CNA is really detrimental in this environment

True, but they are seriously underpaid and I'm happy to ignore that rule and tuck a $20 into CNA's pocket when I go. I'm discreet. No one is going to get fired. Why shouldn't I tip the one who takes the time to put lotion on mom's hands and and actually shows interest in what she has to say? I also keep fresh flowers in the room, often cut from my yard or picked up at Trader Joes. As in any home, it brightens the atmosphere.

Because she might get fired if anyone reports it. All the homes I have worked in have posted policies about tipping- it's not acceptable. I'm not a CNA but residents have offered me tips/ tried to stuff them in my pocket. I thank them and decline, and explain that accepting a tip would cause me to lose my license.

I'm sure everyone appreciates your efforts to keep a nice room for your mom, and I'm not saying the CNA doesn't earn the tip. Good and great CNAs are invaluable and hard to come by. I work in a nursing home but also have a family member in a different nursing home. I take the staff treats all the time, because I cannot tip. I can give a holiday gift, which I do every year, to all the CNAs that work with my relative.

Those Medicare ratings are notoriously inaccurate. https://www.nytimes.com/2014/08/25/business/medicare-star-ratings-allow-nursing-homes-to-game-the-system.html?_r=0

Anonymous wrote:Here's a link to Medicare's Nursing Home Compare site, which gives good into.

https://www.medicare.gov/nursinghomecompare/About/What-Is-NHC.html

Here's a link to Medicare's Nursing Home Compare site, which gives good into.

https://www.medicare.gov/nursinghomecompare/About/What-Is-NHC.html

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:CNA's that seem to be actually engaging the patients. This is job one! The CNAs are on the front lines.
Choose one near your home so you can drop in regularly and provide little special treats for the CNAs whenever you go, or tip on the sly. Don't just show up on weekends.
Those who have regular visitors who are kind to staff get considerably better treatment.
Don't be taken in by a lot of fancy decorating and activity rooms. The CNAs and their attitude is the key.

Please don't tip staff on the sly. At many places, if staff is caught accepting gifts or money from patients/families, they will be fired. That said , treats for everyone are welcome. I do agree though, CNAs are really the most important thing at a SNF. They are way more involved in the patients care than an RN and a bad CNA is really detrimental in this environment

True, but they are seriously underpaid and I'm happy to ignore that rule and tuck a $20 into CNA's pocket when I go. I'm discreet. No one is going to get fired. Why shouldn't I tip the one who takes the time to put lotion on mom's hands and and actually shows interest in what she has to say? I also keep fresh flowers in the room, often cut from my yard or picked up at Trader Joes. As in any home, it brightens the atmosphere.

My wife is a nursing home administrator. You have no ea how many CNAs get fired for accepting tips. You are not doing them any favors.

Thank you so much! This is so helpful!

Be aware that assisted living provides very little care. My mom once ended up on the floor of her assisted living apartment for 24 plus hours in extreme pain, with a broken collarbone. Be sure they have a way to regularly check up on residents. Also, look for signs of overmedication (lots of residents parked with open-hanging mouths and blank eyes).

Anonymous wrote:

Anonymous wrote:CNA's that seem to be actually engaging the patients. This is job one! The CNAs are on the front lines.
Choose one near your home so you can drop in regularly and provide little special treats for the CNAs whenever you go, or tip on the sly. Don't just show up on weekends.
Those who have regular visitors who are kind to staff get considerably better treatment.
Don't be taken in by a lot of fancy decorating and activity rooms. The CNAs and their attitude is the key.

Please don't tip staff on the sly. At many places, if staff is caught accepting gifts or money from patients/families, they will be fired. That said , treats for everyone are welcome. I do agree though, CNAs are really the most important thing at a SNF. They are way more involved in the patients care than an RN and a bad CNA is really detrimental in this environment

True, but they are seriously underpaid and I'm happy to ignore that rule and tuck a $20 into CNA's pocket when I go. I'm discreet. No one is going to get fired. Why shouldn't I tip the one who takes the time to put lotion on mom's hands and and actually shows interest in what she has to say? I also keep fresh flowers in the room, often cut from my yard or picked up at Trader Joes. As in any home, it brightens the atmosphere.

If you're looking at a memory unit, make sure there is a security system. Check out the star ratings - they don't tell the whole story, but it's good information to consider. If you can get information about their last state survey, find out about deficiencies.

Besides safety, I'd want to know about the activity program. After all, he's not going to have visitors all the time and CNAs aren't going to hang around and chat - important that they are engaging, as others have said, but they are not there to provide companionship.

Anonymous wrote:CNA's that seem to be actually engaging the patients. This is job one! The CNAs are on the front lines.
Choose one near your home so you can drop in regularly and provide little special treats for the CNAs whenever you go, or tip on the sly. Don't just show up on weekends.
Those who have regular visitors who are kind to staff get considerably better treatment.
Don't be taken in by a lot of fancy decorating and activity rooms. The CNAs and their attitude is the key.

Please don't tip staff on the sly. At many places, if staff is caught accepting gifts or money from patients/families, they will be fired. That said , treats for everyone are welcome. I do agree though, CNAs are really the most important thing at a SNF. They are way more involved in the patients care than an RN and a bad CNA is really detrimental in this environment

Anonymous wrote:Rooms/bathrooms clean and well appointed.
Varied and interesting menu.
Staff actually engaging residents.
Staff working and not hanging around the nurses desk.
Dr.s that come there on a regular basis, i.e. podiatrists.
Weekend staffing vs weekday.

Did I say clean, updated and well staffed?

I second all of this. As for the staff at the nurse's desk, just remember that they have to do charting so they will be at the desk a lot!

Pay attention to night staff ratios. I worked at a SNF while in nursing school and at night there were 2 CNAs and 1 RN for about 40 residents. Wasn't safe and residents did not get the care they deserved. I knew of ones in the area that had one CNA at night.

What are the other residents like? Often times different parts /floors have different levels of patients. If your dad is still oriented and wants companionship, you want to ensure he doesn't wind up on a floor with mostly nonverbal residents.

Room size. It's tough to have a roommate in a small area. If you can afford so, look for a place with a private room option. (you'll have to pay)

CNA's that seem to be actually engaging the patients. This is job one! The CNAs are on the front lines.
Choose one near your home so you can drop in regularly and provide little special treats for the CNAs whenever you go, or tip on the sly. Don't just show up on weekends.
Those who have regular visitors who are kind to staff get considerably better treatment.
Don't be taken in by a lot of fancy decorating and activity rooms. The CNAs and their attitude is the key.

Rooms/bathrooms clean and well appointed.
Varied and interesting menu.
Staff actually engaging residents.
Staff working and not hanging around the nurses desk.
Dr.s that come there on a regular basis, i.e. podiatrists.
Weekend staffing vs weekday.

Did I say clean, updated and well staffed?

I need to tour a memory unit of a nursing home for my Dad. Anyone have suggestions on what to look for or what are some good questions to ask? Thanks!