CHOOSE A SKILLED NURSING / BOARD-AND-CARE FACILITY

The differences among retirement communities, convalescent homes and nursing facilities are not always clear to friends or family considering placing a relative. Retirement homes are basically for active people while convalescent hospitals are for those requiring constant medical monitoring. Between those two poles lie numerous offerings in skilled-nursing or board-and-care facilities.

Long-Term Care Ombudsman Services, which keeps listings of board-and-care and skilled-nursing facilities in Orange County, serves as “expressed-wish advocates” as opposed to “best-interest advocates,” said Sally Russell, the organization’s field service coordinator.

“In choosing a facility, we spend a lot of time asking what the resident’s wishes are in the way of their environment and what their needs are in the way of care. We ask what they desire, not tell them what they need.”

DETERMINING FACILITY AND LOCATION

The ombudsman assigned to that area will inquire into the family member’s physical and mental condition to determine the type of residential facility required. Different facilities specialize in particular behavioral problems. Some communities are licensed for non-ambulatory residents.

CHECK THE PUBLIC RECORDS

Residential care is under the supervision of Community Care Licensing, whose representatives go to the facilities, do investigations and write reports. These reports are public information. Ombudsman Services encourages people to be sure to look at the report to gain necessary information. Ombudsman Services itself also publishes a report and maintains a computerized program that records how many visits the community-care licensing department has made and how many deficiencies were reported.

TAKE THE RELATIVE OR FRIEND TO THE FACILITY

This visit avoids moving the relative into a completely new environment and risking a traumatic response. Have the relative take a look at the rooms and sample the food. All facilities must meet the same requirements, but how the food is presented depends on the cook.

Many residential communities in Orange County have six beds, but some people are better suited for larger facilities. “Everybody’s got different preferences,” Russell said. “If you don’t like to be around people you could just stay in the room. Other people prefer a lot of socialization, more close contact, more outings.”

VISIT THE FACILITIES RECOMMENDED BY THE OMBUDSMAN

Facilities are open to the public for inspection. A visit should be made by prospective residents and family in order to talk to administrators, care providers and residents. Visitors should try to get a feel for the personalities to see how congenial the combination.

CHOICES IN THE TYPE OF COSTS

Ombudsman Services will know which facilities accept SSI (Supplemental Security Income) in payment from low-income people living on Social Security. A wider variety of facilities is available to private-pay residents.

TYPES OF FACILITIES

A nursing home (licensed and inspected by the state Department of Health Services) is for patients with chronic conditions who must be monitored and have their medications administered but who are not sick enough to need the services of a hospital. There are two types of nursing homes: the intermediate care facility, which offers eight hours of nursing a day; and the skilled-nursing facility, which provides around-the-clock nursing care.

Board-and-care homes--also known as residential homes or community care facilities (under the supervision of Community Care Licensing, state Department of Social Services)--are designed for people who need assistance in such daily activities as dressing, getting out of bed, eating and getting to and from the doctor’s office but who do not need constant medical monitoring.

SOURCES TO FIND THE RIGHT FACILITIES

Ask for referral from the patient’s doctor or hospital for skilled nursing facilities.

The Long Term Care Ombudsman Service in Santa Ana ((714) 972-2676) is operated by the Orange County Council on Aging. This organization acts as an independent patients’ rights advocate and makes regular unannounced visits to nursing and residential homes. In cases of a complaint, the service investigates and acts as mediator in disagreements between home operators and patients.

The Alzheimer’s Assn. of Orange County has information about facilities and day care. For information, call (714) 283-1111.

The Senior Citizens Information and Referral of Orange County is an extensive networking and support system. For information, call (714) 567-7500. In the western section of the county, call (714) 220-0366; in South County, (714) 768-5615.

Source: Long Term Ombudsman Services