YOU and Your Doctor Are Your Medical Team – February 2023

It is never an easy decision to move a loved one into a care facility. Watching someone lose their ability to live independently can be very difficult. Even when it is clearly the right decision, deciding where the best place for your spouse, family member, etc.. to live is often overwhelming.

We are not in our ’home country’ where we may possibly be familiar with the multitude of  government legal regulations that are imposed on facilities or the agencies governing care  provided in various types of care facilities. The focus of this article is on guidelines only, for things you need to observe, or ask questions about, when visiting a care facility.

To pick the ‘right’ facility, you first need to determine what ‘daily care needs’ the person requires. Knowing what services will be needed will help you focus on those facilities that provide that appropriate level and type of care. Also consider, is the person going to be there for a short time, i.e. recovering from a surgery, short term medical situation, or going to be a long time resident. Essentially there are  4  levels of care  locally:  Independent Living,  Assisted living, skilled / total Long -Term Care and   ”Memory Care”-  most likely long-term care. Although a care facility is not like one’s own home, nonetheless, the feeling of genuine warmth, respect and sincerity should be apparent in the setting.

I have made this a two-part column. This first article will deal with things to observe when  touring a care facility. Part two, next month  will deal with questions to ask during a tour of a potential care facility for your loved one. Most facilities will give a tour with an appointment. I would suggest make at least two visits to a potential facility, at different times of day.

 Things to Observe:  Cleanliness – is it neat and orderly? FYI: a facility should not smell like a disinfectant chemical, nor urine, nor a spray “cover-up scent“. Look at the resident’s appearances – clean, well-groomed i.e. shaved, makeup, hair combed, clean fingernails, wearing appropriate clothes for that time of day – i.e. street clothes in the day time, not in night gowns – PJs in the day time. Are the doors/exits locked -protected for those residents who wander? Does staff check on each resident on a regular basis? Are the grounds level and safe to walk?  Do staff speak [enough] English or [only] Spanish to ex-pat residents? Are there fire extinguishers in the facility? If allowed, [ask permission– be respectful to staff and the resident] speak with a current resident, to see how they are doing / adjusting to their new ‘home’. Or have a polite conversation with a visitor who might be there.   

Making a tour time during a mealtime or social activities provides a good opportunity to observe staff and resident interactions. Speak with some of the staff and see if the residents are treated with dignity and respect. Note the staff-to-resident ratio. Are residents engaged in activities, sitting or walking outdoors, ‘common’ sitting rooms with others, or alone by themselves? If at mealtime, are those who cannot feed themselves, given  assistance by  staff. If you actually see a person being given ‘personal hygiene’ care [in their room, etc..], it may mean privacy is not provided – valued, and resident respect not shown.

This is a big decision for all persons involved, do your research, do not be timid [but polite] to observe and ask questions. Next month– questions to ask; and make notes about and during each of your facility visits.

For more information about Lake Chapala visit:

Jackie Kellum

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