By Nancy Mace

Philosophy and Criteria for Admission to the Unit

One of the first things for a family to decide is if a dedicated special care dementia unit would be right for their loved one. A unit is only "special" if it offers a service that is "special" and needed by their family member. Preadmission assessments should include the family's imput regarding the patient's ability level. Management of difficult behaviors should be possible without the use of restraints. Matters like cost, unit security and medical services available may not seem important now, but will have long range importance to the family.

* How does unit care differ from care in the regular facility? [Request written materials from the facility relative to philosophy of care, services provided for dementia patients and cost per day. Ask what this charge includes and are there additional costs?]

* Does the Unit accept Medicaid?

* What is the unit's policy regarding medical and physical restraints? [Federal law requires that the facility use the least amount of medical and physical restraints possible to insure the resident's quality of life.]

* How often does the staff monitor the necessary restraints?

* What type of security system is used in the unit?

* Are there special policies written for the unit residents?

* Are medical specialists available to serve residents in the unit?

* Are skilled rehabilitation services available in the unit?

* Can resident's private physicians be retained in the facility?

* Does the facility do a pre-admission assessment personally or by the telephone?

Family Related Area

* Is the resident allowed personal items to furnish his/her room?

* What is the policy on home visits outside of the unit?

* Is there a policy on family visits within the unit?

* Is there a quiet, private area for residents to entertain visitors?

Staffing on units varies greatly. There should be enough staff on day and evening shifts so that residents can be assisted to do tasks for themselves rather than have the tasks done for them. Ongoing dementia behavior training is essential to the staff and residents. Activities are vital for a good unit. These activities should support remaining abilities, minimize failure, enhance dignity and enable pleasure. A beautiful environment does not necessarily insure quality care for the resident.

Services of the Facility

* Is the environment clean [odor free], comfortable, and well lit?

* How many people as staff are scheduled on each shift?

* How is the staff selected and trained for the unit?

* Is there an ongoing training program for the staff working on the unit?

* Do the residents seem to interact well with the staff?

* Does the staff appear to display respect to the residents?

* What is the availability of the beauty salon and barber shop for residents?

* How often are snacks made available with finger foods offered for self feeding?

* Are activities personalized and what are some examples?

* Who plans and carries out the activity program and what are some examples of personalized activities?

* What pharmacy does the nursing home use?

* Are unit residents included in social outings?

* Is there a courtyard connected to the unit for the residents and how is it monitored?

* Are the residents allowed to go out of the unit to take part in facility activities?

* Is smoking allowed and supervised?

Selecting a nursing home for your loved one is difficult. Below are several tips you might want to consider before the final decision is made.

* Make an appointment for formal tour of the facility with the unit director.

* Return to the facility at a different time of day and make an informal tour.

* Consider the location of the facility in relationship to that of the family.

* Talk to families with residents currently in the unit.


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