A wall-sized calendar hanging in the Fox Hollow Independent and Assisted Living Community's foyer lets people know what activities the Bend facility is offering its 70 residents, what meals will be served in its dining hall and when its shuttle bus can take people to the doctor.
It's usually the first thing General Manager Lisa Greer shows people who are searching for a long-term care facility they or their loved ones could call home. Many people are caught off-guard when they make this choice, she said, which is why it's important to know what's out there.
“Our job is to educate them and let them know what their options are," Greer said.
Central Oregon is home to 103 long-term care facilities that have been licensed by the state's Aging and People with Disabilities Service. Experts in this field say picking the right facility requires knowing what's available and who you are trying to help.
“It all depends on what a person needs," said T'Ann Curtis, a case worker and trained options counselor with the Central Oregon Council on Aging.
The Oregon Department of Human Services' Aging and People with Disabilities Service splits the state's almost 3,500 long-term care facilities into four categories that vary depending on the type of care and the environment it provides (see “Long-term care designations," Page B6).
These categories include:
* Adult foster homes, which provide care for up to five residents in a private residence or a homelike setting;
* Residential-care facilities, which provide care to five or more residents in a setting where people may share a room or use a communal bathroom;
* Assisted-living facilities, which provide care to five or more residents in a setting where people have their own apartments, kitchenettes and bathrooms;
* And nursing homes, where people receive 24-hour skilled nursing care in a hospitallike environment.
The APD's licensing agency also gives some facilities, known as memory care units, a special endorsement because their buildings have been designed to provide a safe environment for people with late-stage Alzheimer's disease or dementia and their staff has been trained to meet the needs of this population.
But even long-term care facilities that fall into the same category can vary significantly when it comes to services they provide and the type of people who could comfortably live there, said Bob Weir, APD's advocacy and development manager.
“One type of provider may not feel comfortable performing a certain task, while another provider may feel perfectly capable with it," he said, adding that's why important to know a person's basic needs and whether a facility can meet its before you plan a visit.
One example, Weir says, of how two facilities may differ is their ability to perform a two-person lift.
State law requires any long-term care facility to have at least one person on duty 24 hours a day to help residents with activities, such as getting out of bed or moving from a bed into a wheelchair, but some residents may require two people to help them move. Weir said not every facility — especially smaller ones like adult foster homes — may not have enough staff members to perform these services around the clock. Some facilities may not even accept residents that require a two-person lift because they don't have the personnel needed to get them out of bed in an emergency.
But, he said, adult foster homes may also be better equipped to provide specialized care to people who suffer from dementia or an advanced health problem because they serve fewer residents.
Greer said one of Fox Hollow's selling points is its ability to provide most levels of care. Some residents live by themselves with little or no help, some require hospice services or end-of-life services and another is completely bedridden.
Greer's goal is to make Fox Hollow a place where each resident can stay until he or she die. Every resident has a detailed care plan and pays rent based on his or her level of need. But Greer has turned some people away or referred them to another facility in town, including people whose dementia has reached a point where they may wander or become violent and who need to receive specialized care for their conditions. Some people may also find a better fit someplace else.
Felista Martin, 87, seems like a natural fit for an assisted-living facility like Fox Hollow.
“(My family members) feel better with my care here and I'm happy," said Martin, who moved to Fox Hollow in March 2010 after her children started to worry about some problems she had on her own. Martin's family chose Fox Hollow, and she supported their decision because a friend said, “It was a great place."
Martin said she is the fourth of 12 siblings and is used to living in large groups. But she also wanted her own apartment — a guarantee at an assisted-living facility — because she can sometimes get impatient with people and needs her own space.
Finally, Martin said she wanted to live in a place that had lots of resident-organized events, because “I like to be needed."
And while Greer has dozens of residents, like Martin, who have found the perfect niche at Fox Hollow, she knows the facility isn't for everybody who comes by her front door — not because it cannot meet their needs, but because it may not be exactly what they want.
She said some people may like Whispering Winds Retirement in Bend, for example, better because it has garages they can rent for their cars; they may prefer Touchmark at Bachelor Village's glamorous decor over the down-home, kitschy features that adorn her facility's walls; and they may like the freedom of choosing their own seats at Stone Lodge Retirement Living's dining hall better than being assigned a table at Fox Hollow.
Each reason someone may decide not to pick Fox Hollow for their long-term care needs is also a reason someone else may decide pick it, she said.
Weir said the lifestyle a facility provides its residents can be just as important as its ability to meet their health and personal care needs.
That's why he recommends people ask about these details — especially when it comes to things like the type of meals they or their loves ones want to eat, activities they want to be involved in and how easily they can get to activities the facility may not offer — in addition to their health concerns when they screen facilities, and come up with a list of at least three places they would like to tour (see “Before you decide").
They should pay attention to these concerns when they tour the facility, he said, and if possible eat a meal in its dining room, talk to its staff members and talk to its residents. Curtis, with the Central Oregon Council on Aging, said people should also bring a friend with them on the tour to make sure they don't miss anything when they visit.
“A lot of people have a friend who stayed in long-term care," she said, adding people should also check to see if their friends know somebody who lives at a facility and talk to that person about its quality of life. Many people have picked a facility based solely on a friend's recommendation, she said.
The two experts said people should also check with the state Adult Protective Services program or their local area agency on aging to see whether someone has filed a complaint against it over their care issue (See “Tools that help").
Finally, they should check to see how many spaces the facility has set aside for Medicaid recipients and whether they could qualify for this assistance given their current physical condition or whether their condition gets worse and puts them in a situation where they may need more intense care.
“My first question is do you have a policy for long-term care and what does it cover," Curtis said, adding some long-term care insurance policies place limits on the type of facility they cover and it helps to know these restrictions before a person makes their choice.