Tips for Advocates
When you visit long-term care facilities, use your senses! Put yourself in the resident’s position and ask yourself what you would want or need.
The Resident’s Condition:
- Is the resident’s hair clean and combed?
- Are men shaven? Are women free of facial hair?
- Are nails trimmed and clean?
- Do residents’ teeth look clean (free of plaque)?
- Does the residents’ skin look hydrated and soft, with no cracking, flaking or chapped lips, or hands?
- Are residents wearing clean and appropriate clothing, suited for the temperature?
- Are the residents’ glasses clean?
- Is the resident’s hearing aid in?
- Is wheelchair/walker/cane in good repair and clean?
- Do the residents have on identifying bracelets on?
- Is there use of physical restraints? If a resident is in some form of restraint (lap cushion, bedside rails, waist belt), does s/he seem anxious or upset about it?
- Are residents sitting comfortably in their chairs? (Special wedged cushions can help prevent sliding out of chairs).
- Are residents being helped to walk (if help is needed) in order to get regular exercise?
- Are individuals who are unable to leave their beds being turned every two hours?
- Is there evidence that measures are being taken for them to avoid contractures of knees and hands (e.g., a rubber device gripped in one’s fist)?
The Resident’s Room
- Are call buttons accessible to the residents, wherever they are in their rooms?
- Are needed items (eyeglasses, telephone, and books) within reach?
- Is there fresh (cool or cold) water within reach?
- Are residents’ bedroom and bathroom floors free of spills, grime, and trash?
- Is there a comfortable chair for each resident or a visitor to use?
- Are the places for storage (closet, dresser, and nightstand) in good repair?
- Are the bed linens in good condition (no holes, stains, or worn plastic covers on pillows)?
- Does the resident’s toilet and bathtub or shower have grab bars for safety?
- Is the lighting adequate and soft?
- Is there a clear, unimpeded path that ambulatory residents can take down a given hall, with sturdy handrails?
- Are benches or chairs strategically placed in long hallways for brief rests?
- Is the room temperature comfortable, free of drafts?
The Dining Room(s)
- Is the atmosphere pleasant and relaxed?
- Is the seating comfortable?
- Are many residents present?
- Are many residents present? If a significant number are eating in their rooms, why is that?
- Are appropriate utensils provided (i.e., large-handled/easy-grip forks and spoons, or plates with a plate guard) if needed?
- Is staff providing needed assistance, such as opening milk cartons, or telling visually impaired people what and where food items are on their plates?
- Are residents who need assistance to eat waiting in the dining room for long periods while others eat (whether the food is or is not in front of them)?
- Is there enough staff to assist those who need to be fed?
- Does the staff sit down beside individuals who need to be hand fed and take their time in feeding them?
- Do the residents consume most of the food served to them?
- Are call bells ringing for long periods of time?
- Are residents constantly hollering out? Are they being ignored?
- Is the public address system overused, causing unsettling noise?
- Is a TV or radio blaring with the resident absent from his/her room?
- Is staff speaking or laughing too loudly?
- If music is playing, is it a type that would appeal to the residents?
- Do you hear staff discussing a resident’s personal care or medical condition in a way that violates the person’s privacy?
- Is staff speaking in English when providing care for a resident?
- Do you notice urine, fecal, or other odors that persist?
- Are odorous diaper and laundry bins not being emptied?
- Does the food served smell good, as well as look good?
- Is the menu posted?
- Is there variety in the menu?
- Are the residents served what is shown on the menu?
- Are fresh (versus canned) fruits and vegetables served regularly?
- Are the meals nutritionally balanced?
- Are residents’ hands sticky, dry, and/or chapped?
- Are resident’s possessions or the furniture (e.g. over-bed table) sticky to the touch?
- Are a significant number of residents present at a given activity? If not, why not?
- Are staff or volunteers available to assist in bringing residents to the event?
- Are residents aware of the scheduled activities?
- Is the calendar of events (whether posted or in the newsletter) written in large, legible print?
- Are the activities appropriate for the residents?
- Is the activity leader audible to the participants?
- Are there a variety of opportunities to suit different tastes?
- Do residents say that they enjoy the activities?
- Are activities offered on weekends or in the evenings?
- Are any activities held outdoors?