I’d like to say I was oh so clever and strategically chose the ideal location for Mom when I selected her assisted care home. Truth be told, I had a singular, selfish focus – what would be easiest for me in terms of integrating visits and care for Mom into my life.
Finding an ideal location was truly dumb luck
I chose Mom’s care home because it was close to me - a 7-minute drive, unless I hit the red lights on Dundas, which was most of them most of the time. With the lights, the commute stretched to a monumental 9 minutes.
The facility was clean, friendly and her unit had the best view; from the sixth floor, she could see over the neighbourhood houses down to Lake Ontario. Mom’s view, out three big windows and from her little balcony, was green in the summer, ablaze with colour in the fall, magical on snowy winter nights, and bursting with hope in the spring.
Her private, one bedroom unit was comfortable and had all she needed. There was a separate bedroom and bath, a living room for entertaining, a little kitchen for snacks, and a table where most people would dine but she spent endless hours painting.
We brought the furniture she had chosen so carefully over the years and set it up the way she had taught us – position for function first and then to please the eye. We had learned that when you did this, the outcome was almost always useful, comfortable and attractive. Her theory worked perfectly in the new space. It was lovely.
The building itself was incredibly well-thought out. It offered three meals a day in a bright, common dining area. It had a movie theatre, a huge, airy lobby for entertainment and seasonal celebrations, a fitness room, a salon for getting glammed up, a games room to bring people together, a library on each floor for friendly gatherings, cards or change of scenery. There was a health and wellness centre for treating minor ailments and distributing medication for those who needed extra help. In addition to the main dining hall, there was a private dining area, as well as a huge kitchen that had many tables for families to book for large parties, birthdays, or other special occasions. We transformed that kitchen into a gallery that featured 140 of Mom's paintings one snowy day last year.
The care home was nestled in the perfect location – especially as Mom’s health deteriorated.
As time went by, Mom’s care needs grew in number and complexity. Appointments for the elderly are endless – family doctors, emergency room visits, specialist appointments (so many, many specialists!), pharmacists, diagnostic labs….
Luckily for us, the location of the care home I had so carefully chosen (or was it dumb luck?) was within a few blocks of Mom’s family doctor, a pharmacy, a diagnostic lab, a nail salon, and a variety of essential stores (clothes, grocery, Dollar Daze!).
When Mom first moved in, she was quite mobile and independent. She could walk to everything herself. I often found her strolling back from shopping and brimming with stories. Later, she would tell me about the nice people who walked her home because she couldn't remember her way back to the building that was visible across the parking lot.
Much time is spent travelling to and from many locations.
As Mom’s physical and cognitive strength decreased, she needed a walker to get around the building and then a wheelchair for getting to the ever-increasing myriad of appointments.
Travel became significantly more challenging and time-consuming. I think we forget how easy it is to get around when you are young (or at least young-ish). It is much more difficult when you struggle to put on your shoes and coat, walk down long hallways, get in and out of vehicles, and simply find the energy you need to get yourself out the door.
Our most frequent visits were to the hospital. Once again being oh-so-lucky, I could walk there from my house. We spent many hours tracing the path to my street through Mom's hospital window and telling her that although it was actually easier to visit her at the hospital, we’d prefer she stay at the care home. I had no idea when we started our journey that I, who am a directional moron, would become an expert tour guide for other hospital visitors who looked as tired and confused as we did.
People matter.
The services provided by the staff at the care home became more important as time went by. They had to do so much more to keep Mom healthy and safe. And, by luck or otherwise, we had chosen a place where the staff were amazing -- all of them -- from the front desk to the handyman, from dining room servers to the program coordinator, from the nurses and PSWs to the general manager. They were all incredible.
Their support expanded from playing games, going on field trips and serving food to delivering meals to her room and checking her vitals after each hospital visit. Initially, they provided her with medication at the health center and then, as she became unaware of time, in her room. They dialed my number for her when she needed comfort but could no longer dial the phone herself. They called me each time she fell. They called me when she was so upset they could no longer calm her. And, they called me to tell me they’d taken her to the hospital by ambulance and that they would no longer be able to care for her because she now needed more support then they could provide.
I can’t imagine how difficult some of those calls were for them to make and yet they did so with professionalism and positivity. Mom is pretty darn adorable and the affection staff had for her was genuine. I believe they grieved the loss of her as a resident as much as we missed their compassionate care.
I continue to be thankful for the luck that helped me choose such a wonderful place. If I had to select the ideal location now, I would be much more deliberate in my search for what would be best for Mom at the present time in her journey and what she might need in the future.
Lessons Learned
Plan carefully for the future no one wants. Relying on dumb luck and hoping everything will work out when choosing where a vulnerable will live is too important to leave to chance.
It is important to select locations that allow your loved one to be as independent as possible for as long as possible.
The best neighbourhoods for those with dementia are close to all the amenities that are currently needed - and will be essential in the future - as care needs increase.
Medical emergencies, appointments, and unexpected events will happen more often and take more time and energy than you think.
People matter most. Be sure to observe how residents and staff interact with each other as much as you consider the bricks and mortar when selecting a care home.