| 1. Are you a Nursing home?
No. We are an assisted living facility.
2. What is the difference between a Nursing
home and an assisted living facility?
Nursing homes provide a more intensive
level of care than an assisted living facility. Nursing
home residents usually have complex medical conditions
that require interventions such as injections, feeding
tubes or restraint. Nursing homes are required to have
nurses around the clock who provide and supervise the
care of their patients. Nursing homes also are oriented
toward a medical model of care, with physicians on staff.
Some nursing homes receive public funding such as Medicare
and Medicaid and most Long Term Care Insurance policies
pay for Nursing home care.
Assisted living facilities provide a less
intensive level of care and, generally, do not subscribe
to the medical model of care. Most Assisted Living Facilities
do not have nurses or physicians on their staff and
provide mainly physical and personal care, such as assistance
with bathing, eating, dressing and toileting. Generally
speaking, any complex medical or nursing care needed
must be performed by an outside agency such as home
health. Some Long Term Care Insurance Policies will
pay for care in an assisted living facility. Many assisted
living facilities have a more home like feeling and some
are actually small homes with just 3 or 4 elderly residents.
3. Does Barton House have Nurses on staff?
Yes. We have a Nurse Manager who manages the
home and oversees the care of each resident. Our nurses will
also work with the resident's physician when minor illnesses
or medication problems arise. The Nurse Manager is usually
available during normal business hours. We also provide basic
first aid.
4. What are your staffing ratios?
During waking hours, our staffing ratios
range from 1 direct care staff for every 4-6 residents.
During sleeping hours, our ratio is 1 awake direct care
staff (and one back up staff who is asleep) for 20 residents.
5. Does Barton House
take care of people with all types of Dementia?
The types of Dementia that we see most frequently
at Barton House are Alzheimer's type and Vascular type. We
will perform pre-admission assessments and evaluations on
individuals with other types of Dementia.
We screen our residents carefully to make sure
that we can provide the level of care that they need
and that they will be a good "fit" with the
other residents at Barton House. We also perform assessments
to ascertain that the potential resident is able to
benefit from the program that we offer.
6. Do you
help residents take their medication?
Absolutely! In fact, we supervise or administer
all of the resident's medication, as we believe that this
aspect of care is dangerous for the residents to cope with
on their own. All resident medication is kept in a locked
medication room in the office.
7. What about over-the-counter
medications, nutritional supplements and herbal remedies?
We will gladly supervise or administer any substance
that the resident's physician prescribes that can be given
through a non-invasive route. We must have a physician's
order for all substances that are supervised or administered.
All substances that we supervise or administer must be labeled
by a pharmacy. Residents are not allowed to keep any type
of medication or other potentially dangerous items/substances
in their room. We cannot give injections, intravenous, or
tube feedings. In many instances some of these types of medications
can be provided at Barton House through a home Health Agency.
8. Can you provide
special diets?
We are able to provide certain modified diets
such as those that would be regularly prepared at home. Those
include but are not limited to: No Added or Concentrated Sugar,
No Added Salt, and certain food allergies such as shellfish.
Our regular diet is specially designed for individuals
with Dementia. It is attractive, flavorful, high calorie,
high fiber, high fat, high nutrient, easily chewable and easy
to eat with limited motor skills.
9. Do you provide
transportation to and from appointments?
Because of our small size, it is difficult for
us to provide transportation for the residents. Only in certain
special circumstances can we provide transportation. The cost
of these services are passed on to the family without any
mark-up. In the event of an emergency we call EMS or another
ambulance service to transport the resident to an appropriate
medical facility.
10. Do you take
the residents on field trips?
Because of the nature of dementia and the
limitations that our residents have, we believe that
to safely provide field trips we would have to have
one staff for each resident once we left the facility.
Many times, although the residents express the desire
to leave the facility, once the leave, they feel insecure,
anxious and uncomfortable. For these reasons we have
yet to have any facility sponsored field trips. Instead,
we try to bring the community to Barton House through
presentations, volunteers and other visitors.
11. When does
the resident have to leave Barton House and go to another
type of facility like a Nursing home? The simple answer to this question is "when
we can no longer provide the level of care that the
resident needs." This decision is difficult to
make in some situations. We work with the family in
deciding when a resident needs to be moved, either temporarily
or permanently, to a more appropriate level of
care. An acute medical crisis, (such as stroke or heart
attack) necessitates an immediate resident transfer.
12. What type
of Activity Program do you provide?
Because individuals with Dementia need routine
and structure, our Activity Program is designed to structure
the residents day from the time that they arise throughout
the day, until they go to bed. The Activity Program is designed
to accentuate our residents' strengths and minimize their
disabilities. We incorporate hygiene and activities of daily
living into the program. The activities are designed to stimulate
cognition, movement, communication and socialization.
13. Are the residents allowed to have
pets?
Yes, we allow pets at Barton House as long
as the pet is not too large, and house trained. Each
house has a dog that belongs to everyone. Barton House
has a dog that is found to be therapeutic for our residents.
14. May I drop in
for a tour?
We prefer to provide tours by appointment
only. Our residents find tours during certain times
of the day to be disruptive. We have several requests
for tours each day and to honor all of these requests
is not conducive to a calm environment. We believe that
Barton House is the residents' home and they should
not feel like they are on display.
15. When can I visit?
We have no set visiting hours. Families are welcome
at any time of the day or night. In fact, some of our families
from out of town spend the night in the house when we have
room. We strongly encourage the families to be involved in
the resident's life. It gives the residents continuity.
Families are also welcome to have meals with the
residents, free of charge. We ask that you give us a few hours
notice so that our kitchen staff can make sure there is enough
food for everyone.
The residents may leave with family any time the
family wants to take them out. We do ask that you sign them
out and back in and let on of the staff know you are leaving
with them so that we are sure where they are. We do not allow
residents to leave unaccompanied. We will not let a resident
leave with someone that we are unfamiliar with unless we first
obtain permission from the family.
16. What services
are not covered by the rent?
Generally speaking, the services that are not
covered are services that are not required by all residents
or special products that are individual to each resident.
Examples of these are: Beauty Shop services, incontinence
products, medications, doctor visits, in room phone and cable
service, walkers, canes and other assistive devices.
17. What kinds
of behaviors are your staff capable of handling?
We are equipped to work with individuals who display
most of the common (and not so common) behaviors associated
with Alzheimer's Disease and dementia. Behaviors such
as hoarding, "shopping", wandering, paranoia,
hiding objects, confusion and disorientation, reluctance
to bathe, difficulty dressing, layering of clothing,
problems with toileting, agitation, anger, frustration,
difficulty with mobility, problems with eating, withdrawal
and exit seeking are all behaviors that we expect to
see in our residents. We try to "normalize"
these behaviors an when they become problematic in our
"normalized" environment we brainstorm and
try to use creative interventions to lessen the impact
of the behavior on the other residents, the environment
and the staff.
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18.
What behaviors are you incapable of dealing with?
Physical aggression is very difficult for
us to deal with successfully in our environment. If
a resident is dangerous to himself or others we will
try behavioral intervention first, then use medication
when it is ordered. If neither of these interventions
is successful, or if the resident's aggression is extreme,
we will ask that the resident be placed in an environment
either temporarily or permanently that is more capable
of intervening with such physical aggression.
Repeated verbal aggression or abuse is also
a behavior that is difficult for us to work with as
it makes the environment difficult for all who are present.
When another resident is the object of the aggression
or abuse, and the abuse is not controlable with behavioral
intervention or medication, we ask that the resident
be placed in a more appropriate setting.
We only use psychoactive medications as
a last resort for dealing with resident's problem behaviors.
In most cases we will try every other independent intervention
possible before giving medication to a resident to control
behavior.
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