Sunday, January 19, 2014

Elder Care Referral Services: Know What They Know!

Oftentimes, elder care referral services will advertise in hospital waiting rooms, online, television, and even on the side of vans. I know this having done some CNA training at several near my home years ago.

So what is an elder care referral service? When someone is about to be discharged from a hospital, or when they are no longer able to live independently (or at the same level of care to which they were accustomed), these services are supposed to provide an informed choice to seniors.

Based on the information they receive from your loved one or your family, they make recommendations as to facilities that are able to care for your loved one. There are two problems. First, often the referral service hasn’t done their research on the facilities. Second, often they’re basing their recommendations based on incomplete information.

There are several types of facilities that may be able to accomodate your loved one. The facility type often varies based on the level of care your loved one requires.

For example, Nursing Homes are usually able to care for varying levels of dependent individuals. Some simply have some trouble getting around or need a little assitance with washing. Some are completely dependent on others for all of their activities of daily living (ADLs). Adult Family Homes provide a more close-knit care system, with fewer beds and more caregivers per person. However, they lack the large infrastructure and resources of a nursing home. Independent Living Facilities offer activities and meals, but largely let your loved one remain independent in a condominium or apartment style setting.

Most referral services are by no means charitable. They operate to garner a profit. The way they make their profit is generally by receiving the first month’s rent that you pay the facility. This means that the less they spend on research of the facility, the more money they are able to make. So its important to know which questions to ask.


  • Has anyone from the referral service visited the facility?
  • What staff are available to your loved one at the facility?
  • Is there an nurse or doctor onsite or readily available?
  • Are they able to meet the needs of your loved one?
  • What does the facility have in place to prevent pressure ulcers?
  • What training do the caregivers at the facility have?
  • What does the facility do about medications?
  • Has the facility been cited by DSHS?
  • Have their been any lawsuits against the facility?
  • Have their been any actions against licensed staff?
  • What forms of payment do they accept?
  • What are the refund policies?
A lot of these things may seem like they require a lot of time and effort. However, a quick visit and a couple of questions to the facility’s owner can turn up most of the information. Most DSHS websites offer quick and easy public disclosure requests (or even online checks) into licensing and actions against a provider’s license.


The facility should be collecting information from your or your loved one in order to make the right recommendation. A lot of facilities will claim to have “care advisors”, but are solely making their recommendation based on ability to pay and geographic location. However, that is only the tip of the iceberg. In order to properly care for your loved one, they need to know what activities they can and can’t do. Can they brush their teeth, are they incontinent, do they have the potential for skin breakdown and require a higher level of care to prevent pressure ulcers. If the facility cannot meet the care needs of your loved one, they should not recommend that facility.

The referral process does not end there. Once options are given, the family should go check out the facility. Talk to the caregivers, talk to other residents.

Finally, once you choose a facility, visit early and visit often. Stagger the times and days you visit, so you can get an idea of the care that is actually being offered at the facility. If you are not comfortable with the care, move.

It may seem like a lot of work, but taking the time to ensure a proper referral will help to make sure your loved one isn’t exposed to abuse or neglect.

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