- Your elderly relative requires and demands twenty four hour of continuous care and attention.

- Your elderly relative can not anymore cope up with the activities of day-to-day living such as eating, bathing, using the toilet, changing etc.

- Your elderly relative is more likely to have either physical or verbal violent out burst and is a threat to himself and to others.

- Your elderly relative has wandered off from the safety of home.

- The caregiver's physical condition and welfare is harmfully affected.

Q. What out of home choices for the elderly are available?

A. A variety of choices are available, and it is an important decision, so choose wisely.

1. Residential care facility.

For the elderly that is no longer able to live alone however does not require skilled nursing attention and care. Assistance is given in grooming, bathing and other daily activity as well as care and supervision for temporary illness.

2. Assisted living facility.

Granting independence to the elderly who are moderately healthy and active. An impaired spouse and a healthy spouse may live together in an assisted living facility, where most include apartment style of living with separate kitchens, twenty for hour security, social and recreational programs.

3. Skilled nursing facility.

Also known as nursing homes, wherein patients are given continuous nursing services and assistance from a licensed vocational or registered nurse. Skilled nursing facility provides extensive and broad services and help, such as medication, injections and constant monitoring of blood pressure as well as support for patients with ventilators. Compared to residential care facility and assisted living facility, skilled nursing facility provides the much needed medical care of patients.

4. Others. There are special care centers that offer and give special attention to certain medical conditions like dementia or Alzheimer's disease. Psychiatric facilities are an option for the elderly that displays violent behaviors.

Q. What qualifications should I look for in a primary care physician?

A. A primary care physician should be competent, well trained and has concern for and about the elderly. Ask these questions to guide you in choosing the right one for your relative:

- Does the physician practice as part of a group or does he practice on his own?

- Does the physician accept patients with Medicare?

- Is the physician's clinic accessible from where you live?

- Are you comfortable with him?

- Where does he treat his patients? At which hospital?

- Can he explain to you things clearly? Can you easily understand his explanations?

- Does he readily listen to you and to his patient?

- Does he show concern when communicating with you?

- What is his policy and guidelines about following up patients with regards to patients that has moved to a residential care center?

Q. What should I consider when choosing an elder care facility?

A. Carefully consider the following areas: services, facility, staff, rooms, respect, and medical considerations

1. Services

- What are the care services that the facility provide? Do these satisfy your needs?

- What accommodation choices do they offer?

- What items from your home can you bring in the facility? What items are not allowed?

- Can you have your own car on the grounds?

- What are their policy regarding visitation?

- Is it licensed by the State?

- Is there a balance of social and recreational activities?

2. Facility:

- Is it well kept and sanitary?

- Are the safety measures such as fire exits should be clearly marked, hallways should be well-lighted and bathrooms should have grip bars appropriately set up?

- Is it located in a convenient and safe location?

- Does it have a twenty four hour security?

3. Staff:

- Are they friendly, approachable and respectful?

- How many are assigned per shift?

- What are the staff's credentials?

- What medical services (physician, physical therapist, nursing, respiratory care, etc.) do they specialize in?

4. Rooms:

- Are the rooms bright and airy? Are they arranged in a cheerful manner?

- Does it permit privacy?

- Does the room offer a view? Does it have wide windows?

- Is the dining room clean and spacious, in such a way that one can move around easily?

- Is the kitchen clean, organized and sanitary?

5. Respect:

- Does the facility clearly state the rights and responsibilities of patients?

- Are the staff well trained, so as they treat each elder with respect and dignity?

- With regards to the patient's care plan, do they encourage family members to get involved?

6. Medical considerations:

- When emergency arises, is there always a physician available?

- Is the personal physician of the elder permitted to follow up the patient or does the facility appoint a resident physician to each elder?

- In cases of emergency, does the facility have arrangements with a hospital nearby?

- Is there always transportation that is available at all times?

Now you are prepared to plan out the elder care for yourself or a relative! I hope you have found this article useful.