Moving a loved one into a group home can be a stressful experience. I have found that the parents/caregivers often experience more stress during this transition than the individual that is actually moving into the group home. The choice to move someone into a group home can stem from a variety of circumstances. The most common reason from my experience is that the parents have reached an age where they can no longer provide adequate care due to their age and/or medical conditions. Some parents make the decision based on behavioral difficulties or medical needs that they can no longer handle.
The Role of Case Managers
No matter what the reason, the decision to place a family
member in a group home is a stressful and scary time. Families often have
limited knowledge of the disability system and have difficulty determining
which group home is best for them. That’s when the case manager or service
coordinator becomes a key component in the process. Although the choice is
ultimately up to the client and the family, the case manager can offer
suggestions based on their experience. I will discuss some of the most
important issues families should take into consideration when choosing a group
home. This is by no means an all-inclusive list.
Location
Just like any of us looking for a new home, location is very
important. Many prefer a location close to family so they can be available to
come by in an emergency. Some may prefer a location close to the nearest
hospital. It also makes a difference if the home is located in a more private
location such as a cul-de-sac (dead end) as opposed to a location near a busy
street. This definitely makes a difference if there is a tendency to run off or
wander from the residence.
Staff Experience
Don’t be afraid to ask questions regarding the experience of
the staff providing care. All staff should be certified in CPR and First Aid.
They should also be certified in medication administration. Staff should
also be certified in approved behavioral management techniques and be able to
respond appropriately during a crisis.
Staff to client ratio is also important. This is an area
where many group homes tend to cut corners in order to save money. A home with
limited staff is just a disaster waiting to happen. A medical emergency or a
physically aggressive client with limited staff can lead to an inadequate level
of care or result in serious injuries to staff and clients. Inadequate staffing
can also result in citations from the licensing board. Speaking of licensure,
many states provide public access to provider violations on the internet. It
never hurts to check for violations. A violation or citation does not
necessarily mean that they provide poor service. Of course, it all depends on
the type of violation.
Accommodations
It is important to make sure that the group home meets your
unique needs. These needs include items such as wheelchair accessibility,
specialized showers, safety bars, and stair lifts. Other special considerations
are bedrooms on the first floor for those who have difficulty moving around. I
also favor homes that have multiple master bedrooms. This allows more residents
to have privacy instead of sharing a bathroom with other residents. After all,
this is their personal space.
I also emphasize privacy when it comes to bedrooms. One of
my personal pet peeves is when group homes want to have two adults in one
bedroom. Anyone over the age of 18 should not have to share a room in a private
residence (just my opinion). This is especially the case if the resident is
paying $500-$700 a month on average for rent. When I see this, the first thing
that comes to mind is that this home is putting money over quality of care.
Other Residents
It’s also important that there is a good match with the
other residents that live in the home. Most of the families I work with prefer
homes where all of the residents are the same gender. Some homes offer co-ed or
mixed-gender homes, but they tend to be rare due to the obvious liability
involved. In my opinion, it’s a better idea to have a home with all females and
one with all males. If the agency is only going to have one home, they should
make a decision one way or another.
Personality differences are important as well. It’s always a
good idea to make sure that the new resident will be able to get along with the
other established residents. Some agencies have different group homes based on
behaviors and medical issues. In this case, staff that have more expertise in
behavior management can work with residents with challenging behaviors, while
staff that have more experience with the medically fragile can provide more
specialized support for those with more extensive medical needs.
Community Integration
Ask about activities that they do as a group. It’s important that the residents are doing more than just sitting around watching television. The goal is to help residents work on independent living skills and community integration. It’s also a good idea to inquire about their ability to accommodate individual activities. Some people like to go to church or other activities during the week that are separate from the other residents. Agencies should be taking a person-centered approach to assist people with achieving their goals as much as possible.
These suggestions are just some of the major areas I examine when I’m helping families through the selection process. This is a major decision and is often the first time away from family for any extended period of time. As service coordinators, it’s our responsibility to give families as many options as possible to they can make the most informed choice. New group homes seem to be opening up every year and it’s important that we as experienced clinicians help them sift through a complicated and an increasingly competitive disability system.