How to Select a Pay & stay type of Senior Citizens Home?

Introduction

Many Senior Citizens nowadays are forced to move into Old Age Homes. Societal
changes like the break up of joint family system, Children leaving for greener pastures to
earn better, maladjustments between parents and children and so on are some reasons.
Generally the phrase Old Age Home has come mean a home organized by charity or
philanthropies where destitute and the poorest of the poor are provided food and shelter
free of charge. However middle class older persons, though not rich, have their own
means (say pension or savings) to pay for their own routine living expenses, even after
retirement. They seek clean senior care homes with wholesome food and congenial
atmosphere. Thankfully many Pay and Stay type of Senior Citizens Homes (=SCH) have
come in and near big cities in India. Hyderabad is no exception.

When we chat with several senior citizens staying in such SCH we find that not all are
fully satisfied. They face problems such as: inadequate space, dingy surroundings,
unpalatable food, lack of greenery or walking facilities, poor management, lack of
emergency care, arrogant staff and in-house elder abuse, financial frauds etc. Many of
these problems can be avoided if proper care is taken before selecting and settling in any
SCH. As at present the supply is slightly more than demand (many Old age Homes are
underutilized), one can afford to be choosy. Many good, affordable Homes are indeed
available. ASARA, Seniors Helpline (Phone 1253) started recently by GHMC in
Hyderabad gives reliable and quick information on Old age Homes in the areas you
specify. Many problems may be tackled by arming yourself with requisite knowledge to
handle unpleasant situations that may arise after moving in.

This paper attempts to provide help in this direction. Some sane practical advice is given.
Using the information given here, the prospective SCH inmate can compile his own
check list. Sources to gather further information are listed. Experience of inmates of
many SCH has been culled in formulating these guidelines. Let us look into them under
various headings.

Location: The Home must be in a calm pollution free environment. Facilities such as
hospitals, post office, temples, essential supplies, banks/ATMs, browsing centers etc must
be within easily reachable distance. If it is located away from the city, transport facilities
must be available, including emergency transport.

The home must have a prominent Name board showing the sponsor’s name at the
entrance to enable anyone to locate it easily. In the office or in the lobby Rights and
responsibilities of inmates, rules & regulations, Do’s & Don’ts must be displayed.

Design: structural and architectural aspects: The home must be protected sufficiently say
with its own compound wall or by security men. Greenery and walking path add to
comfort of seniors. Rooms must be well ventilated with lot of natural lighting. Bathrooms
must be fitted with supporting bars, anti-skidding flooring, If entire accommodation is not
in the ground floor then ramps or lifts must be available. Steps in the stair case must be of
small height. Guiding rails, good lighting, western type of commodes, instant alarms at
bedside etc are important. Safe Drinking water and adequate water for other needs must
be available.

Sufficient number of bathrooms and toilets must be provided with water facility.
The Home must have separate space for puja, meditation, recreation, dining, sick-room
where sick persons are isolated, visitors lounge, kitchen, library, washing clothes &
vessels, etc. Each inmate must have sufficient leg space and elbow space to live
comfortably and not feel suffocated. Storage shelves for personal belongings, beds with
clean linen are a must. Common furniture / equipments like Fridge, TV, Phone,
Computers, Micro wave oven etc add value. First Aid Kit, stock of emergency medicines,
assistive devices such as walkers, bed pans, magnifying glasses are additional attractions
which do not cost the earth.

The building must also provide safety vaults or other safe place to keep personal jewelry
or important personal belongings of inmates. The building must be safe form fire
accidents, electrical short circuits etc. Adequate firefighting equipment and first aid kits
must be available

Accommodation per-se: The actual place where senior lives, the cot & environs should
be neat & tidy. It must be airy and well ventilated. Certain minimum furniture like a chair
and a Table, cup board for personal things, are expected.

Staff and management:

A coordinator or administrator, cooks, bed-side assistants, security guard and other

helpers are needed. A medical officer hired on part time basis must pay regular visits at
appointed time to check our health related problems if any. Other part time staff on hire
could be a nutritionist, social workers, para-medical staff like auxiliary nurse etc Persons
managing the show need to be trained and qualified for the job. In addition, they need to
have certain special qualities like of serving senior citizens demanding patience,
compassion, understanding and empathy.

If the SCH takes care of bed-ridden elders also then ayahs with training for geriatric care
are needed, besides part time services of qualified nurses. Medical supplies like Oxygen
cylinder, BP apparatus, thermometer, Glucose measuring instruments, and suction
apparatus are all required. Ambulance on call should be arranged.

The office of the coordinator must maintain proper records of Inmates, visitors, assets,
income & expenditure, Staff attendance, Staff payments, Bank accounts, directory of all
important addresses and phone numbers needed in any emergency, Admission Register,
receipts register etc. These must be audited periodically.
The duties and responsibilities of all staff members must be clearly made known to all by
prominently displaying the same in the Notice board or in the Homes bulletin/brochure.

Code of Ethics for staff of SCH:

The staff members must abide by a code of ethics which may be on following lines:

 Staff member must exhibit positive role model as a mature individual by nor
resorting to drinking alcohol, tobacco or taking drugs
 He should not restrict inmates and treat them with dignity
 He should not have any sexual relationship with any inmate
 He should not deny food as a means of punishing an inmate
 He should not restrain or give any corporal punishment when inmates
misbehave.
 If inmate requires external help, refer him to a counselor or some qualified
agency.
 He should not take any photo, or make audio or video recording involving an
inmate without express consent of any inmate

Provision of Food:

Food must be wholesome, nutritious and tasty. It must be hot and served with care and
affection. Regular timings must be maintained. Variety of items served adds to satiation.
The quality & quantity should be commensurate with charges and elder’s requirements.
Dining hall & kitchen should be properly equipped with all crockery cutlery furniture
utensils etc. Washing facilities & drying facilities must be there. Kitchen must be clean
devoid of insects or dirt. Potable water should be available.

The linen must be washed and replaced frequently. A part time dhobi or press-walah may
be employed. Facilities for activities like gardening, puja, yoga, meditation, reading,
indoor games, walking, light games, physical exercises, laughter sessions, periodical
escorted outings to nearby places like cinema, plays, exhibitions, meetings etc may be
arranged as agreed to. Availability of Cable TV, PCs with Internet Connection is
becoming a must these days. Inmates may be encouraged to engage themselves in
productive activities like helping staff in kitchen, garden, shopping etc. Hobbies may be
encouraged.

Restrictions:

Some Old Age Homes place many restrictions on inmates. They may not be allowed to
smoke, drink, eating non-vegetarian food, bring pets, entertain visitors, etc. Enlightened
managements will have fewest of such restrictions. Be aware of restrictions and join only
if you are conceding to abide by them. If the policy of the Home places such restrictions
then you can take it up only if you agree to them. But ant government funded home can
not have restrictions based on caste creed religion etc.
Personal freedom:

Every SCH should allow the inmates to enjoy: Dignity, privacy, choice, and safety,
realization of full potential, equality & diversity. Inmates have a right to be treated with
respect, to enjoy relationship you choose to develop. None can intrude into your privacy.
The staff should strive to provide & protect privacy you need. Inmates should know what
choices you have and be able to make informed choices. You should feel safe and secure.
You should not be exploited based on your vulnerabilities. You should have opportunities
to make the most out of your life in ways you choose. The home should not discriminate
you on the basis of caste creed sex or religion. All are equal before law. There should be
no bullying or harassment on this score.

Before joining:

Prepare your own personal check list of items to look for based on info given above.
Pay a visit to the home and check for yourself about facilities, place, surroundings etc
Taste a sample of routine food provided.
Ask questions and enquire a few inmates.
Get to know the staff, their responsibilities & duties.
Find out the sponsor, funding agency or the body running the home.
Get a copy of written agreement form.
Verify charges to be paid, extras, optional, refund policy for deposits etc.
Is the institution accredited by some agency?
Is it getting grants from government?
Get a copy of the brochure and study it not just peruse it.
Learn about the policy of the Home.

Summary

Foregoing sections have spelt out, though somewhat haphazardly, points to be kept in
mind while selecting and joining an old age home. All of these may not be relevant in the
case of every individual. It is better to know the whole menu of probable expectations
and match as many as possible. As the inmates are paying customers and not living on
charity, it augurs well to know what is to be expected and demand what is due.

Sources for further Information:

1. A directory of Elder Homes in Andhra Pradesh. Published by Federation of AP Senior

Citizens Organizations (FAPSCO), Hyderabad. 2004
2. Asara. Senior Citizens Helpline. Phone 1253 Set up by Greater Hyderabad Municipal
Corporation (GHMC), Hyderabad. and run by HelpAge, Hyderabad.
3. Website: http://societyforservingseniors.satyamcsr.org/sources/shelter This website
gives uptodate info on many Senior citizens homes in AP and rest of India.
4. Manual on minimum standards of services under the integrated programme for
Older Persons. Covers stipulations for Old Age Homes receiving grants and is meant for
the poor who do not pay. Issued by MOSJ, New Delhi.2004.
5. Scottish Executive: National Care Standards: Care Homes for Older People. 2005
(lays down standards for Elder care homes from user’s perspective).
6. Guidelines for establishing Seniors Housing Facility. Prepared by Society for serving
Seniors, Secunderabad. 2007 (Under publication).
===============================================================
(Paper presented by Dr P Vyasamoorthy, President, Society for Serving Seniors,
Secunderabad at National Seminar on Senior Citizen Care – Issues and Strategies held on
1st October 2007 organized by VNR Senior Citizens Home, Hyderabad. The author may
be contacted at: vyasamoorthy@gmail.com or