Choosing the Right Group Home Placement
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 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.
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, Location, 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.
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 that 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.
It is important to make sure that the group home meets your unique needs. These needs include items such as wheelchair accessibility, specialized showers and 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.
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.
Ask about activities that they do as a group. It’s important that 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.
What do you think is most important when choosing a group home placement?
© 2014 Martin D Gardner