1. Do not be judgmental about the person's choice of living arrangements.

The care team may not have full knowledge of a person's medical condition. Someone who may appear perfectly healthy to you may have a medical condition that they do not wish to disclose. They may require more medical care than you realize or they may be aware of the need for future care and have made a step to obtain it by moving into a facility.

Also, a person's financial circumstances may dictate where they obtain care. Long-term care is costly, and not all persons have the ability to pay privately. Finally, family circumstances may dictate where the person chooses to live. The person may move across town to be minutes from family members even if this puts them a distance from their former home or church. The most important thing is to support their choice of living arrangements no matter what your own opinion may be.

2. Recognize that the staff cannot give you information about the resident.

When an elderly church member becomes ill or confused, it may seem logical to inquire about their health status by talking to the staff at the facility. Due to HIPAA and other privacy concerns, the staff cannot share the person's medical or personal information with you. Some facilities may not even share what level of care the person is receiving. You should first try to talk with the individual to ask if they are in the facility for a short-term stay for rehabilitation, or if they are there as a permanent resident. They may be willing to share more about their condition with you. If talking with the resident is not possible, try to talk with family members without prying into personal details. If it is not possible to obtain this information, visit the person with an open mind and do not assume you know more about the person's medical condition than you do.

3. Be aware of the policies for visitation of the facility.

Most facilities encourage residents to have visitors. You will most likely be asked to sign in when you enter, and when you leave. You might inquire if visitors are permitted to stay during meal times and how you might join the resident for a meal. Many facilities welcome pets. If the resident enjoys animals, ask what the policies are for bringing in a pet. During flu season, young children may be asked not to visit. Ask before bringing young children to any facility. Do not visit if you yourself are ill, even if you have the "sniffles."

Do not take a resident on an outing without knowing the procedure for doing so. Many facilities will ask that residents sign out when they leave and give an estimated time of return. This is for their safety and should be taken seriously. The different levels of care will likely have different policies which are often tied to state and federal regulations. Staff members can assist you so that you understand the proper procedures. Although you may find a rule silly, the staff and resident may not. Follow the rules of the facility.

4. Be aware of the services the resident should receive from the facility before offering to provide them.

Most facilities offer basic services such as meals, transportation, laundry service and more. If a church member is new to a facility, discuss with them what they can expect from the facility. For example, a resident who has given up driving may worry about how they will get to the doctor. Ask if the facility will provide them with this service. If needed, offer to go with the resident to ask the staff about transportation before agreeing to provide it. It may be better for the facility to transport a resident to a doctor's appointment as they have experience in transporting a person recovering from an illness or surgery. If the resident seems unsure of what services to expect, the care team coordinator might offer to go with the person to meet with facility staff to have the services explained. That can help the care team formulate a plan of care for the person that builds upon services they already receive.

7. Don't be afraid of dementia!

One of the best things a care team can do is to learn how to visit those with memory loss. In the early stages of memory loss, a person may carry on conversations but mix up words or confuse events. Do not try to correct them if they are not bothered. It doesn't matter if they have mixed up their facts. Listen to them, ask simple questions such as "You always wear hats to church, don't you?" As their memory loss progresses, they may not carry on conversation. However, they will remember familiar hymns and Bible passages. You might bring a CD and play old hymns and have them sing with you. You might recite the Lord's Prayer or the twenty-third Psalm with them. Although you may want to keep your visits more brief when a person has memory loss, remember that although they may forget things, that God has not forgotten them.

8. Arrange your visits at a convenient time for the resident.

If you plan to visit, ask the resident or staff if there are scheduled activities that the resident likes to participate in. For example, if the resident likes to play bingo at 1:00 p.m. each day, you might wish to visit at another time. Although some activities may seem trivial to you, they may be very important to the resident. Encourage the person to participate and work around their schedule. Also, for those who may be experiencing memory loss, a familiar routine helps to keep them grounded. If in doubt, ask the staff when a good time to visit might be.

9. Visit, visit, visit! And send mail!

After a person has adjusted to the move to their new home, it can be easy for friends and church members to visit less frequently. But visits matter! The care team should help ensure that there are regular visitors from the church. The care team might also work with the resident's family to plan extra visits if the family is planning a vacation or lives out of town. One mistake churches often make is to plan extra visits during the holidays. While those visits are nice, the resident may already be overwhelmed by visits from family, old friends and special activities taking place at the facility. Try to balance visits over the year, or visit on days such as birthdays or wedding anniversaries when others may not remember to be there.

Everyone likes to receive mail, even if they are unable to read it. Often, mail delivery is the highlight of the day. Send postcards, notes or simple greetings as often as possible.

10. When to advocate for the resident.

Ideally, a resident should be able to advocate for their own needs with the staff of the facility. They should be able to say that they prefer tea to coffee, or that they would like to put on a sweater. However, a care team member may step in for small needs such as this. When a resident is unable to advocate for greater needs, family may step in. The care team should not presume to advocate for a resident on major care related issues. However, if there appears to be a care-related issue that causes the resident distress during a visit, the care team member may ask the resident if they would like assistance.

In the case of an immediate need, such as incontinence, the staff should be notified immediately. If the resident expresses ongoing concerns and is not able to convey them to the staff, the care team coordinator should alert the family to the problem. If there is no one else to advocate for the patient and there is a care-related issue, the care team coordinator should be notified and may consider alerting the staff of the facility.