In Part 1 of the articles on Nursing Home Choices, we discussed some of the helpful websites available to assist you in your search. There are two others worth mentioning, as all contain useful aspects, and differ somewhat from the other sites mentioned in Part 1.
4. National Citizen’s Coalition for Nursing Home Reform Website: http://www.nccnhr.org
5. Medicare (Nursing Home Compare)
We mentioned that doing your “field work” of visiting the nursing facilities or sending a professional to check them out for you in person is essential. Nursing homes are a place of last resort for many of the people who live in them. They need too much care for family members to manage, they have no family, or they are without adequate funds to choose any other assisted living option. A nursing home does not have to be dismal. Many administrators make a serious effort to provide a clean and safe environment for their senior residents. However, the federal and state programs of Medicare and Medicaid, which cover some care for certain times by regulation, are not enough for the nursing homes to provide many amenities or luxuries for anyone. The focus is on the care that must be delivered to the sickest persons there. The less ill, who need what is referred to as “custodial care”, meaning non-nursing things like bathing, dressing toileting and feeding, may often receive less attention than those more ill.
The family, if there is family, will have to do their best to insure the quality of life that is possible under the circumstances of living in a nursing facility. The staff may be overburdened, and poorly paid. Nursing homes have a notoriously high turnover rate of employees. Risks are many, particularly with safety. Family members who are trying to do their best by their aging elders who stay in nursing homes must take on the task of being watchful, as often as possible. Ideally, this involves a visit every day for at least an hour. If this is not possible, it is important to visit as often as you can.
Choose a nursing home close to you, if you are able to do so. The burden of visiting often is lessened by having your loved one close to your home. Your stress level counts! Consider your needs in the decision-making process too. You may be responsible for a great deal of business and work when your loved one enters a nursing home, and if you and any siblings can share it, all the better.
Finally, watch for danger signs in any nursing home you are considering. Large numbers of wheelchairs in the hallway with no one attending to the residents in them is a bad sign. Heavy odors, no one at the nursing station, and wandering residents who are not dressed except in hospital gowns are other signs of trouble. Make an unannounced visit to explore a nursing home you may be considering. Visit at mealtimes. You will learn a lot by observing, using a checklist from one of the websites listed in these articles, and by taking the time to plan ahead.
©2008 Carolyn L. Rosenblatt, R. N., Attorney at Law
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