NURSING HOMES

Alzheimer’s Disease facilities have been developed specifically for the Alzheimer’s or dementia patient and are usually excellent facilities.  The environment and all of the services and activities are geared to people who have a form of dementia, specifically Alzheimer’s.  The building itself is set up to facilitate movement and provide safety for their residents.  The environment is very homelike and cheerful.  Each section is usually self-contained but still provides options for the residents to move around freely.  All of the programming is planned to promote socialization and activity of the residents.  These facilities are usually private pay and expensive but worth the cost.  Some may take Public Aid after the person has been there a while and funds have run out. 

Long-term care facilities are usually basic nursing homes.  Some focus on skilled medical care and are considered “acute care” facilities for people who have just been discharged from the hospital and need more intensive care.  Most LTCs offer several levels of care – skilled, intermediate and some still have a sheltered level.  Many LTCs offer custodial care for dementia patients and some have special units.  Many LTCs will accept Public Aid but not all and that is an important question to ask.  Some specify a certain time period before they will accept Public Aid, usually after so many months or years of private pay.  Many times, a patient is discharged from a hospital and is not yet able to take care of themself or needs more rehabilitation.  Nursing homes provide that link to give the person time to more fully recover and receive additional rehab.  Of course, for many, it is their final home because they are no longer able to take care of themselves and family may not be able to do so.

My main bit of advice about choosing a nursing home is to start looking before you need one for your loved one.  Don’t wait until there is a health emergency.  Today, hospital stays are short and you usually don’t get much warning when a parent is being discharged.  When I worked in a nursing home, we had residents come in whom we had to send back to the hospital within 24 hours because they were too sick for the skilled care unit of the nursing home. 

Some other tips for looking at nursing homes:

1. Call and make an appointment with the Admissions Director, don’t just drop in, especially for the first visit.
2. Have a list of questions written down so you can get the answers you need.
3. Go on the tour and especially look at the level of care that is needed.
4. Use all of your senses –
1. smell – there should not be any pervasive unpleasant odors or a strong disinfectant smell (I always wonder what they are trying to cover up.) 
2. sight – are the surroundings attractive, how are people interacting with each other and staff
3. hearing – how are the residents talked to by staff, how does staff talk to each other
4. taste – most homes will allow you to arrange for a sample meal, look at the portions and presentation, what options does the person have if they don’t like the menu selection for the mealtime
5. touch – are the residents being touched appropriately and gently when they are given care.
5. 5. Ask about policy on public aid, stealing, outside visits (yes, some people can leave the nursing home for home visits with family for limited times), visiting hours, family interaction  and notification, restraints, psychotropic medications, amenities, senior’s private funds, etc.
6. 6.  Make a second visit at a different time of day, with or without an appointment.
7. 7.  If your loved one is competent, make every effort to include him or her in the decision if possible.  It will make their adjustment much easier.

WHAT TO DO IF YOU ARE NOT HAPPY WITH THE CARE

Complaints are best handled as calmly and locally as possible.  Don’t start in by hollering and screaming, even though you may feel like it.  You will be considered the “family member from Hell” and that will not solve the problem.  Don’t threaten.  Make sure you are talking to the correct person; someone who can handle the situation.  Yelling at an aide or other staff is not the answer and will only gain you a reputation for being unreasonable.

If you are unhappy with the care that has been given, first approach the nurse in charge of your loved one’s care and discuss the issue with her.  Give her a couple of days to fix the situation.  If you are not satisfied after a few talks, then go to the facility’s administrator.  The Administrator has a vested interest in seeing that proper care is given and that families are happy.

It is a good idea to document what has happened and when and who was responsible.  Write down dates, staff names and exactly what transpired.  It will help you keep your facts straight and add to your credibility.  You may need this information if your complaint is not handled appropriately and you want to make a complaint to the state.  Most states have a regulatory body for nursing homes and an ombudsman program.  Also, state public aid and public health agencies are responsible for investigating any complaints.  Complaints can be made anonymously by phone, but you will need your facts to back up the complaint.

Extended Care        Elder Net    

Medicare        To check on nursing home inspections,
click on nursing home inspections

Consumer Justice Group - Informative site re abuse or neglect/NH complaints