Choose a safe nursing home
There are several factors
that shed light on the increasing reports of elder abuse
and why care facilities are experiencing such
problems: Nursing home employees are usually paid significantly
less than hospital employees, they are expected to do more
work in a shorter period of time, and are dangerously understaffed.
Given these stressful working conditions, it becomes increasingly
difficult to attract and keep qualified, skilled, adequately
How to evaluate the facility
- First, buy yourself more time. About half of all nursing-home admissions follow at least
a brief hospital stay, where you
may get as little as 24 hours' notice to find a facility.
patient is on Medicare, tell hospital administrators you
want to appeal the discharge. This will automatically
give you two
extra days to check out the nursing homes in your area.
Be sure to use all the resources the acute care hospital
on hand — social
workers, nurses, doctors, administrators — anyone
who is willing to answer your questions and give you information.
- The most important step is to
visit the facility — talk with staff and
the other residents who live there, and observe the living conditions. Notice
if residents seem happy and well cared for. Also, notice if phones ring for long
periods of time without being answered, or if trays are not attended to after
meal time, (indications as to whether the facility is adequately staffed). Too,
you can find recent nursing home inspection reports, research the current staff’s
qualifications and length of employment, etc., and view resident doctors.
- Get the list. Begin your search for a nursing home with
your local Area Agency on Aging, which will give you a list
of nursing homes in your area.
It also will
provide contact information for the local long-term care ombudsman. Ombudsmen
aren't allowed to recommend one facility over another, but if you ask
them specific questions about staffing, continuing problems,
- Look close to home. Once you have a list of facilities,
start with the ones nearest your home. It's not only more
convenient for you, it's also
a guarantee that your charge will be well cared for. That's because nursing
home staffs are keenly aware of the residents who get regular visitors
they don't want any complaints, they tend to bestow just a bit more care
on those patients.
- Pop in unannounced. If your
first visit is during regular business hours, don't make
an appointment — you'll
get a better idea of how the facility is run. Just walk in
and ask for the administrator, who should be on site.
If not, ask
for the next person in charge to show you around. Be sure to ask about
the ratio of caregivers to residents or seek a copy of the
staffing schedule. Do
urine, feces, or other bad odors? Also, pay special attention to corners
and windows: these are often the first places where shoddy
cleaning shows up.
- Go to the bathroom. Any restroom
in the public areas will do. Sure, evaluate the overall
cleanliness — but what
you really want to check out is the hot water, the lack of
which is a common complaint in a lot of nursing homes,
especially larger ones.
- Look for residents. If you see
them in activity areas, dining rooms, and outdoor areas,
that's good. If you see
them being changed, dressed, or toileted,
the facility doesn't value their privacy or dignity. Also, look for restraints
being used on the residents — things like wheelchair trays, vests
that keep patients sitting upright, or other devices that restrict movement.
restraints may be temporarily necessary in a medical emergency, better
nursing homes work to meet residents' needs using restraint-free methods.
- Check out the food and drink. Ask to see the kitchen where
the residents' meals are prepared. A good nursing home will
have no problem with this request.
fact, most will invite you to have a meal in the dining room with the
residents.) Is the kitchen clean? Does it smell good? Are
dry goods properly stored on
shelves off the floor? Ask to see inside the refrigerator. Is the food
covered? Is there
a licensed dietitian on staff? Is there a list of resident food allergies
and dislikes on record? Is fresh drinking water accessible?
- Chase the paper. All long-term care facilities must provide
their most recent state inspection survey (Form 2567). The
report lists the most recent
found by state inspectors. Even the best of nursing homes can have problems
sometimes, so read the report carefully, weigh the severity of each problem,
the administrator about how the infractions have been corrected.
- Come back again and again. Once your charge is admitted,
make sure there is a patient care plan on file. This document,
required for all patients,
an outline of care requirements including dietary needs, medications,
and rehabilitation directives. The most important thing you
can do is to visit
often, to make sure
the patient's care plan is being followed, and to consistently monitor
his or her care.
In short, be vigilant and remember that these facilities are where people
live and they should offer as many home-like amenities as possible. Never
to speak up. It's your right.