A Guide To Elder Care Choices

Nursing Homes – A Difficult (But Important) Choice

Author: gmanty

Luckily, I am blessed with independent parents who are in excellent health.  My father is turning 70 this July and my mother is only a few years behind (sorry to blow your secret, mom!)  While they could both stand to lose a little weight and get a bit more active, they still get around well and certainly don’t need my help to make their way in the world.  Sadly, of course, time is one race we all lose.  Hopefully I won’t have to worry about care for my parents for many, many years.  This topic comes to mind, however, as I have had several cases come into my firm lately related to abuse and neglect at elder care facilities.

If you come to a point where you are unable to provide care for a loved one at home, you will be faced with some difficult decisions.  The fact is, most nursing homes are run and staffed by compassionate and caring individuals.  With some effort and homework, you should be able to find a facility where the odds of abuse, neglect or dangerous conditions can be minimized.

A good first step in the process is to obtain several recommendations from the physician providing care to your loved one.  You can also ask friends and family members if they have suggestions.  You should plan on getting at least three or four names of conveniently located facilities, and plan on visiting each one.  When you visit, make sure to make an appointment to visit with the Administrator or the Director of Nursing.  Come prepared with a list of written questions.  Take careful note of the demeanor of the person you are interviewing.  Are they providing direct and clear answers, or do they appear to be hedging or avoiding questions?  Are their answers inconsistent with what you have observed on your visit?

On your visit, use all your senses.  How does the facility look?  Does it appear clean?  How does it smell?  Do the residents appear well cared for?  Are the kitchen facilities (if any) clean?  Do the staff seem interested and energetic?

Be sure to ask to see the most recent state survey report.  All nursing homes are inspected and surveyed by the state annually.  The report will cite deficiencies in detail and will also list facility efforts to correct problems.  Be careful if there are excessive deficiencies or if it appears that the facility is not taking adequate steps to address the cited issues.  Also ask to see any complaints which have been filed against the facility in the last year, as well as documentation of the facility’s response.  Also always ask for complete explanations  of the facility’s policies in regard to chemical or physical restraint.  See if these policies are available in writing.  Always ask about the incidence of pressure sores (bedsores) at the facility.

Ask about staffing ratios.  While the law only requires that a facility maintain “sufficient” staff, the National Citizens’ Coalition for Nursing Home Reform has set some rough guidelines for staffing.  According to the NCCNHR, during the day there should be at least one direct care giver for every five residents, one for every ten residents in the evening, and one for every fifteen at night.  Remember, these ratios will vary depending on the needs and independence level of the residents.  Also, keep in mind, the majority of direct day to day care in most facilities is provided by nursing assistants.  On your visit, take the time to introduce yourself to a few of the direct care providers and see if you can get a feel for their level of care, skill and compassion.  Be sure to ask management about the turnover rate for providers.

If you have more questions about nursing home facilities or possible problems or issues, you should call the Texas Department of Aging and Disability Services at (800) 458-9858.  Sometimes, despite all your research, you may be faced with the tragic situation where your loved one suffers abuse or neglect at their facility.  If this occurs, or if your loved one suffers a serious injury at a nursing home, you and your loved one have important legal rights.  In this event, it is important that you contact a qualified attorney to help investigate the matter and assess the situation.

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