Thursday, March 3, 2005

Young at heart


Know what to ask
of a nursing home

It is a difficult experience moving a loved one into a nursing home. It is hard to believe someone you love and who has nurtured you can no longer take care of themselves.

The role reversal of parent and child is unsettling, and I would urge anyone facing this situation to get help if they need it.

You might want to remember some tips that can help you and your loved one when in the facility.

It is always good to work with the staff. A good home will revolve around the residents, and staffers want to know about the daily life and routine of their new resident.

It is important for you to be involved. Be there and show that this person makes a difference to you, and become knowledgeable about state laws, good practices, programs and agencies in your area.

If you are not happy, do not accept what is being told you. You are a consumer, and you are entitled to expect good care and do not accept less.

The following is a checklist that can help you select the appropriate facility:

>> Is there cheerful, respectful, pleasant, warm interaction between staff and residents?

>> Does the administrator seem to know the residents and enjoy being with them?

>> Do staff and administration seem comfortable with each other?

>> Do the rooms appear to reflect the individuality of their occupants? Do all the rooms look alike?

>> Are residents using the common rooms, for example, the front lounge?

>> What is the noise level of the facility? Is it comfortable and homelike? Are there quiet places for residents?

>> Do residents look clean and well groomed?

>> Is the home free from unpleasant odors?

>> Do you notice a swift response to call lights?

>> Are the residents crying out? If so, do they get an appropriate response from staff?

>> Is the dining room atmosphere relaxed and conducive to pleasant meals?

>> Do the meals look appetizing? Are the residents eating most of their food? Do they have assistance if they need it?

>> Does the home seem clean, cheerful, uncrowded?

>> Are there pleasant areas for family visits?

>> Are the residents in physical restraints?

>> Do residents appear to be engaged in meaningful activity by themselves or with others (as opposed to staring at the wall, blaring TV, slumped over or in a line)?

Things you can ask of staff:

>> What kinds of activities are residents involved in?

>> Is there access to books, gardening, community activities, pets, to retain linkages to former interests? Does the nursing home have a wheelchair-accessible van?

>> What kind of activities are there for residents with dementia (structured, walking paths, evening activities, music)?

>> Is there permanent assignment of staff to residents?

>> How are the nurse assistants involved in the resident's care-planning process? (They should attend and contribute ideas.)

>> How does the staff accommodate the family's schedule to assure participation in care planning meetings?

>> What happens if a resident refuses to take a medication?

>> What does the facility do if residents are depressed? Is counseling available?

>> What is the facility policy toward missing clothing and other possessions?

>> What does the facility do to encourage employee retention and continuity? Does the staff receive health benefits?

>> Does the facility provide transportation to community activities?

>> What kinds of therapies are provided for residents on Medicaid (occupational therapy, speech therapy, physical therapy, mental health services, etc.)?

>> Is there a family council? Are there family members I can speak to?

>> What happens when someone has a problem or complaint? Are family/staff conferences available to work out problems?

>> Who is your ombudsman? Does that person visit regularly?

>> What are the extra charges not included in the daily rate?

>> (If you pay privately) How often have private pay rates increased? How much notice is given before an increase? Are there charges for extra care that are not included in the daily rate?

>> What do staff see as the facility's main strengths and weaknesses?

>> Who decides for each resident how she bathes and how often?

>> Who selects roommates? What do you consider in selecting roommates? How are residents involved in the selection?

>> How are smokers and nonsmokers accommodated?

Jerrold S. Zivic has more than 25 years' experience in representing disabled individuals before the Social Security Administration. He can be reached at ziviclaw.com



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