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Tips for Finding Quality Nursing Home Care

  1. #1
    Join Date
    Mar 2012

    Lightbulb Tips for Finding Quality Nursing Home Care

    Some things to look for and ask about when looking for a nursing home for a spouse or family member. More here.

    Before you choose a nursing facility

    Check licensure, certifications, qualifications and care
    When touring a nursing home:

    • Ask to see the nursing home’s license.
    • Ask if the nursing home is Medicare and/or Medicaid certified.
    • Ask about the services the nursing home offers. For example, does it provide wound management for seniors who develop bedsores? How about physical rehabilitation services? Do they have a special unit for older adults with dementia?

    Get to know the staff

    When visiting a nursing home, think about your comfort with staffers:

    • Are they friendly? Do they answer questions from both residents and family members?
    • Are routine care planning meetings held at convenient times for family?

    It’s important to get to know the staff and create a “partnership relationship” with those who will be caring for your family member. The better the communication and interaction between staff and relatives, the better residents will fare. Try to meet with the nursing home administrator and nursing director. These two leadership positions are very important to maintaining quality care in the nursing home.

    Scrutinize facility cleanliness and safety
    Here are some things to look for in a nursing home:

    • Are there handrails in the bathing areas and hallways?
    • Are there plenty of safe walking areas inside and outside?
    • How many staffers are working at a given time during different shifts?
    • Are there emergency and evacuation plans in place in case of fires, floods and other hazards?
    • Are the bed rails or guard rails on nursing home beds raised up? Raised guard rails on beds pose a serious injury risk for older adults, and should rarely be used to restrain patients. Likewise, residents sitting in chairs should not be restrained with seat belts or trays.

    Make sure residents with special nutritional needs are well nourished
    Find out how staff help residents who have special dietary needs, or are unable to feed themselves. Some questions you can ask are:

    • Does the staff try to feed seniors out of bed? What strategies do they use to do so?
    • Does the nursing home accommodate special dietary needs? For example, do they prepare pureed foods, and carefully monitor meals for residents with diabetes and food allergies?
    • Take a look at the dining room. How is the food served; on trays or from steam tables?

    Evaluate routines and activities
    Residents in nursing homes who don’t have dementia or other cognitive problems should be able to make choices about their daily routines. For example, they can decide when to go to bed, and when to bathe.

    In special care units for residents with dementia, however, it should be clear that the nursing home follows a consistent routine. This is especially important for residents with dementia.
    You should also consider the range of activities offered. Activities help nursing home residents remain social and stimulated. These may include:

    • arts and craft classes
    • chair exercise programs
    • religious services
    • discussion groups
    • entertainment (for example, such as musical and dance performances or movie nights)

    Ask the nursing home if they can provide other activities if your family member has difficulty participating in the existing options.

  2. #2
    Join Date
    Feb 2016
    Houston, Tx.
    Good tips, SeaBreeze. Thanks.

  3. #3
    Join Date
    Oct 2014
    I think I'm in Florida, but I'm not sure any GPS blew away.
    ...and hope to good heaven that they have honest staff.

    The Spousal Equivalent's mother died in the nursing home three days ago. Her purse "disappeared" shortly afterward. Luckily, they apparently couldn't get her rings off or they probably would have been gone, too. What the hell is wrong with people??? That's one step above grave-robbing.
    If we're ever in a situation where I am "the voice of reason", then we are in a very, very bad situation.

  4. #4
    Join Date
    Feb 2016
    Houston, Tx.
    That above all else. When my friend Louis died in a supposely high end one his nice rings were not on his fingers and he never took them off. I did not even ask, I knew what happened.

  5. #5
    Join Date
    Aug 2016
    Near Mount Pilot
    It's very sad when these things happen but I don't think it will change for the better.

    When it comes to eldercare and childcare we all want the best for our loved ones until we see the cost. We hire the cheapest lowest skilled people to provide that very personal care and expect to hold them to a high standard when they are just barely able to survive themselves. We do need to work on our priorities in this country.

  6. #6
    Join Date
    Apr 2017
    Sorry to burst your bubble,but,good luck...
    Retired nurses aide with 25 plus years in nursing homes.
    There are rarely enough staff to accomplish 1/4 of your lists.
    The state minimums for staffing is much,much lower than you would think is safe.
    Even the specialized dementia,locked units are difficult, you have the wanderers, the fighters,the thieves(unintentionally) and the "Goldilocks"(you never know what bed you'll find them in)
    Your best bet as far as quality of care is your presence,showing up at various times or even the same time as often as possible and interacting with your loved ones reading,helping with their meals is a huge help to the staff and will be appreciated it will also put you in the 1st line of defense by noticing bruises,skin breakdown,sores or simply missing clothing or other personal effects.
    In NYS,its against the law to restrain a resident which believe it or not is unfortunate, no one can be watched 24/7,its simply impossible with the demands on the staff,Im not talking about a strait jacket but a simple seat belt across their abdomen and tied in the back would prevent many injuries and falls from simply trying to pickup something on the floor.
    Sadly,like most things it only takes 1 bad apple...
    Good luck to you.

  7. #7
    Join Date
    Aug 2014
    California, USA
    My step father just got home from rehab and I don't know how long he'll last at home. They moved someone in with bedbugs and moved his stuff to a new room while he was in therapy. Didn't even tell him. He had cleaned and wrapped his upper partial in a paper towel, put it on the table and likely they threw it out. Had they given him a minute to get his own things, he would have remember the partial. Anyone helping with this there? Of coarse not, not one will call me back.

    These places are very understaffed. The state is of no help. They are sociopaths in my opinion. Many of them are defunct director of nurses, knowing full well what the staff and patients endure. Now they work for the state and they are so high and mighty. It's a nightmare for all.

    But one person or even family can't be expected to kill themselves for someone at the end of their life. So where else do they go. In my case if my stepfather does need a lot more help, he'll end up in one. I'm it and my brother thousands of miles away refuses to even give verbal support, he actually puts me down while he does nothing.

    My stepfather has a decent retirement but apparently not even enough for an assisted living place. Plus he was donating like crazy hundreds of dollars a month, writing checks and then acting like he was broke. I have his mail box key and he agreed for me to keep it. I've been fighting solicitations for two months. Once 71 in one day. He's not getting that key back.

    Should he end up in a nursing home, I'll feel bad but I never married, never had kids and I won't do direct care like bathing, cleaning, feeding. If he can't do that himself, he will have to go to a home.

  8. #8
    Join Date
    Aug 2014
    San Francisco Bay Area
    Quote Originally Posted by jujube View Post
    ...and hope to good heaven that they have honest staff.

    The Spousal Equivalent's mother died in the nursing home three days ago. Her purse "disappeared" shortly afterward. Luckily, they apparently couldn't get her rings off or they probably would have been gone, too. What the hell is wrong with people??? That's one step above grave-robbing.
    Many staff work for minimum wage. I don't think we can expect people not to be tempted.

    We've had several friends who have used home healthcare aides for their elderly parents. Pretty much everything in the homes that could be stolen, was.

  9. #9
    Join Date
    Oct 2017
    Los Angeles
    When my mother went to a skilled nursing facility to rehab from a broken hip the director strongly recommended/requested that I take anything of value with me - jewelry, money beyond a couple of dollars, ID, any beloved clothing, etc. I used a label maker to mark her possessions, including her eyeglasses (name on the outside of the ear pieces, then wrapped the label with heavy cello tape). The assisted living director had the same advice when Mom moved there. I brought some of her costume jewelry and put the good stuff in her safety deposit box.

    Giantsfan has it right - if at all possible a family member needs to show up. Often. And for more than 20 minutes. Make yourself useful while you're there. Get to know the names of the caregivers. You are not only another set of eyes, your presence puts the facility on notice that someone is paying attention to the level of care your loved one is receiving, and subconsciously impresses on them that this is an especially valued - and valuable - human being.

    My family does this for each other when a loved one is in a hospital, nursing home or assisted living facility, but there are several of us nearby and we're a fairly tight-knit group.

    Kitties, I feel for you with regard to your stepfather. His care be a big burden on one person. It's a good thing that you have taken over his mailbox. Most solicitors and scammers have no consciences and they prey on the elderly because they're such easy pickings. Hang in there and do what you can.
    Most folks are as happy as they make up their minds to be. - Abraham Lincoln

  10. #10
    Join Date
    Jul 2018
    I worked in long term care for over thirty years. Some of my suggestions would be to visit a place you are interested in and visit it more than once.

    The best place in the states is to go to the department of aging websites and check the state inspection results. They will list each nursing home, assisted living facility etc. and list the deficiencies. Some are relatively minor like the beds were too close to the walls or the therapy room door happened to be unlocked when no one was in there. I would look for serious deficiencies like abuse reports, physical harm (actual or potential),
    any food issues, facility problems(there should be things posted for evacuation plans, where to go for tornados, floods, fire etc.) The facility you go to should have their recent copy of inspection report available and it should be public. I would be wary of a facility that will not let you look at it or be willing to discuss what they did to correct the items listed on the report.

    When you do choose, as some of the others have said, be involved. Call and say you plan to eat with your family member on a specific day so you can see what the food is like. There are usually care plan meetings at least quarterly so you can meet with the different departments to discuss the residents care and the resident is usually included.

    Do NOT admit your family member with any expensive jewelry etc. especially if they are forgetful. I remember working in a facility once and a woman's multi thousand dollar ring turned up missing. We were all polygraphed, interviewed, police were everywhere. The family went through her room, her coat pockets, the linings of her purse. Nothing until one day her daughter came, pulled a nearly empty jar of face cream out of the medicine cabinet. When she opened the lid she found the ring, a pair of earrings, a key and two bobby pins all stuck neatly inside the remaining cream. It was very stressful for the staff as well as the family.

Please reply to this thread with any new information or opinions.

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