What Can I Do Now That My Loved One is in a Nursing Home?
There are thousands of nursing homes throughout the United States. Most are funded through Medicare and Medicaid. These nursing homes are often understaffed. The residents of these nursing homes often receive poor care. If someone you love is a resident of a nursing home, there are number of things to look for to determine whether or not your loved one is receiving appropriate care.
Visit Often and at Different Times.
One of the best ways to increase the likelihood that your loved one is receiving appropriate care is to visit them often, at all different times, including during the night, to monitor the care that they are receiving, and to report anything that concerns you either to the Administrator of the nursing home, or to the Director of Nursing of a nursing home, or both. If your concerns are not addressed, follow-up. Put your concerns in writing. Write a letter to the Administrator. Write a letter to the Director of Nursing. If that does not work, consider moving your loved one to another nursing home. It may be very difficult to move your love one to another nursing home. There may not be another nursing home in the area. If that is the case, then you can contact the ombudsman regarding your concerns. You can also contact the Department of Health and make a complaint regarding your concerns.
Things to Look For.
The following is a list of things to look for and/or to be concerned about regarding the care that your loved one receives.
Popcorn Machine.
Is there a popcorn machine in the lobby. Fun right? Not necessarily. Some Nursing Homes use popcorn machines and the strong smell of popcorn to cover up bad smells like urine and feces.
Decubitus Ulcers or Bedsores.
Many nursing home residents develop bed sores. Bedsores are often caused by unrelieved pressure, particularly on a bony prominence. Bedsores are common on the buttocks, on the heels, he elbows, sometimes on the back, and often the sacral area. A lack of hygiene can contribute to or cause bedsores. If a nursing home resident is incontinent, the failure to change their adult protectors can cause bedsores. Nutrition and hydration play an important role in the development of bedsores and in the healing of and prevention of bed sores. Malnourished residents are at much greater risk to develop bed sores. Dehydrated residents are much greater risk to develop bed sores. Proper nutrition and proper hydration can help prevent bedsores and can help heal existing bed sores.
Bedsores are classified into four stages; Stage I, Stage II, Stage III, and Stage IV. Stage IV bedsores can be extremely difficult to heal.
The family of a nursing home resident are often unaware that their loved one has a bed sore. Often this is because the bed sore is on the buttocks or the resident or in their sacral region. It is not common to visit your parents in a nursing home, and examine their buttocks or sacral area. However, that may be necessary. Especially if your loved one is mentally incompetent. If your loved one suffers from Alzheimer’s disease or is otherwise demented, they may not be able to articulate the concerns they have. Certainly, if your loved one was coherent, and they complained of pain in the buttocks or sacral region, you should inspect that region. You should look for skin breakdown. You should look for sores.
You can also be vigilant for unpleasant odors. Often an infected bedsore is foul-smelling. If your loved one has a bedsore, and it has a dressing on it, you should check for drainage. Often infected bedsores will ooze or drain. If your loved one is developing bedsores at the nursing home and they’re getting worse, you should insist that they be transferred to a hospital where they can receive appropriate wound care. The skin is an organ. One of its primary functions is to protect the body from diseases. Once the skin is broken, like in the case of a bedsore, that protective barrier is breached. Particularly if someone has a bedsore on their buttocks or sacral area, they are very susceptible to infection. If a nursing home resident is incontinent and they have a bedsore involving broken skin, that bedsore can come in contact with urine or feces and can often lead to infection. This is a very serious concern as an infection could ultimately cause a person’s death. You should be very vigilant about whether or not your loved one has any bed sores and if they do, whether or not they’re receiving appropriate care for those bed sores.
Bedsores can be prevented by frequent turning and repositioning. But if your loved one is not able to turn themselves, they should be turned and repositioned every two hours, if not more frequently, by the staff at the nursing home. If they are incontinent, they must constantly be changed so their skin is kept dry and clean. If they are able to walk and/or participate in any physical activities, they should be encouraged to participate in as much physical activity they can tolerate. Physical activity helps stimulate the circulation and helps prevent bedsores.
Proper nutrition is essential in preventing and healing bed sores. If your loved one is losing weight unintentionally, this may be cause for concern. You should make sure your loved one is consulting with a dietitian at the nursing home regarding his or her dietary needs. Are they losing weight. Nursing Homes are supposed to weigh their residents regularly. Often when a resident is transferred to a nursing home, they are in unfamiliar surroundings, they are not familiar with the food, they may not want to eat because they are depressed. They may not like the food served at the nursing home. They may miss the food that they are used to from their home. The nursing home has a duty to address their nutritional needs. The nursing home has a duty to provide your loved with plenty to drink and palatable food. The nursing home has a duty to offer them alternatives. The nursing home has a duty to consider supplements to supplement their nutrition if they are not eating enough regular food. In extreme cases your loved one can receive nutrition and hydration through a feeding tube. However, before extreme measures are taken, your loved one should be encouraged to eat. The staff at the nursing home should involve the family to help educate the resident and encourage them to eat so they receive proper nutrition and hydration. This can play an essential role in preventing bedsores and healing existing bed sores.
Falls.
Many older people who fall suffer serious injuries including fractures. Fractures represent a significant risk of death in older people. The fracture puts considerable stress on a person’s system. The surgical repair of a fracture can be very risky. Hospitalization for a fracture creates additional risk. Fractures are a matter of life and death for older people. As a result, the nursing home must take every precaution to make sure that your loved one who is a resident of their nursing home does not fall and suffer a fracture. The hallways and your loved one’s room must be free of hazards which could cause the resident to trip and fall. If your loved one has a problem falling out of bed, their bed should be as low as possible, pushed against the wall and there should be a mat next to their bed. If your loved one cannot walk safely, then they must not be permitted to walk by themselves. The nursing home should use sensors and alarms so an employee of the nursing home knows if your loved one is trying to get up so they can respond to your loved one and help them. Your loved one should be on a toileting program so the nursing home is anticipating their need to go to the bathroom so they do not get up to use the bathroom without assistance. If your loved one is in pain that should be addressed. Your loved one should be provided with activities so they are not bored all day.
Falls are a serious problem in many nursing homes. Many falls can be prevented. Many falls can lead to significant injuries and even the death of a nursing home resident. As a result, nursing homes must endeavor to prevent falls.
When you visit your loved one at the nursing home, push their call button and see how long it takes someone to respond. Do this at all different times of the day. Do this during all different shifts at the nursing home. Do this during the morning shift. Do this during the breakfast rush. Do this during the afternoon shift. Do this at lunch time. Do this at dinnertime. If no one responds quickly, talk with the Director or Nursing or the Administrator. Keep testing this until the nursing home gets it right. Likewise, if your loved one starts to get up and their chair sensor or bed sensor goes off, does someone respond immediately. If it takes a minute or two to respond, that is all of the time it takes for your loved one to stand up, take a step or two and fall and break a hip. The staff at a nursing home needs to respond quickly to call lights and especially to sensors and alarms. If they do not your loved one is not safe.
Dehydration.
Your loved one must receive proper hydration at the nursing home. Dehydration puts your loved one at significant risk. Dehydration can cause confusion. Dehydration can make your loved one more susceptible to bedsores, as stated above. Dehydration can make your love one more susceptible to suffering urinary tract infections which can lead to additional consequences. If your loved one is able to take a drink on their own, hydration may be a simply matter of making sure they have adequate fluids available to them all day and they are constantly encouraged to drink.